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Definitions and Clinical Guidance on the Enteral Dependence Component of the Avoidant/Restrictive Food Intake Disorder Diagnostic Criteria in Children
Authors:Terence Michael Dovey PhD  Markus Wilken PhD  Clarissa Isabel Martin CPsychol  MSc  Caroline Meyer PhD
Institution:1. Institute of the Environment, Health and Societies, Social Sciences and Health, Brunel University London, London, Middlesex, United Kingdom;2. Institute for Pediatric Feeding Tube Management and Weaning, Siegburg, Germany;3. University of Applied Science Fresenius, Idstein, Hessen, Germany;4. Midlands Psychology, Stafford, Staffordshire, United Kingdom;5. WMG and Warwick Medical School, University of Warwick, Coventry, Warwickshire, United Kingdom;6. Coventry and Warwickshire Partnership NHS Trust, Coventry, United Kingdom
Abstract:The aim of the current article is to offer definitive guidance on weaning children who are reliant on nasogastric/gastrostomy feeding tubes. To date, no internationally recognized definitions or principles for interventions exist, and clinics have been reliant on creating their own unique intervention criteria. To achieve the aim, 2 goals are set out within the current article. The first goal was to definitively define the process of tube weaning. To achieve this, both tube dependency and oral eating also required definitions. It is necessary for these 2 additional definitions to fully understand the process of tube weaning and the transition that the child is making within these clinical interventions. The second goal of this article was to propose a set of minimum measurement criteria within a tube weaning protocol so that different clinical practices and perspectives may be measured accurately. This would then allow outcomes from different clinical services to be compared for efficacy. The culmination of this article is a set of 5 core principles that should govern clinics that adhere to the auspices of evidence‐based practice. These principles, if adopted, will provide the basis of a set of internationally recognized criteria within this field of pediatric gastroenterology.
Keywords:pediatrics  life cycle  enteral nutrition  nutrition  medical/nutrition ethics  nutrition support teams  nutrition support practice  eating disorders
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