Types of Feeding Tubes and Devices

A feeding tube is a medical device that connects to the stomach or small intestine to provide nutrition support for children and teens who cannot take food by mouth. Nutrition given by tube feeding is called enteral nutrition.

Feeding tubes differ based on how the tube is inserted (through the nose or abdomen) and where the tube ends in the digestive system (stomach or intestine). If possible, the tube is placed in the stomach for more normal digestion.

Your doctor will decide what type of tube is best for your child. Find more information about tube feeding.

Nasal feeding tubes

Nasal feeding tubes are placed by passing the tube through the nose, down the throat, through the esophagus, and into the stomach or intestine. The tubes are long and flexible. The length depends on the child’s size. The end that stays outside the body has an opening or feeding connection to attach the feeding syringe.

Nasal tubes include nasogastric (NG) tubes, nasoduodenal (ND) tubes, and nasojejunal (NJ) tubes.

• Nasogastric tube (NG tube) - An NG tube is inserted into the stomach through the nose. The tube passes down the throat, through the esophagus, and into the stomach.
• Nasoduodenal tube (ND tube) - These tubes enter the nose like nasogastric (NG) tubes. Unlike an NG Tube, an ND tube extends past the stomach to the first part of the small intestine, called the duodenum. This type of tube is used if the stomach cannot tolerate feedings.
  
• Nasojejunal tube (NJ tube) - An NJ tube is like an ND tube. But the tube continues through the stomach into the middle of the small intestine, called the jejunum.

Surgically placed feeding tubes 

Surgically placed tubes include gastrostomy (G) tubes, gastrojejunal (GJ) tubes, and jejunostomy (J) tubes. These tubes are used for a longer time or if a child is not able to have a nasal tube. Surgically placed tubes are put in place through a cut (incision) in the abdomen. The surgery is often done using small surgical tools. This is called a laparoscopic procedure. Feeding tubes can also be placed with the help of a thin tube with a light on the end (endoscope).

The opening on the abdomen where the tube is placed is called a stoma. On the outside of the body, patients have a long tube or a low-profile (button) tube. Once healed, the stoma should not be painful, and children should be able to do most regular activities.

Gastrostomy tube (G-tube) 

Surgery to place a feeding tube in the stomach is called a gastrostomy. A gastrostomy tube (G-tube) is inserted through a small cut in the skin. The tube goes through the skin directly into the stomach. The G-tube is held in place by a balloon filled with sterile water on the inside of the stomach. This keeps it from sliding out. A small disc rests on your child’s belly to hold the tube steady. There is an opening (port) in the G-tube for feedings.

Gastrojejunal tube (GJ-tube)

A GJ-tube is inserted into the stomach like a G-tube, but the tube extends through the stomach to the small intestine. The GJ-tube has 3 openings (ports):

The gastric port goes into the stomach. The gastric port can be used to give fluids and medicines and remove extra fluid or air from the stomach.

The jejunal port goes to the jejunum, a part of the small intestine. This port can be used to give feedings.

The balloon port is used to put water into a balloon that holds the tube steady. A small disc holds the tube steady on your child’s belly.

A GJ-tube might be used if:

• Your child’s stomach does not empty normally.
• Food or water leaks from the stomach back into the throat (esophagus).
• Your child is at risk of breathing in food or water from the stomach.

Jejunostomy tube (J-tube)

A J-tube uses a small incision to place the feeding tube through the abdomen directly into the small intestine.

Long tube vs. low-profile tube  

Your child may have a long tube or low-profile tube placed. The type of tube depends on your child’s needs. In some cases, a long tube is placed first and then changed to a low-profile tube 6-8 weeks later.

Percutaneous endoscopic gastrostomy (PEG) or long tube - A long tube is inserted through the abdomen. One end of the tube stays inside the stomach or intestine. It has a mushroom-shaped end or internal balloon to keep it in place. A bumper or disc keeps the tube in place on the outside of the skin. Part of the 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 tube - A low-profile or button tube is also inserted through the abdomen, but it is a short feeding tube that stays close to the skin. Examples of this type of tube are the Mic-Key* and MiniONE®. Low-profile tubes are easier to cover with clothing and less likely to be pulled out. A small balloon filled with sterile water 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. Button tubes can go to the stomach or to the stomach and intestine depending on what your child needs. A gastric button has 1 port that goes to the stomach. A gastrojejunal button has 2 ports. One port goes to the stomach and the other port goes to the intestine (jejunum). To use a button tube, you connect a device to the port.

Read more about gastrostomy and placement of G-tubes, GJ-tubes, and J-tubes.

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