Feeding Tube Placement for Enteral Feeding

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Placement of a feeding tube into the stomach or intestine is a common procedure in children with cancer. The type of the tube depends on how the tube is placed (through the nose or abdomen) and where the tube ends in the digestive system (stomach or intestine). A feeding tube allows enteral nutrition support for children who are unable to get all the nutrients they need from food.

How Are Feeding Tubes Placed?

There are 2 main ways feeding tubes are placed for enteral feeding:

Through the nose (non-surgical) — Nasal tubes include NG tubes (nasogastric ), ND tubes (nasoduodenal), or NJ tubes (nasojejunal).
Through a small opening made in the wall of the abdomen (ostomy surgery) — Surgically placed feeding tubes include G tubes (gastrostomy), GJ tubes (gastro-jejunostomy), and J tubes (jejunostomy).

A young patient with an NG tube going into the right nostril and taped onto the face. — An NG tube is inserted into the stomach or small intestine through the nose and down the throat.

Several factors determine what type of feeding tube is best for each patient. These include:

Health of the digestive system
Duration of nutrition support
Frequency of use
Child’s age, size, and health status
Child’s activity level
How much care is needed to maintain the feeding tube
Risk of infection and other problems

A feeding tube can stay in place for months to years, as long as nutrition support is needed. Many children are able to eat food by mouth with a feeding tube in place. If infection or other problem occurs, the tube will be removed and replaced as needed.

Each type of procedure is different. A care team member will explain the details and discuss the risk and benefits of a feeding tube. A child life specialist can also help children prepare and know what to expect. Many children go home with a feeding tube. A nurse or patient educator will go over feeding tube care and instructions. Be sure to keep a list of questions, and write down information to make it easier to remember.

NG Tube (Nasogastric), NJ Tube (Nasojejunal), and ND Tube (Nasoduodenal)

NG, NJ, and ND tubes are long, flexible, hollow tubes. The length depends on the size of the child. The end that stays outside the body has an opening or port to attach the feeding syringe.

Illustration of a Nasogastric tube placed through the nasal cavity of a person

Illustration of a Nasojejunal tube placed through the nasal cavity of a person

G Tube (Gastrostomy), J Tube (Jejunostomy), and GJ Tube (Gastro-jejunostomy)

Feeding tubes placed through the abdomen fall into 2 main categories: long tubes and low-profile or button tubes. Patients often get a long tube first and then have it replaced with a low-profile tube 6-8 weeks later after the insertion site has healed.

Illustration of a Jejunostomy tube placed in the abdomen of a person

Medical illustration of the placement of a gastrostomy tube (G Tube) and a gastrostomy-jejunostomy tube (GJ tube)

Long Tubes

Long tubes are tubes inserted through the abdominal wall. The end of the tube that stays inside the stomach or intestine has a mushroom-shaped end or internal balloon to keep it in place. An external bumper or disc keeps the tube in place on the outside of the skin.

A length of tube stays outside the body. The long end of the tube has one or more openings called ports. The ports are used for feeding, giving medicines, or removing air or fluid from the stomach.

Low Profile or Button Tubes

Low-profile or button tubes are short feeding tubes that stay close to the skin. A small balloon holds the end of the tube in place inside the stomach or intestine. A port outside the skin attaches to a removable extension set for feedings.

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Reviewed: December 2018