Tube feeding generally involves delivering a liquid feed through the nose (nasal tube) or stomach (gastrostomy tube). Feed types include expressed breast milk, infant formula or a specialised liquid feed.
There are 2 types of nasal tubes - nasogastric (NG) tubes and nasojejunal (NJ) tubes.
A doctor or nurse will put a soft polyurethane tube into your child's nose, this runs down your child's food canal (oesophagus) to their stomach. This type of nasal tube is called a nasogastric or NG tube.
In some cases, the tube may avoid the stomach and end in a part of the intestine. This type of nasal tube is called a nasojejunal or NJ tube. Your child may need an NJ tube if they cannot tolerate feeding to the stomach.
Your child will not need an operation - nasal tubes are usually put in by a nurse. Nasal tube feeding is a temporary way of feeding.
A gastrostomy tube goes directly into your child's stomach from the skin of your child's tummy. A doctor may put the tube in during an operation, or by a procedure called endoscopy. Endoscopy is a way of looking inside the body using a flexible tube with a small camera on the end of it. The endoscope goes in through your child's mouth and down the food canal (oesophagus), which leads to the stomach. Your child will need to recover in hospital for a few days after the gastrostomy tube goes in.
Your child's health professional will discuss the best type of tube with you. Types of gastrostomy tubes include retention disk PEG, PEG-J, balloon gastrostomy or MicKey button.
Your child's dietitian and feeding team will give you a feeding plan for your child. This will include times and type of feed. The type of feeding plan will depend on your child's medical condition and how much feed they can handle. Specialised liquid feeds are only available on prescription from your dietitian, family doctor, or paediatrician. There are 2 ways you can feed your child:
There will be a range of professionals supporting you and your child with tube feeding. These professionals may also help your child begin to change to feeding by mouth (oral feeding). Your child needs this range of professionals (called a multidisciplinary team) because of the different factors that contribute to feeding. The professionals can include:
Tube feeding takes some adjustment, but many families report relief at seeing that their child is getting the nutrition, liquid (hydration) or medications that they need. With the help of your health professionals, you will be able to learn to use the feeding tube safely at home. If safe, your child will still be able to eat by mouth (orally) while they have a feeding tube.
Your child will still be able to take part in most activities and go to daycare or school. People who care for your child can also learn to use the feeding tube.
It is a good idea to have some prepared responses to questions people in the community may ask about the tube (what it is for, why it is there, etc).
You may find it emotionally overwhelming if your child is on long-term tube feeding. It will be helpful to seek support from your feeding team, other professionals, or parents. You can ask your health professionals if there are support groups in your area. There are also links at the bottom of this page to New Zealand and international support networks.
Your child will need to tube feed until they can eat or drink enough by mouth (orally) to meet their nutritional needs. Some children will have medical conditions that mean they may always need some degree of tube feeding.
To be ready for feeding by mouth (oral feeding), your child will need to show that they can swallow safely and are otherwise medically stable.
It is helpful to plan for feeding by mouth (orally) with your health professionals as early as possible. You may start to include 'mealtime' experiences into your child's tube feeding routine, such as:
Seek guidance regularly from your health professionals about when your child may be ready to change from tube feeding to feeding by mouth (oral feeding).
Find out about the process of going from tube feeding to oral feeding [2]
The content on this page has been developed and approved by the Clinical Network for Paediatric Tube Feeding, Paediatric Society of New Zealand | Te Kāhui Mātai Arotamariki o Aotearoa.
This page last reviewed 30 June 2022.
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Links
[1] https://kidshealth.org.nz/general-mealtime-strategies-support-your-child-go-tube-feeding-oral-feeding?language=zh-hant
[2] https://kidshealth.org.nz/moving-tube-feeding-oral-feeding?language=zh-hant
[3] https://kidshealth.org.nz/tags/tube-feeding?language=zh-hant
[4] https://kidshealth.org.nz/node/2064?language=rar
[5] https://web.facebook.com/groups/177124695794208/
[6] https://kidshealth.org.nz/node/2065?language=rar
[7] https://www.feedingtubeawareness.org/
[8] https://kidshealth.org.nz/contact?from=http%3A%2F%2Fkidshealth.org.nz%2Fprint%2F2063%3Flanguage%3Drar