Feeding Tubes for Nutrition Support

What is a feeding tube?

A feeding tube is a medical device that helps provide nutrition support (enteral nutrition) for patients who are not able to swallow or who can’t get all the nutrients they need from food.

The most common feeding tubes include nasogastric tubes (NG tubes) and gastrostomy tubes (G-tubes). But there are several types of feeding tubes based on how and where they are placed in the digestive system.

Your child might need a feeding tube if they:

• Have trouble sucking or swallowing normally
• Have trouble gaining or maintaining weight
• Have trouble taking medicine by mouth
• Need fluids for hydration

Tube feeding, or enteral nutrition, provides nutrition in liquid or formula form through a tube placed into the stomach or intestine. Some medicines may also be given through the feeding tube.

There are generally two ways feeding tubes are placed:

1. Through the nose (non-surgical)
2. Through a small cut or incision in the abdomen (surgical)

The type of feeding tube your child has depends on how the tube is placed (through the nose or abdomen) and where the tube ends in the digestive system (stomach or intestine).

Nasal feeding tubes

Nasal tubes include:

• Nasogastric (NG) tubes
• Nasoduodenal (ND) tubes
  
• Nasojejunal (NJ) tubes

An NG tube is inserted through the nose and down the throat into the stomach. ND and NJ tubes end in the small intestine.

Nasal feeding tubes are generally used when tube feeding is needed for a relatively short time. The tube extends out from one nostril and is secured to the skin using medical tape. They have several advantages including lower risk of infection and ease of placement.

But the tube must be taped to the face. This may bother some children. Other children may have problems with nasal tubes because of irritation of the skin and mucous membranes due to chemotherapy or other treatments.

Surgically placed feeding tubes

Some feeding tubes are placed through a surgery to make a small opening in the wall of the abdomen.

Surgically placed feeding tubes include:

• Gastrostomy (G) tubes
• Gastro-jejunostomy (GJ) tubes
• Jejunostomy (J) tubes

Surgically placed tubes (G-tube, J-tube, GJ-tube) are used for a longer time or if a child is not able to have a nasal tube. 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 “button” or low-profile tube. Once healed, the stoma should not be painful. Children should be able to do most regular activities.

Read more about the types of feeding tubes and feeding tube placement.

The type of feeding tube that is best for your child depends on several factors. Your doctor will consider:

• Your child’s age, size, and medical needs
• Your child’s activity level
• How well your child’s digestive system works
• How long your child will need nutrition support
• How often the feeding tube will be used
• How much care is needed to maintain the feeding tube
• Risk of infection and other problems

A feeding tube can be used for short- or long-term nutrition support. Many children can eat food by mouth with a feeding tube in place. If infection or other problem occurs, the tube can be removed and replaced as needed.

Before your child gets a feeding tube, your care team will discuss the risk and benefits of a feeding tube and help you know what to expect.

Possible problems with a feeding tube

Problems after getting a feeding tube may include:

• Infection or irritation where the tube is located
• Tube moving out of position or coming out
• Formula getting into the lungs

Some patients may have side effects from tube feeding. These include nausea, vomiting, stomach cramps, diarrhea, constipation, and bloating.

Most problems can be prevented by following instructions for care and feeding. Be sure to keep your child from touching or pulling on the tube. Take good care of the skin around the tube site to prevent irritation or infection.

A nurse or patient educator will go over feeding tube care and instructions. Keep a list of questions and write down information to make it easier to remember.

Living with a feeding tube

Most children adapt well to having a feeding tube. It is important to help your child understand that tube feeding is not a punishment. Sometimes a patient is simply not able to get enough nutrition by mouth. This is no one’s fault. Feeding tubes can help children be healthier and feel better.

Ways to support your child

• Make sure your child understands that a feeding tube helps provide nutrition to stay healthy. Explain that there are different ways people can get nutrition. The feeding tube is one of those ways. When you get enough nutrition, it helps you feel better and have more energy.

• Some children may blame themselves. They may think that they had to get a feeding tube because they didn’t try hard enough or did something wrong. Help your child understand that getting a feeding tube is not punishment. It is not their fault.  
• Explain that the feeding tube is not permanent. Your child will have it as long as it is needed to get nutrition. Some patients might still be able to eat with the feeding tube in place. This can help your child feel more normal.
• If your child is old enough, involve your child in caring for the feeding tube. For example, you can explain why it is important to keep the feeding tube clean and let your child assist in cleaning the feeding tube. This can help children be more comfortable with the feeding tube and understand why it is needed.

Read more about nutrition and tube feeding.