{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T12:34:02Z","timestamp":1786365242962,"version":"build-2736575974"},"reference-count":45,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951126113031_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Feeding difficulties and prolonged reliance on enteral nutrition are common in children with CHD, often leading to tube dependency. Despite its clinical relevance, evidence-based recommendations for tube weaning remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126113031_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This study prospectively evaluated outcomes of the \u201cGraz Model of Tube Weaning\u201d in 70 tube-dependent children with CHD (median age 1.67 years) treated between 2016 and 2024. Children participated either in a two-week on-site programme (\u201cEating School\u201d) or a telemedical home-based programme (\u201cNetcoaching\u201d). Outcomes included weaning success, changes in growth parameters (weight-for-age\n                      <jats:italic>z<\/jats:italic>\n                      -score, height-for-age\n                      <jats:italic>z<\/jats:italic>\n                      -score, standards-z-values for body mass index), treatment duration, feeding-related adverse effects, and caregiver burden.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126113031_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 98.6% of children (\n                      <jats:italic>n<\/jats:italic>\n                      = 69) transitioned to full oral feeding. Both programmes were effective. Younger children more often enrolled in Netcoaching and required longer treatment durations (median 2.23 vs. 1.48 months,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Adverse effects from tube feeding were prevalent in 97.1% of cases, with oral aversion and vomiting being most common. Temporary but significant decreases in growth parameters were observed in both groups; infants under one year showed greater height reductions in the Eating School cohort. Caregiver burden remained substantial, particularly among mothers. Average treatment duration until tube feeding cessation was 29 days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126113031_as4\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Both treatments offer safe, effective methods to help children with CHD transition from enteral to oral feeding. Early intervention with an interdisciplinary, hunger-based approach emphasising autonomy appears advantageous. Further research is needed on long-term growth, nutritional development, motor skills, social interactions, and speech after tube weaning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951126113031","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T10:35:29Z","timestamp":1781778929000},"page":"1170-1177","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Standardised tube weaning in children with CHD: telemedical Netcoaching approach is as affective as on-site treatment"],"prefix":"10.1017","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7437-6997","authenticated-orcid":false,"given":"Karoline","family":"Pahsini","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02n0bts35","id-type":"ROR","asserted-by":"publisher"}],"name":"Medical University of Graz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Marinschek","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02n0bts35","id-type":"ROR","asserted-by":"publisher"}],"name":"Medical University of Graz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Beckenbach","sequence":"additional","affiliation":[{"name":"NoTube LLC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Reininghaus","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02n0bts35","id-type":"ROR","asserted-by":"publisher"}],"name":"Medical University of Graz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Dalkner","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02n0bts35","id-type":"ROR","asserted-by":"publisher"}],"name":"Medical University of Graz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Russell","sequence":"additional","affiliation":[{"name":"Creighton University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asa N.","family":"Russell","sequence":"additional","affiliation":[{"name":"NoTube LLC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Stoesslein","sequence":"additional","affiliation":[{"name":"Medicover Genetics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Scheer","sequence":"additional","affiliation":[{"name":"NoTube LLC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerite","family":"Dunitz-Scheer","sequence":"additional","affiliation":[{"name":"NoTube LLC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"S1047951126113031_ref44","doi-asserted-by":"publisher","DOI":"10.1016\/S0882-5963(97)80029-2"},{"key":"S1047951126113031_ref14","first-page":"209","article-title":"Tube dependence: a reactive eating behavior disorder","volume":"3","author":"Dunitz-Scheer","year":"2011","journal-title":"ICAN: Infant Child Adolesc Nutr"},{"key":"S1047951126113031_ref29","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-056415G"},{"key":"S1047951126113031_ref32","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002264"},{"key":"S1047951126113031_ref12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3435"},{"key":"S1047951126113031_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S104795111700258X"},{"key":"S1047951126113031_ref33","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12030"},{"key":"S1047951126113031_ref5","doi-asserted-by":"publisher","DOI":"10.3390\/nu14081671"},{"key":"S1047951126113031_ref40","unstructured":"40. 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About congenital heart defects. 2025 Mar 15. https:\/\/www.heart.org\/en\/health-topics\/congenital-heart-defects\/about-congenital-heart-defects. 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