"A tube is given to support life and make it easier for the child to grow without the risk of malnutrition, excessive fatigue, or aspiration" (Morris & Klein, 2000). The first years of life is a critical time period for development and can cause major setbacks if the child is malnourished.
A tube is used for children that have one of the following: prematurity, anatomical abnormalities, neurological issues, aspiration, fatigue, pending surgeries, Failure-to-Thrive diagnosis, or decreased appetite (Fraker et al., 2007; & Morris & Klein, 2000). It is important to consider and know what tube your child will use. The doctor will examine and determine what is best for your child's needs. The non-permanent tubes that may be considered include the orogastric, nasogastric, nasojejunal, and gastronomy tubes.
Orogastric Tube:
Tiny premature infants receive this due to their small nasal passageway
A thin and flexible tube that is inserted through the mouth to the stomach
It is put in temporarily for feeding and taken out when feeding is not occurring
Feedings typically take 15-20 minutes
Nasogastric Tube:
Plastic or silicone tube inserted through the nose into the stomach
Often used for a short time
Most "normal" feeling of feeding since the food is entering stomach like any other food would
Often invasive and uncomfortable for children since the tubing is taped on the face
Surgery is not required
Can interfere with normal swallowing mechanisms
Nasojejunal Tube:
Inserted through the nose passing the stomach to the jejunum of the small intestine
Used when physicians feel the stomach is functioning poorly
Special predigested formula is used due to bypassing the stomach
Slow delivery of food via feeding pump
Gastronomy Tube:
Surgically inserted into the stomach through the abdominal wall
Often used for a long time
Food directly goes to the stomach without having to go through the mouth and throat
Does not conflict with oral motor development of the mouth
Types of Tube Feeding:
Bolus:
Delivered several times a day
Lasts up to 10-30 minutes
Requires less equipment
Often less expensive
More convenient to administer
More mobility and normality in everyday activities as the tube is not connected to a pump all the time
Continuous:
Provided by a feeding pump
Formula is put in a feeding bag that connects to the feeding tube
Is administered for several hours
Feedings are up to 8-12 hours (usually at night)
Tips for Children on Tube Feedings:
Provide positive touch around the mouth and face
Encourage object/toy mouth play or chewing
Offer teething or chewy toys
Offer soft spoons to explore
Offer a soother for sucking development
During tube feedings, provide positive interactions
Encourage the child to participate in family mealtimes (e.g., sit in a high chair or booster seat with the family at the table during meals even though they are not eating)
Introduce toothbrushing
During tube feedings, have food present or cooking to associate the two
*Once your child can prove they can meet their growth and nutritional needs, the tube can be removed.
References
Fraker, C., Fishbein, M., Cox, S., Walbert, L. (2007, November 2). Food chaining: The proven
6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet.
Hachette Books.
Gillette Children's Speciality Healthcare. (2021). Using a nasogastric Tube. Retrieved
June 15, 2023, from
Marcus, S., & Breton, S. (Eds.). (2022). Infant and child feeding and swallowing: Occupational
therapy assessment and intervention (2nd ed.) AOTA Press.
Morris, S. M., & Klein M. D. (2000, January 1). Pre-feeding skills: A comprehensive resource
for mealtime development. Pro-ed International Publisher.
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