Feeding tube issues

Feeding tubes for children with CP and other chronic conditions

When to place a feeding tube must be tailored to each child's/family's situation. Preliminary research suggests that a well managed feeding tube usually (but not invariably) has a positive impact on nutritional status but little is known about the overall impact of a feeding tube on a child's or family's function. Indications for a feeding tube may include:

Unsafe oral feeding;
Inefficient feeding due to oral motor dysfunction leading to prolonged labor-intensive feeding or poor weight gain;
Recurrent periods of dehydration or weight loss associated with illness; or
A need for an alternate route to give medications, fluids, or unpalatable diet (e.g., ketogenic formulas).

While most caregivers report 'general satisfaction' at their child having had a feeding tube placed, many report the need to develop complex coping strategies over the first months to manage the equipment, feeding schedules, and general care in the face of family life. The primary care clinician is critical to this process by:

facilitating family coping strategies;
adjusting the child's diet for optimal growth and nutrition (and prevention of obesity);
adjusting the child's feeding schedule for optimal family/child functioning;
monitoring the feeding tube for complications (feeding intolerance, reflux with aspiration, stoma leakage etc.);
ensuring that the family has adequate equipment for using and caring for the feeding tube;
ensuring that the family is aware of what to do if the tube dislodges;
working with the familiy to ensure adequate and safe feeding at school, childcare and respite settings; and
if appropriate, helping the child and family continue to focus on advancing oral feeding by monitoring safety, prescribing oral motor therapy (if indicated), and optimizing the feeding schedule to enhance hunger during meal times.

Resources

Information & Support

For Professionals

Continuous Drip Nasogastric Feeding with Pump
From the Cincinnati Children's Hospital Website, instructions for parents using a continuous drip tube feeding with pump. Includes supplies, preparation, and general information. There is a link to instructions in Spanish.

For Parents and Patients

Tube Feeding with Gravity Feeding Set
From the Cincinnati Childrens Hospital website, a simple straight forward instruction on gravity tube feeding. Includes a supply list, procedures,checking tube placement, feeding, trouble-shooting and when to call the physician. Information also offered in Spanish.

Gastrostomy Feeding by Syringe
From the Cincinnati Children's Hospital website, instructions for parents on gastrostomy feeding. Includes explanation, supplies, procedure and safety tips. Also available in Spanish.

Parent to Parent G-Tube Tips
Parents of children with feeding tubes share problems and offer successful tips.

Nasogastric Feeding Tube Insertion
From the Cincinnati Children's Hospital website, parent instructions on NG tube insertion and removal. Includes explanation, supplies, and procedure. The site offers a link to instructions in Spanish.

Services

For other services related to this condition, browse our Services categories or search our database.

Helpful Articles

Sullivan PB, Juszczak E, Bachlet AM, Lambert B, Vernon-Roberts A, Grant HW, Eltumi M, McLean L, Alder N, Thomas AG.
Gastrostomy tube feeding in children with cerebral palsy: a prospective, longitudinal study.
Dev Med Child Neurol. 2005;47(2):77-85. PubMed abstract

Sullivan PB, Juszczak E, Bachlet AM, Thomas AG, Lambert B, Vernon-Roberts A, Grant HW, Eltumi M, Alder N, Jenkinson C.
Impact of gastrostomy tube feeding on the quality of life of carers of children with cerebral palsy.
Dev Med Child Neurol. 2004;46(12):796-800. PubMed abstract

Authors

Compiled and edited by:

Lynne M Kerr MD, PhD, 10/2008

Content Last Updated:

5/2011