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FOR PATIENTS
Tube feeding is a way of getting your body the nutrition it needs. Tube feed is a liquid form of nourishment that’s delivered to your body through a flexible tube. The nutrients of a tube feed are similar to what you would get from normal food, and are also digested in the same way. Tube feed contain all the nutrients you need on a daily basis, including carbohydrates, proteins, fat, vitamins, minerals and water. Everyone has different nutritional requirements. The type of feed that you receive is tailored to your needs and will depend on your weight, height, activity level, medical condition and home circumstances. There is a wide range of tube feed products that covers all nutritional needs, including: When in hospital, your dietitian will discuss with you the best type of feed for your unique circumstances, which will ensure you receive the optimal nutrition and care. Your feed can be delivered using one of the following types of tubes: Your healthcare professional will recommend the type of feeding tube that’s best for you. Gastrostomy and jejunostomy tubes are less visible than the NG or NJ tubes but require a procedure/ surgery for placement and stoma site infections can occur. NG or NJ tubes, by contrast, do not require surgery for placement but they are more visible than a gastrostomy/ jejunostomy and insertion can cause discomfort. FOR PARENTS
Tube feeding is a way of getting your child’s body the nutrition it needs. Tube feed is a liquid form of nourishment that’s delivered to your child’s body through a flexible tube. The nutrients of tube feed are similar to what they would get from normal food, and are also digested in the same way. Tube feed contains all the nutrients your child needs on a daily basis, including carbohydrates, proteins, fat, vitamins, minerals and water. Types of tube feedEvery child has different nutritional requirements. The type of feed that will be recommended for your child is tailored to their needs and will depend on their weight, height, activity level, medical condition and your home circumstances. There is a wide range of tube feed products that covers all nutritional needs, including:
When in hospital, your dietitian will discuss with you the best type of feed for your child’s unique circumstances, which will ensure he or she receives the optimal nutrition and care. Types of feeding tubesYour child’s feed can be delivered using one of the following types of tubes:
Your healthcare professional will recommend the type of feeding tube that’s best for your child and you.
Gastrostomy and jejunostomy tubes are less visible than the NG or NJ tubes but require a procedure/ surgery for placement and stoma site infections can occur. NG or NJ tubes, by contrast, do not require surgery for placement but they are more visible than a gastrostomy/ jejunostomy and insertion can cause discomfort. Gastrostomy buttonAt some point, your healthcare professional may decide to replace your child’s gastrostomy tube with what’s called a low-profile gastrostomy button. The small ‘button’ acts like a port leading to the stomach. It has a much shorter tube that sits closely to the skin A button is placed the same way as a gastrostomy tube, and both are held in place by a water-filled balloon. This option is generally preferred by healthcare professionals and parents alike as it is more practical for use in children.
The types of feeding tube are:
METHODS OF ENTERAL FEEDINGThere are multiple methods to deliver an enteral feed. Your dietitian will recommend the most suitable method of delivering your feed. The following are some common feeding techniques. Pump or continuous enteral feeding: Your enteral feed is connected to a pump, which gradually delivers the nutrition to you at a controlled speed. The speed (or rate) and duration of your feeding will be discussed with you by your dietitian. Bolus Feeding: Your dietitian may recommend bolus feeding as a way of receiving your enteral feed. You will receive the feed in small doses, given through a syringe several times throughout the day, instead of being fed continuously through a feeding pump. Gravity Feeding: The enteral feed will flow out of the bag/bottle or syringe and into your feeding tube by gravity. This can be done several times each day, like bolus feeding with a syringe; however, a gravity feed may take a little longer to be delivered. Disclaimer: The content on this website is for educational purposes only and should not be considered to be medical advice. It is not intended to replace the advice of your healthcare team. Please consult your healthcare team with any questions about your home tube-feeding plan. Medically reviewed by Katherine Marengo LDN, R.D., Nutrition — By Megan Dix, RN, BSN — Updated on October 30, 2018 Enteral feeding refers to intake of food via the gastrointestinal (GI) tract. The GI tract is composed of the mouth, esophagus, stomach, and intestines. Enteral feeding may mean nutrition taken through the mouth or through a tube that goes directly to the stomach or small intestine. In the medical setting, the term enteral feeding is most often used to mean tube feeding. A person on enteral feeds usually has a condition or injury that prevents eating a regular diet by mouth, but their GI tract is still able to function. Being fed through a tube allows them to receive nutrition and keep their GI tract working. Enteral feeding may make up their entire caloric intake or may be used as a supplement. Tube feedings may become necessary when you can’t eat enough calories to meet your nutritional needs. This may occur if you physically can’t eat, can’t eat safely, or if your caloric requirements are increased beyond your ability to eat. If you can’t eat enough, you’re at risk for malnourishment, weight loss, and very serious health issues. This may happen for a variety of reasons. Some of the more common underlying reasons for enteral feeding include:
