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Types of Tube Feedings

Updated: Jun 30, 2023

"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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