Enteral feedings delivered by either gastrostomy or a nasogastric tube are often used in infants and toddlers to ensure adequate caloric and nutrient intake. If we are not aware of a rapid introduction of oral feedings they may develop poor feeding skills.
Patients: Seven infants (mean age: 6.7 months; SD: 3.6) presented this problem during the 1993-96 period. Six of them were using a nasogastric tube, another one a gastrostomy (PEG). At the beginning of the enteral feeding regimen their weight was -3.32 z-score (SD: -1.2) and for height: -2.11 z-score (SD: -0.51). The underlying disease was gastroesophageal reflux (n = 4), esophageal atresia (n = 1), short bowel syndrome (n = 1) and unexplained anorexia (n = 1).
Results: The mean length of artificial nutrition was 20 months (SD: 11.5), although two of the patients still receive nocturnal enteral drip. Six patients resumed a normal feeding pattern within 3 months to 2 years after behavior modification program was started.
Conclusion: According to our experience, there is a critical period involved with oral feeding during the first year of life. If not aware, children in transition for tube to oral feeding may display oral-motor, sensory and developmental feeding problems.