Transition from gastrostomy to oral feeding following renal transplantation.

Feeding through a gastrostomy button (GB) provides benefits to the families of children on chronic dialysis. But data on the transition to oral feeding following renal transplantation--especially in children under 2--is scarce. Here, we report our experience of more than 14 years in 22 children who were GB fed at under 5 years of age (median age: 1.66 years; range: 0.25-4.25 years). We excluded 6 children from the analysis of transition following transplantation because of factors precluding early return to oral feeding--specifically, cognitive impairment and a tongue tie. We compared 10 children who commenced GB feeding at less than 2 years (group 1) with those who commenced at 2-5 years (group 2, n = 6). All 16 children made the transition to normal oral feeding by 10 months post transplantation. Median duration of GB feeding post-transplant in group 1 was 0.3 years (range: 0.1-1.0 years) as compared with 0.2 years (range: 0-0.3 years) in group 2 (p = 0.2). Children with normal cognition and no other precluding factors who have a GB inserted at less than 2 years of age can make a successful transition from GB to oral feeding with no significant delay. Family support should be individualized during this period of potential anxiety.