Tube dependency is our main focus

We are experts in the field of tube dependence and have weaned more than 1’600 patients from all over the world - mainly aged 0-3 years – over the last 20 years (via the In-/Outpatient treatment and Netcoaching). These children all had one thing in common: All of them were suffering from various severe feeding problems that were considered as “incurable” in their home cities. As medical professionals with senior staff on board, we offer a unique mix of expertise for the various medical as well as the psychological aspects, which develop when children don’t eat.

Now your patient is our mutual patient!

Our main service to parents with tube dependent children is the Netcoaching program. The Netcoaching program is an entirely internet-based medically supervised tube-weaning program, in which the child can stay at home. The actual weaning takes place in an intensive process of 3-4 weeks, in which our staff communicates with the patient twice a day on our online platform. On this platform, parents submit their child’s medical data, feeding protocols and videos of their child’s interaction with food. We analyze this data critically and coach the parents through the entire tube weaning process. The ultimate goal of the Netcoaching program is for the child to learn how to eat in a self-regulated and sufficient manner. At the end of the program, the child will eat sufficiently and the feeding tube can safely be removed. During the past three years, more than 130 children and their parents have successfully participated in the Netcoaching program with a success rate of 92%.

Key Benefits of the Netcoaching program for professionals:

• Your patient’s tube weaning treatment can start immediately
• The weaning is being undertaken by the most renowned experts in this field with decades of clinical experience
• Through our expertise we can treat almost any age or severity of feeding disorder. Our patients age ranges from birth to adolescence – their developmental status from age appropriate to severely handicapped.
• Conducting the Netcoaching program together with the NoTube team will enhance your know-how in the field

What is your role as a professional in the Netcoaching program?

We would like to state very clearly that each child needing our highly specialized and specific support at the time of contacting the NoTube team, needs your backup, moral support and help too! We have identified 2 core areas, in which we need your support:

1. Voice your concerns

Any kind of professional academic debate will be discussed openly and a joint goal will be defined before the Netcoaching starts. We kindly ask you to tell us frankly if you have any reasons or concerns why the child should not be weaned at all or why the time for doing so might not be appropriate.

There might be:

• medical concerns (e.g. cardiac operations within a short period of time)
• growth related concerns (has tube placement changed the weight problem clearly to the better or do negative side effects overrule any possible positive effects?)
• psychological concerns (e.g. are the parents emotionally stable enough to help their child to make a substantial developmental change after prolonged tube feeding)

If any of these concerns make you think that the project should not be performed at all or that it even might be dangerous (e.g. unsafe swallow function, risk of aspiration), please voice your concerns with us by contacting support@notube.at

2. Medical supervision

For all patients receiving help and support via Netcoaching, we may not and cannot take on direct medical responsibility and kindly ask for your assistance in the project within these 2 subjects:

1. Weight supervision

This involves weighing the child before the program starts, and weighing the child on a weekly basis until the phase of weight loss (approximately 1-10% of former body weight). Weight loss is less in children with PEG-tubes and less if the child already masters certain oral abilities before the weaning process starts. The phase of weight loss is influenced by the speed of oral intake abilities and usually stabilizes within one month.

2. Patient visits

If you agree that weaning the child off its feeding tube is advisable, then we kindly ask you to be prepared to see the child on demand during the 1-2 critical weeks after starting reducing the feeds. A supportive backup system of medical and paramedical professionals and family resources are crucial for securing the parents. This is crucial if the child is make a big step forward in its eating development.

Costs

There are no costs associated with pursuing the Netcoaching program as a professional. If your support and assistance involves any financial aspects, this must be negotiated between the family and you directly.