What you should know if your child needs tube feeding

Taking care of kids at every stage of growth is at the heart of everything we do as parents. When it comes to making sure your child is getting the nutrition they need, your pediatric therapy team is also on your side with help from a variety of specialized therapists. For example, speech-language pathologists who specialize in feeding and swallowing have the skills and expertise to assess and treat problems in these areas. They determine a safe diet and build a plan of care to address specific problems, including:

• Arching of the back or stiffening during feedings
• A severely limited diet preventing adequate nutrition, which is typically less than 20 foods.
• Oral motor coordination deficits leading to spillage and poor management of foods/liquids
• Coughing, choking, or spitting/throwing up
• Difficulty breathing while eating or drinking
• Difficulty transitioning between stages of food or from bottles to cups
• Difficulty using utensils and/or cups
• Inability to gain weight
• Eating a limited variety of foods/aversion to certain textures of foods
• Caring for/working with structural abnormalities (e.g., cleft lip and/or cleft palate)
• Taking an abnormally long time to eat

Occupational Therapists can also address feeding issues such as:

• A severely limited diet preventing adequate nutrition, which is typically less than 20 foods.
• Difficulty using utensils and/or cups
• Motor deficits that prevent bringing food to mouth
• Eating a limited variety of foods/aversion to certain textures of foods

What is a G-tube?

February 28 was Rare Disease Day — a day to raise awareness of the more than 7,000 rare diseases that impact 300 million people around the world. It's also the perfect time to think about the infants, kids, and young adults facing rare diseases, conditions, and challenges that require special treatment and advanced approaches.

When a child can't eat or drink on their own, for example, a G-tube, short for gastrostomy tube, can be used to provide the necessary calories and nutrition they need to grow and develop. G-tubes can also be used to administer medication.

A nasogastric tube (NG) is another type of feeding tube that may be used to deliver formula to children who are unable to receive nutrition on their own. NG tubes can also be used to administer medicine.

Although many medical conditions and diseases require patients to have a feeding tube, it's not something most parents think about until their child needs one.

Who needs a G-tube or an NG tube?

Some of the most common reasons children need a G-tube include:

• Health problems at birth, including difficulties with the esophagus and mouth, and intestinal conditions
• Inability to gain weight and grow normally
• Severe problems with taking medicines
• Sucking and swallowing issues caused by injury, premature birth, or developmental delay

The risks of having a G-tube are minimal, but the list of benefits is long — improved energy and strength, a stronger immune system and overall, a healthier child.

Some of the most common reasons children need a G-tube include:

• Child needs extra calories
• Digestive issues such as digestive tract inflammation
• Difficulty swallowing
• Premature birth

How are G- tubes and NG tubes inserted?

In most cases, putting a G-tube in place only takes about 30 to 45 minutes and the process usually entails a minimally invasive procedure. Two procedures for placing a G-Tube include:

• A laparoscopic technique uses two small incisions in the abdominal wall. A tiny telescope is inserted to help guide the G-tube into place.
• The PEG procedure inserts an endoscope — the surgeon inserts and endoscope (a thin, flexible tube with a tiny camera and light at the tip) through the mouth and into the child's stomach to guide the G-tube into place.
• An NG tube is inserted into the nose and down the throat to the stomach. NG tubes are usually used for short periods of time.

After a feeding tube is placed, your pediatricians/surgical team will make sure you have all the information you need to feed your child and care for the feeding tube site, including detailed instructions on home care, including bathing, dressing, physical activity, giving medicines through the tube, and venting.

Children with feeding tubes may not be able to continue to eat by mouth, which will depend upon the type of tube placed as well as upon the reason for the placement of the feeding tube. NG tubes are small and do not get in the way of swallowing. G-tubes are placed directly into the stomach or digestive tract, and therefore would not directly impact swallowing. However, if your child is aspirating (liquid, food or refluxed material going into the airway during or after feeding/swallowing), your child will most likely not be able to eat orally. Your child may benefit from a referral to speech therapy, so a speech-language pathologist can address oral motor, feeding or swallowing difficulties that may be preventing him/her from feeding/swallowing safely. Things might feel a bit unsure at first, but with the help of experts and a little practice, you and your child will have a process down before you know it.

From newborns to young adults, Reid Health is by your side to help your child thrive. Please continue reading to learn more about our pediatric therapy services and our approach to compassionate care.