{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T06:48:19Z","timestamp":1791787699349,"version":"4.3.4"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T00:00:00Z","timestamp":1791676800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004325","name":"Signe ja Ane Gyllenbergin S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the outcomes and safety of an outpatient tube\u2010weaning programme involving rapid tube feed reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective patient record\u2010based cohort study included children referred to a multidisciplinary, hunger provocation\u2010based tube\u2010weaning programme from 2016 to 2023 in our tertiary paediatric hospital. The primary outcome was complete tube weaning. Secondary outcomes were changes in oral feeding skills and adverse effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We traced 49 children with mostly somatic underlying diseases who had taken part in the programme. Of them, 65% achieved complete weaning and oral feeding improved in 92%, by programme completion. At a median follow\u2010up of 2.4\u2009years, 69% remained fully weaned. Patients with neurodevelopmental diseases benefited least. Adverse effects occurred in 49%, most commonly hypoglycaemia (37%) and dehydration (31%). Lower initial oral feeding skill was associated with reduced weaning success and a higher incidence of hypoglycaemic events. Children experiencing adverse effects\u2014particularly hypoglycaemia\u2014were less likely to be fully weaned.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rapid tube feed reduction within an outpatient hunger\u2010provocation programme improved oral feeding but was associated with notable adverse effects. These findings support individualized tube feed reduction, patient monitoring and careful patient selection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70799","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:27:02Z","timestamp":1791782822000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rapid Outpatient Tube Weaning Is Effective but Associated With Frequent Adverse Events: A Retrospective Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7977-124X","authenticated-orcid":false,"given":"Josefine","family":"Limnell","sequence":"first","affiliation":[{"name":"New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"The Wellbeing Services County of Ostrobothnia Vaasa Central Hospital  Vaasa Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Ahlroos","sequence":"additional","affiliation":[{"name":"Clinical Nutrition Unit, Internal Medicine and Rehabilitation University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisa","family":"Keski\u2010Kuha","sequence":"additional","affiliation":[{"name":"New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Institute of Public Health and Clinical Nutrition University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1607-7101","authenticated-orcid":false,"given":"P\u00e4ivi","family":"Peldan","sequence":"additional","affiliation":[{"name":"New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8523-2008","authenticated-orcid":false,"given":"Jetta","family":"Tuokkola","sequence":"additional","affiliation":[{"name":"Clinical Nutrition Unit, Internal Medicine and Rehabilitation University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Institute of Public Health and Clinical Nutrition University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3379-1139","authenticated-orcid":false,"given":"Anna Kaarina","family":"Kukkonen","sequence":"additional","affiliation":[{"name":"New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8000-8891","authenticated-orcid":false,"given":"Laura","family":"Merras\u2010Salmio","sequence":"additional","affiliation":[{"name":"New Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki Finland"},{"name":"Pediatric Gastroenterology Unit, Children's Hospital University of Helsinki and Helsinki University Hospital  Helsinki 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