Research shows that 98.6% of children with heart disease can successfully stop using feeding tubes through structured weaning programs, with both in-person coaching and home-based video guidance working equally well. According to Gram Research analysis, the average time to achieve full oral feeding is about 29 days, making this a relatively quick transition when using evidence-based methods that emphasize natural hunger and child autonomy.
Children born with heart problems often struggle with eating and rely on feeding tubes for nutrition. Researchers tested two different programs to help these kids learn to eat normally again: one where families came to a special clinic for two weeks, and another where doctors coached families at home using video calls. According to Gram Research analysis, both methods worked incredibly well, with 98.6% of children successfully switching to regular eating. The study of 69 children with heart disease found that home-based coaching worked just as well as in-person treatment, giving families more flexibility while their children recovered.
Key Statistics
A 2026 prospective study of 69 tube-dependent children with congenital heart disease found that 98.6% successfully transitioned to full oral feeding using the Graz Model of Tube Weaning, with both in-person and telemedical coaching approaches proving equally effective.
Among 69 children with heart disease undergoing tube weaning, 97.1% experienced adverse effects from tube feeding before treatment, with oral aversion and vomiting being most common, but these problems improved significantly after the weaning program.
A 2026 study published in Cardiology in the Young found that children with heart disease achieved tube-free feeding in an average of 29 days using structured weaning programs, with younger children in home-based programs requiring slightly longer treatment (2.23 months versus 1.48 months).
Research on 69 children with congenital heart disease showed that home-based telemedical coaching for tube weaning was as effective as intensive in-person treatment, offering families a more flexible alternative while maintaining high success rates.
The Quick Take
- What they studied: Can children with heart disease learn to eat normally instead of using feeding tubes? Do they do better with in-person coaching or at-home video coaching?
- Who participated: 69 young children with congenital heart disease (average age about 1.5 years old) who were dependent on feeding tubes. Some received treatment at a clinic, others received coaching at home.
- Key finding: Nearly all children (98.6%) successfully stopped using feeding tubes. Both the in-person program and home-based video coaching worked equally well, though younger children in the home program needed a bit longer (about 2.2 months versus 1.5 months).
- What it means for you: If your child has heart disease and uses a feeding tube, there are proven methods to help them learn to eat normally. You may have the option to do this at home with professional guidance rather than traveling to a clinic, which could be easier for your family.
The Research Details
Researchers followed 69 children with heart disease who were dependent on feeding tubes between 2016 and 2024. The children were divided into two groups: one group attended an intensive two-week in-person program called “Eating School” at a hospital, while the other group received coaching at home through video calls and phone support, called “Netcoaching.” Both programs used the same proven method called the “Graz Model of Tube Weaning,” which focuses on helping children feel hungry naturally and giving them control over their own eating.
The researchers carefully tracked what happened to each child, measuring whether they successfully stopped using feeding tubes, how much they grew, how long treatment took, any problems that came up, and how stressed the parents felt. They compared the results between the two groups to see if one method worked better than the other.
This type of study is valuable because it follows real children through actual treatment programs rather than just testing something in a laboratory. By comparing two different delivery methods (in-person versus at-home), the researchers could figure out which approach works best for different families.
Feeding tubes save lives for children who can’t eat normally, but staying on them too long can actually make eating problems worse. Kids can develop a fear of food (called oral aversion) and forget how to eat naturally. This study matters because it shows doctors have effective, evidence-based methods to help children transition back to normal eating. It also matters because it proves that families don’t necessarily need to travel to a hospital for weeks—they can get the same results at home, which is more practical for most families.
This study has several strengths: it followed children over 8 years (2016-2024), had a very high success rate (98.6%), and compared two real-world treatment approaches. The researchers measured multiple important outcomes, not just whether tubes came out. However, the study doesn’t have a control group of children who didn’t receive treatment, so we can’t say for certain that the program itself caused the improvement rather than natural development. The sample size of 69 children is moderate—larger studies would give us more confidence. The study was published in a peer-reviewed medical journal, which means other experts reviewed it before publication.
What the Results Show
The main finding was striking: 98.6% of the 69 children successfully transitioned from tube feeding to eating food by mouth. This means only one child out of 69 didn’t achieve this goal. Both treatment approaches—the two-week in-person “Eating School” program and the home-based “Netcoaching” program—were equally effective at helping children stop using feeding tubes.
The average time to stop tube feeding was about 29 days (roughly one month) across both groups. However, younger children who participated in the home-based program needed slightly longer treatment, averaging 2.23 months compared to 1.48 months for children in the in-person program. This suggests that very young children might benefit from the more intensive, hands-on approach of in-person coaching, though the home program still worked.
The study found that feeding tube problems were extremely common before treatment—97.1% of children experienced adverse effects from tube feeding. The most frequent problems were oral aversion (fear or dislike of food) and vomiting. These problems improved significantly after the weaning programs, suggesting the treatment addressed real, serious issues.
Children’s growth showed temporary but noticeable decreases during treatment in both groups. Weight and height measurements dipped slightly, which is expected when transitioning from tube feeding to oral feeding since children typically eat less at first. Interestingly, infants under one year old showed greater height reductions in the in-person “Eating School” group compared to the home-based group, though the differences were temporary. All children’s growth patterns improved after the initial transition period.
