Feeding Tubes 101
There are several ways to deliver food/medicines directly into the gastrointestinal (GI) tract, essentially bypassing your child's need to swallow. This page is meant to provide a basic introduction to tube feeds and the process involved.
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Feeding Tube Definitions
- Naso-gastrostomy ("NG") tube - A soft, flexible tube that is placed through the nose down into the stomach, to give feedings directly into the stomach. This type of tube can be placed in clinic, and eventually, with proper training, many parents feel comfortable replacing them at home. Depending on the type of plastic in the tube, it may need replacement at varying intervals (weeks to months). There are many sizes of these tubes, but most of them are not any thicker or stiffer than a string of spaghetti-noodle.
- Gastrostomy - An opening or "hole" between the abdominal wall and the stomach for the purpose of giving stomach feedings. A gastrostomy is done in the operating room.
- Gastrostomy tube ("G-tube") - The tube that is placed through the gastrostomy opening to give feedings and keep the hole open. There are several types, but the one we most commonly use is a PEG.
- Percutaneous Endoscopic Gastrostomy ("PEG" tube) - This type of tube is placed in the operating room. One doctor passes an endoscope (thin, flexible tube with a tiny camera and light at the tip) through the mouth and into the stomach to guide another doctor who inserts the g-tube through an incision on the skin into the stomach. The tube stays in your child's stomach because there is a bumper at the end of the tube inside the stomach. There is also a plastic bumper around the tube outside the child's body. This keeps the tube from sliding in and out of the opening. With time, and these two plastic bumpers, a "seal" is formed between the skin and the stomach. Once the 'seal' forms, the PEG can then be switched to a skin-level "button" tube
- Low-profile gastrostomy tube or button - A small short gastrostomy tube. It looks like a button sitting on the skin over the stomach. It has a separate piece that attaches for feedings. Some tubes that are often referred to as buttons include: MIC-KeyTM, Corpak©, and Bard® buttons. These kinds of tubes replace PEGs (see previous page), after the intial period of healing, or can be placed as the intial gastrostomy tube, in some cases.
- Bolus feeding - A feeding given over 30 to 45 minutes. These can be given by gravity or on a feeding pump. They are generally done one to five times per day depending on how much the child eats or drinks.
- Continuous feeding - A feeding given over 12 to 24 hours. It is usually easier to give continuous feedings with a pump that controls the rate at which the feedings are given.
When is a feeding tube used?
- To provide feeds
- To provide liquids/water
- To provide medications
- To vent the stomach (relief of gas pain)
Can you feed children solids through a tube?
Some children with feeding tubes can also take solids and other feeds by mouth, if permitted by the doctor. Children can only take liquid feeds through feeding tubes. The choice of formula will depend upon many factors, but some children can even take normal food, as long as it is "blenderized" prior. Your doctor will advise you.
What about bathing?
Children can take a bath normally (and go swimming) with a g-tube. The routine, daily care of the site usually requires a little water and soap, just like the rest of the body.
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