When parents learn that their newborn needs a feeding tube, they may experience a range of emotions. There’s already a lot to learn when you're preparing to be a new parent, and now there’s a whole new set of information that you need to figure out.
Perhaps your baby already has a feeding tube placed in the nose — this placement is generally a temporary solution. If your child needs a more permanent feeding tube, their healthcare team might recommend a G-Tube (gastrostomy tube) or a J-Tube (jejunostomy tube).
What’s the difference between these two feeding tubes? G-Tubes and J-Tubes serve the same function, but they are placed in different areas. They require different placement methods and have different enteral feeding rates.
What Is a Feeding Tube?
A feeding tube is a plastic tube that’s used to provide nutrients, water, and medication directly to the stomach or small intestine. There are many types of enteral nutrition tubes and equipment. Some tubes are intended to be used only for a short period of time.
These tubes are generally fed through the nose to the stomach. Long-term tubes are usually surgically placed, as is the case with J-Tube and G-Tube placement. They allow for more direct access to the stomach or small intestine and are more complicated to remove.
Ultimately, the type of tube depends on the patient's needs.
What Is a J-Tube?
J-Tube is the shorthand term for a jejunal tube. These tubes are placed directly into the small intestine instead of the stomach or fed through the nose. They are placed in the jejunum, the middle of the small intestine.
J-Tubes typically involve more intensive care. A J-Tube may be called for in the event of an anatomical issue or a high risk of clogging that prevents placement in another area, like the stomach or esophagus. They are for people who need permanent feeding tubes.
There are two possible types of J-Tubes that might be placed. J-Tubes can either be buttons, which are tubes that have a closed “port” at the opening that attaches to an extension tube when needed, or long tubes called percutaneous endoscopic gastrostomy tubes.
What Is a G-Tube?
A G-Tube is another kind of permanent tube. The name is short for a gastrostomy tube, which is placed directly into the stomach. It’s a much more common type of feeding tube since the stomach is larger, so it has more room.
If a baby needs a feeding tube for over a month, they might be given a G-Tube. There are many types of G-Tubes. Some are kept in place by a balloon, while others are kept in place with stitches.
Like J-Tubes, G-Tubes have buttons or long tubes. Either can be attached to a feeding bag, or food can be given through a syringe, which means babies should be dressed in accessible clothing.
How Are Feeding Tubes Placed?
The placement of a feeding tube depends on the type of tube and the needs of the patient. We’ve mentioned that some tubes are less permanent than others. These are typically fed through the nose and don’t require any surgery.
Permanent feeding tubes, like the J-Tube and the G-Tube, usually require some form of operation.
These operations are usually performed in one of three ways:
- Endoscopically (a PEJ or PEG)
- Guided by imagery
- Surgically with small incisions and a laparoscope or a larger incision
J-Tubes have procedures used specifically for their placement that aren’t used for other tubes. Tubes usually need to be replaced every few months. Your baby’s doctor will let you know when they need to be replaced and if you need to come in for the procedure.
How Are J-Tubes Placed?
J-Tubes may be placed endoscopically or with a surgical procedure that is either open or guided by a laparoscope. An incision is made in the abdomen, and a small hole is made in the small intestine, which is then attached to the abdominal wall.
A feeding tube is then placed into the incision in the small bowel and abdomen and secured at the tube site.
Another option is a gastric bypass procedure, sometimes known as a Roux-en-Y. This procedure creates a sort of tunnel or limb made with a small part of the small intestine. The choice of placement should be made based on medical advice from your gastroenterologist.
The feeding tube is placed inside the limb. It allows for a more stable feeding tube, but it is also a more complicated surgery.
J-Tubes usually need to be replaced at the clinic or hospital by a professional. They can’t be replaced at home. These tubes are often recommended for patients with low gastric motility or chronic vomiting.
G-Tube
G-Tubes can also be placed endoscopically or by surgery. Most doctors will use the percutaneous endoscopic gastronomy (PEG) method, which is why G-Tubes may also be called PEG tubes.
In a PEG procedure (the one for a J-Tube is called a PEJ), a long, flexible piece of equipment with a camera attached to it is sent down to the stomach through the mouth. The camera and the light allow the surgeon to find the best position to place the feeding tube.
The doctor will make an incision, create the stoma, place the tube inside and secure it. Usually, PEG tubes are long, but once everything heals, it can be swapped with a button tube.
With doctor permission, G-Tubes can be replaced at home, as long as there aren’t any complications.
Why Would a Baby Need a Feeding Tube?
Feeding tubes are necessary when a person can’t get enough nutrients orally. There are various reasons that a baby might need a feeding tube.
An anatomical abnormality might mean that they can’t swallow correctly, or they may not be developed enough to eat on their own, like a premature baby. It’s possible that the root cause of these issues is a genetic issue, allergies, or a gastrointestinal condition.