According to the American College of Gastroenterology, there are six main types of feeding tubes. These tubes may have further subtypes depending on exactly where they end in the stomach or intestines. The placement of the tube will be chosen by a doctor based on what size tube is needed, how long enteral feeds will be required, and your digestive abilities. A medical professional will also choose an enteral formula to be used based on tube placement, digestive abilities, and nutritional needs. The main types of enteral feeding tubes include:
Placement of a nasogastric tube or orogastric tube, while uncomfortable, is fairly straightforward and painless. Anesthesia isn’t required. Typically a nurse will measure the length of the tube, lubricate the tip, place the tube in your nose or mouth and advance until the tube is in the stomach. The tube is usually secured to your skin using soft tape. The nurse or doctor will then pull some gastric juice out of the tube using a syringe. They’ll check the pH (acidity) of the liquid to confirm that the tube is in the stomach. In some cases, a chest X-ray may be needed to confirm placement. Once placement is confirmed, the tube may be used immediately. Nasoenteric or oroentericTubes that end in the intestines often require endoscopic placement. This means using a thin tube called an endoscope, which has a tiny camera on the end, to place the feeding tube. The person placing the tube will be able to see where they’re putting it via the camera on the endoscope. The endoscope is then removed, and placement of the feeding tube may be confirmed with aspiration of gastric contents and X-ray. It’s common practice to wait 4 to 12 hours before using the new feeding tube. Some people will be awake during this procedure, while others may require conscious sedation. There’s no recovery from the tube placement itself, but it may take an hour or two for the sedation medications to wear off. Gastrostomy or jejunostomyPlacement of gastrostomy or jejunostomy tubes is also a procedure that may require conscious sedation, or occasionally general anesthesia. An endoscope is used to visualize where the tube needs to go, and then a tiny cut is made in the abdomen to feed the tube into the stomach or intestines. The tube is then secured to the skin. Many endoscopists choose to wait 12 hours before using the new feeding tube. Recovery may take five to seven days. Some people experience discomfort at the tube insertion site, but the incision is so small that it typically heals very well. You may receive antibiotics to prevent infection. In some cases, enteral feeding may not be an option. If you’re at risk for malnutrition and don’t have a functional GI system, you may need an option called parenteral feeding. Parenteral feeding refers to giving nutrition through a person’s veins. You’ll have a type of venous access device, such as a port or a peripherally inserted central catheter (PICC or PIC line), inserted so you can receive liquid nutrition. If this is your supplementary nutrition, it’s called peripheral parenteral nutrition (PPN). When you’re getting all of your nutritional requirements through an IV, it’s often called total parenteral nutrition (TPN). Parenteral feeding can be a life-saving option in many circumstances. However, it’s preferable to use enteral nutrition if at all possible. Enteral nutrition most closely mimics regular eating and can help with immune system function. There are some complications that can occur as a result of enteral feeding. Some of the most common include:
There are not typically long-term complications of enteral feeding. When you resume normal eating, you may have some digestive discomfort as your body readjusts to solid foods. The main reason a person wouldn’t be able to have enteral feeds is if their stomach or intestines aren’t working properly. Someone with a bowel obstruction, decreased blood flow to their intestines (ischemic bowel), or severe intestinal disease such as Crohn’s disease would likely not benefit from enteral feedings. Enteral feeding is often used as a short-term solution while someone recovers from an illness, injury, or surgery. Most people receiving enteral feeds return to regular eating. There are some situations where enteral feeding is used as a long-term solution, such as for people with movement disorders or children with physical disabilities. In some cases, enteral nutrition can be used to prolong life in someone who is critically ill or an older person who can’t maintain their nutritional needs. The ethics of using enteral feeding to prolong life have to be evaluated in each individual case. Enteral feeding can seem like a challenging adjustment for you or a loved one. Your doctor, nurses, a nutritionist, and home health care providers can help make this adjustment a successful one. Last medically reviewed on October 29, 2018 Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy. |