Safer NICU Discharge for Infants Requiring Nasogastric Tube Feeding

A recent study published in the Journal of Pediatrics shows that combining home enteral nutrition with remote patient monitoring may improve the transition from the Newborn Intensive Care Unit (NICU) to home and even lead to earlier discharge for infants who need nasogastric tube feeding.

“There has been a debate in the literature about if it’s safe to send NICU families home with a feeding tube,” says Rebecca Henkel, MD, neonatologist at Cincinnati Children’s and first author on the study. “Our group wanted to see if the addition of our remote monitoring program made discharge with the nasogastric feeding tube work better and made a difference in outcomes for patients.”

The Benefits of Remote Patient Monitoring

The Remote Patient Monitoring program at the Cincinnati Children’s NICU has been around since December 2018. Its mission is to improve outcomes and experiences for patients with high-risk and chronic conditions outside hospital walls. Here’s how it works:

• Patients and families self-report health information to their care team through an application (app) on their smartphone or tablet.
• Vital stats transmit to the app through a parent report.
• Families complete questionnaires regularly about the health status of their child.
• A team of registered nurses reviews all information and is available by text and video call on demand.

“Other hospitals in the country have some version of a Remote Patient Monitoring program,” says Dr. Henkel. “But Cincinnati Children’s is fairly unique with our mobile application-based check-ins. They allow families to have flexibility with asynchronous data submission and the ability to ask questions at any time.”

Improved Growth, Earlier Discharge and Fewer Emergency Department Visits

To analyze the effectiveness of the Remote Patient Monitoring program in the NICU, Dr. Henkel and her colleagues looked at 385 infants discharged between 2015 and 2022, including 139 infants discharged without remote patient monitoring support (pre-RPM) and 246 infants discharged with remote patient monitoring support. All infants required nasogastric tube feeding.

Despite higher rates of prematurity in the remote patient monitoring group, these infants were discharged about a week earlier than those without remote patient monitoring—most likely because the medical team felt more comfortable sending patients home earlier, knowing they’d receive such close monitoring.

Additionally, infants who received remote patient monitoring:

• Improved weight gain trajectories compared to those without remote patient monitoring
• Had a 53% lower risk of unplanned hospital admission or emergency department visit

“If another hospital is thinking of sending babies home with nasogastric tubes, they should consider implementing a similar remote monitoring program,” says Dr. Henkel. “This has become our standard of care at Cincinnati Children’s because we think it works well, and now we have shown that it works well.”

Read the full study: Henkel RD, et al. Journal of Pediatrics. 2025;114802

To learn more about remote patient monitoring-supported discharge pathways or to make a referral, contact the Perinatal Institute at Cincinnati Children’s.

(Published June 2026)

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