Standardised tube weaning in children with CHD: telemedical Netcoaching approach is as affective as on-site treatment

Abstract Background: 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. Methods: This study prospectively evaluated outcomes of the “Graz Model of Tube Weaning” 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 (“Eating School”) or a telemedical home-based programme (“Netcoaching”). Outcomes included weaning success, changes in growth parameters (weight-for-age z -score, height-for-age z -score, standards-z-values for body mass index), treatment duration, feeding-related adverse effects, and caregiver burden. Results: A total of 98.6% of children ( 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, p < 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. Conclusions: 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.