Originally published on Sept. 5, 2019.
I'm squeaking in at the end of feeding tube awareness week with a post for anyone who has ever wondered why children would have feeding tubes.
My special area of interest is in working with children and families who are tube-dependent (in fact, I'm hoping I will get to do research in this area some day!), and so it is a pleasure to write this post, a quick run-down of FAQs and info about feeding tubes.
What's a feeding tube?
A feeding tube is a way of children/adults getting nutrition into their bodies that is not via their mouths. The one you are most likely to see (because it is most visible, and also a popular solution for more short-term needs) is an NG, or Naso-Gastric tube. That means it goes into your nose and down into your stomach.
The other tube that is fairly common is a gastrostomy (not, as a lot of people think, a gastronomy tube, though that would be great, wouldn't it?). This is a tube that goes directly into the stomach. Sometimes people call it a PEG (percutaneous endoscopic gastrostomy), though technically, that is just a term for one type of gastrostomy that is put in in a certain way.
Other less common tubes are oro-gastric (from your mouth into your stomach) and naso-jejunal/naso-duodenal tubes (from your nose, though your tummy and into different areas of your small intestine).
Why would a child need a feeding tube?
There are a few main reasons:
- The child physically can't eat- they do not have the necessary skills to eat, or they are too unwell to eat. This may be temporary (e.g. if the baby is premature, or they are having an operation or treatment) or it may be permanent (e.g. if the child has an unsafe swallow, leading to food or drink entering the lungs).
- The child is finding it difficult to eat for other reasons- this can be for lots of reasons, but some children who have had a lot of invasive medical treatment, sensory difficulties or pain associated with eating, may develop aversive behaviours in response to food that stop them eating, or stop them eating a good range of foods. These children may need all or some nutrition through their tube to support them.
- The child is not eating enough- this might be because they have a condition that means they require more calories than average, or perhaps their physical condition means that they eat very slowly and it is difficult to get through enough food to grow.
If a child has a feeding tube, does it mean they will never eat?
Not at all! The long-term picture for feeding tubes depends a bit on why they have been put in in the first place, but many children are able to leave them behind and move onto oral feeding. Some children will always need them for all or part of their eating and drinking.
Won't a feeding tube make the child too lazy to eat?
This is not the case. Feeding tubes help us to support children to grow and develop. There are some children who can find it difficult to move on to oral eating, but these are children who have physcial, developmental or psychological reasons why this is the case. These children are not lazy, and neither are their families.
When a feeding tube is introduced as a short or medium-term solution, there should always be a plan for how it is monitored and how and when decisions will be made to support the transition off the tube if it is appropriate.
Children often need therapy support to help them to build skills for future oral eating. In an ideal world, children will have Speech and Language Therapy/Dietitian/OT/Physiotherapy/Paediatrician/Respiratory Team/Gastrointestinal team/ENT/Nursing in the right combinations for their individual needs to help them and their families.
Want to find out more?
I give thanks to all the families sharing their tube-feeding stories this week, and I hope one day that all children will get the right support to reach their feeding potential.