The Post-Wean Panic part 1: Oral Eating Doesn’t look like Tube Feeds
Elisabeth Kraus, MA
Aubrey Phelps, MS RDN PPCES IFNCP CLC
The most common question we hear in the post-wean stage is, “but are you sure this is safe?” Most often, this question comes from parents whose children are settling into being fully oral, without tube support, in the stage where this new “eating life” looks really different than the life they were living on full tube feeds. For most parents, the unpredictability of oral eating can lead to some significant panic, and if we aren’t careful, sometimes that panic can cause parents to jump the gun to resume tube feeds unnecessarily.
When you look at your recently weaned child’s eating and worry about it, it’s important to remember to check what you’re comparing that eating to.
When you compare typical oral eating to tube feeds, it can look terribly unsafe. Tube feeds are regimented and predictable: the same volume goes in, at the same times, in a prescribed routine. These feeds are calculated based on age, weight, and length, and to parents, a child’s safety is often intimately connected to “that exact amount going in.” But oral eating is almost entirely the opposite. Typical oral eaters consume varying volumes and calories: sometimes we eat a lot, and sometimes we eat less. Our safety is determined, not by how much goes in (because the reality is that most of us don’t even know how much that is!), but rather by how much comes out.
So, in this series, we’ve teamed up (Aubrey, one of our Dietitians, and Elisabeth, our Parent Coach) to answer some pressing questions around why it’s safe for oral eating to look nothing like tube feeds! Aubrey is answering questions from a medical perspective, and Elisabeth will include some recommendations for how parents can respond to and cope with those differences! And in this way, we hope we can support both the families of newly weaned children, and the clinical teams who care for them!
But the most important message we want to convey is this: the goal of weaning from tube is not to replace one medical system (tube feeds) with other medical systems (counting calories, weighing diapers, etc). That isn’t freedom! Or joy! Or peace! It’s just a trade.
The goal of tube weaning is to move medically stable kids and families out of medical management and into stable, typical oral eating. So rather than comparing oral eating to tube feeds, consider comparing your new eater’s eating to your own – because when you do that, it’s often going to start feeling much more like the typical life you were hoping for! And that is exciting!