Although both J-Tubes and G-Tubes provide nutrition, each one has its own use.
When Are J-Tubes Used?
J-Tubes aren’t usually the first choice for a permanent feeding tube since there are often other areas for tube insertion for nutritional support.
A J-Tube might be used if there is an anatomical abnormality that prevents inserting a G-Tube. It might be used in place of a GJ-Tube, which goes through the stomach to the small intestine.
Another reason for choosing J-Tube over a G-Tube is if gastric feedings aren’t well-tolerated. It may be because the stomach isn’t working properly, or the patient experiences chronic vomiting. It could be because there is a high chance of aspiration, which is breathing foreign matter into the lungs.
When Are G-Tubes Used?
G-Tubes are the most common feeding tubes. Although they are mainly used for feedings, G-tubes can also help release a buildup of gasses in the stomach or dislodge stomach blockages.
As long as there aren’t any factors that make a J-Tube the better option, the doctor may recommend a G-Tube.
How Long Will Babies Need a Feeding Tube?
Since J-Tubes and G-Tubes are typically implemented for continuous feeding, a newborn may need a feeding tube their whole life. However, in some cases, that may not be the case.
Depending on the reason behind the feeding tube, it is possible for children with G-Tubes to eat orally, as long as your child’s doctor recommends it. A J-Tube, on the other hand, may not allow for oral eating since many of the reasons for a J-Tube involve gastric issues and potential vomiting.
Additionally, it’s possible that with physical therapy, patients will be able to eat orally at some point in the future.
This question is best addressed to your baby’s doctor. They will better understand the infant's condition, including whether it will be permanent or if there’s a chance that they may get better with therapy.
How Do I Feed My Baby With a Feeding Tube?
Using a feeding tube will require training. You will need to know how to provide food and how to clean the tube. Your baby’s nurses should help you learn how to properly feed your baby and care for their feeding tube.
There are two ways to send foodstuffs through a feeding tube. You can use a syringe to send the necessary nutrients and fluids through the tube, or the feeding tube can be attached to another tube by either the port or the end of the long tube. This other tube is attached to a feeding bag and a pump, which pumps the food into the stomach or small intestine.
Either work with a G-Tube (but often feedings with a J-Tube are easier with a pump and a bag).
J-Tube
Since the jejunum (the middle part of the small intestine) isn’t very wide and can’t expand, it can’t absorb a lot of food at once.
To accommodate that, J-Tube feedings generally take place over a long time period, usually 16 to 24 hours.
With a J-Tube, a pump and a feeding bag (or a bunch of feeding bags) is usually the ideal option. That way, the baby can get the food they need without causing any other problems.
G-Tube
Feeding with a G-Tube doesn’t take as long. In fact, you can give your baby food around the same time they would be getting it orally. If they’re older, this may mean that they will need to eat around mealtimes.
Babies, including those with feeding tubes, have a different schedule than older children. Newborns, for example, need to be fed every two to three hours since their stomachs are so small. Their doctor or dietician can help you figure out an appropriate feeding schedule.
What Do I Need To Watch Out For?
G-Tubes and J-Tubes don’t come without their complications. The potential for leakage is more common with J-Tubes, especially when a tube is initially placed. There can also be irritation or the growth of infected granulation tissue.
It is possible for tubes to be pulled out or fall out. If that happens, it is best to call the doctor as soon as possible. If you know how to properly replace the tube, do that as soon as possible. If you notice any symptoms of infection, it’s a good idea to visit the doctor.
If your child uses feeding tubes, opt for baby clothes like Tabeeze Bottom-Up Baby Bodysuits with shoulder snaps so that the onesie can go on and off feet first. Adaptable, accessible, and comfortable clothes can help prevent further irritation and protect the tube from your baby’s curiosity.
Which Feeding Tube Is Better?
Since G-Tubes and J-Tubes have specific uses for tube feeding, one isn’t necessarily better than another. A G-Tube is ideal since the stomach has more space, allowing for quicker feedings by parents and caregivers. It may not be permanently necessary, although it is intended for long-term feeding tubes.
Sometimes, however, a G-Tube may not be the best option, so a J-Tube is used. J-Tubes are generally a last resort, but they are still helpful.
Taking Care of Babies With Feeding Tubes
Your family’s doctors will determine which tube is best for your baby, and each type of feeding tube has its own rules for mealtime and care techniques. Reviewing the differences between each type of tube and following professional medical advice can help us better care for our little ones.
Sources:
Gastrostomy (G) Tubes | Feeding Tube Awareness Foundation
Jejunal (J) Tubes | Feeding Tube Awareness Foundation
Tube Placement of G Tube, J Tube & Gastrojejunostomy Tube | Together - St. Jude
