Often, we refer to the process of weaning as a marathon and not a sprint. This can sometimes be hard to conceptualize, so I like to use the example of a sprained ankle.
Think back to a time when you’ve had an injury, like a sprained ankle, that required maybe a wrap or a brace for support. After a period of rest, you remove the wrap or brace, but that doesn’t mean you are immediately out running sprints. Instead, you probably walk on that ankle a little gingerly for a few days, testing the waters to see how it supports your weight without the aid of the wrap or brace.
Once things start to feel better, your walk becomes more normal going back to your usual cadence, rhythm, and pace. Once you have gained confidence with walking, you might move to jogging as the next test to ensure your ankle has the right flexibility and range of motion. After a few jogs without any pain or discomfort, you then get to a place where you feel confident going for a run at full speed.
The same can be said for weaning. Once you hit the last step of the wean plan and you remove all tube support (and maybe even the tube itself), it doesn’t mean that your child will be eating 100% of the calories he/she needs to be in an anabolic state. Instead, you will see some erratic eating with regards to interest and volume as your child gets used to the new rhythm of how this all works without any external support from tubed calories.
With time and practice feeding skill and endurance are built allowing for volumes to gradually progress. As your child settles into this new way of being, he/she learns to self-regulate intake, driving volumes to the point it becomes enough to support growth. The confidence built post-wean helps your child explore new foods, ultimately expanding repertoire of accepted foods.
This last hurdle of no tube feeds can be particularly challenging for parents, especially if your physician or medical specialist doesn’t feel like the child is meeting their target volumes and this is reflected in a weight that stagnates for a short time.
Just remind yourself (and them) that getting to full feeds doesn’t happen overnight and that this is a transition period where your child is doing all the steps necessary to build the skill and confidence that will drive his/her volume to improve growth and nutritional status. And of course, reach out to your team if you begin to worry – we’re there to support you!
Written by Lisa Grentz, MS, RD, CD