Parental stress and burden remained a significant concern throughout treatment. Mothers, in particular, reported substantial caregiver burden, even though both programs were designed to reduce stress. This finding suggests that families transitioning children away from feeding tubes need ongoing emotional support and reassurance, not just medical guidance.
This research builds on earlier work showing that hunger-based, child-centered approaches to tube weaning are more effective than forcing children to eat. The “Graz Model” used in this study emphasizes letting children feel naturally hungry and giving them control over eating decisions, which differs from older, more rigid feeding approaches. The finding that telemedical (video-based) coaching works as well as in-person treatment is relatively new and important—previous research hadn’t thoroughly tested whether remote coaching could match in-person results. This study suggests that distance shouldn’t be a barrier to accessing this specialized treatment.
The study doesn’t include a control group of children who didn’t receive any treatment, so we can’t be 100% certain the program caused the improvement rather than natural development over time. The sample size of 69 children is moderate—a larger study would provide stronger evidence. The study doesn’t follow children long-term after treatment ends, so we don’t know if the benefits last for years or if some children return to tube feeding. The research was conducted in Austria, so results might differ in other countries with different healthcare systems or cultural approaches to feeding. Finally, the study doesn’t explain why younger children in the home program needed longer treatment—more research is needed to understand this pattern.
The Bottom Line
If your child with heart disease uses a feeding tube and is struggling with eating, ask your doctor about structured tube weaning programs based on the Graz Model or similar evidence-based approaches. Both in-person intensive programs and home-based video coaching are effective options—choose based on what works best for your family’s schedule and resources. Early intervention appears beneficial, so don’t wait unnecessarily. Expect the process to take about one month on average, though younger children may need longer. Work with an interdisciplinary team (doctors, nutritionists, speech therapists, psychologists) for best results. Confidence level: High—this is based on a real-world study with a 98.6% success rate.
This research is most relevant for parents and caregivers of children with congenital heart disease who are tube-dependent. It’s also important for pediatric cardiologists, feeding specialists, and speech-language pathologists who work with these children. Healthcare systems should care about this research because it shows that effective treatment can be delivered at home, potentially reducing healthcare costs and improving family quality of life. Children who are very young (under 1 year) might benefit more from in-person programs, while older infants and toddlers may do equally well with home coaching.
Most children stop using feeding tubes within one month of starting treatment. However, expect the first few weeks to be challenging as children adjust to eating by mouth and parents adjust to new routines. Growth parameters may dip temporarily but should recover within weeks to months. Long-term benefits (improved speech, social eating, motor skills) may take several months to become apparent. Parents should expect ongoing caregiver stress even after successful tube removal and should seek psychological support if needed.
Frequently Asked Questions
Can children with heart disease learn to eat normally after using feeding tubes?
Yes, research shows 98.6% of children with heart disease successfully transition to normal eating through structured weaning programs. The average time is about one month, using methods that emphasize natural hunger and giving children control over eating decisions.
Is home-based coaching as effective as in-person treatment for tube weaning?
Home-based video coaching works just as well as in-person programs for most children. Both approaches achieved the same 98.6% success rate, though very young children (under 1 year) may benefit slightly from in-person intensive treatment.
How long does it take for a child to stop using a feeding tube?
Most children stop using feeding tubes within one month of starting treatment. Younger children in home-based programs may need up to 2-3 months, while older infants typically transition faster, averaging about 1.5 months.
What problems do children have with feeding tubes that make weaning important?
About 97% of children on feeding tubes develop problems like oral aversion (fear of food), vomiting, and difficulty learning to eat normally. Structured weaning programs address these issues and help children develop healthy eating skills.
Will my child’s growth be affected during tube weaning?
Children typically show temporary, small decreases in growth measurements during the transition to oral feeding, but growth recovers within weeks to months. This is normal and expected as children adjust to eating by mouth.
Want to Apply This Research?
- Track daily oral intake percentage (what percentage of nutrition comes from eating by mouth versus tube feeding) and weekly weight measurements. Also monitor specific feeding milestones like first successful meal, number of meals per day, and types of foods tolerated.
- Use the app to log each eating attempt, note what foods the child accepted or rejected, record any vomiting or adverse reactions, and track parental stress levels. Set daily goals for increasing oral feeding percentage and celebrate small victories to maintain motivation.
- Create a long-term tracking dashboard showing the child’s progression from tube-dependent to fully oral feeding. Monitor growth parameters (weight, height) monthly, track feeding-related problems (vomiting, oral aversion) as they decrease, and measure parental burden through weekly check-ins. Use trend analysis to identify which foods and feeding approaches work best for the individual child.
This research describes treatment outcomes for children with congenital heart disease who are tube-dependent. These findings should not be considered medical advice. If your child uses a feeding tube, consult with your pediatric cardiologist and feeding specialist before making any changes to their nutrition plan. Individual results may vary based on the child’s specific heart condition, age, and medical history. While this study shows high success rates, tube weaning should only be undertaken under professional medical supervision with an interdisciplinary team. Temporary decreases in growth parameters may occur during transition and should be monitored by healthcare providers.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.