Life is unpredictable. As parents, we want our kids to live healthy, stress-free lives, but that’s not always possible. If our babies do have any medical complications, it’s our job to learn about what they need, so we can help them have the best quality of life possible.
If your baby’s doctor is recommending feeding tubes, you probably have a long list of questions and may feel worried and nervous. There are so many things that you need to consider. It will take time to process everything, but in the meantime, you can review what type of equipment and know-how your growing family will need.
We’re concerned about helping parents find the information they need to help their little ones live a fuss-free, happy life. Learning is an important part of parenting.
It may surprise some to learn that there are many different types of feeding tubes that can support enteral nutrition. With this basic guide, you can learn more about the different types of feeding tubes that your baby might need.
Why Would My Baby Need a Feeding Tube?
With over 300 possible conditions that can cause difficulty eating, there is a wide range of reasons that an infant might need a feeding tube. Usually, a feeding tube is necessary because your baby has difficulty swallowing.
Premature births are commonly associated with the need for an infant feeding tube. Depending on how far along you are when your baby is born, they may not have developed enough to be able to eat on their own.
It can also be due to:
- Genetic condition
- Anatomical issues
- Gastrointestinal (digestive tract) problems
- Allergies
- Conditions like cystic fibrosis or cerebral palsy
How Long Might My Baby Need a Feeding Tube?
Since there are many reasons that your baby might need a feeding tube, the amount of time that your baby will need to use it can vary depending on the cause. Sometimes, it might be only a few months, but other conditions might mean that a feeding tube is lifelong.
In some cases, feeding therapy can help children graduate from feeding tubes to eating on their own, but that takes time and a lot of work. Talking with your baby’s doctor can give you a better idea of what your expectations for your little one should be.
How Do Feeding Tubes Operate?
Feeding tubes transport nutrients directly to a person’s stomach or small intestine.
There are six different types of feeding tubes, and the type of tube your baby will have depends on:
- How long do they need the tube for?
- How does the food affect their stomach?
- What is the reason they need the feeding tube?
A feeding tube is essentially a flexible pipe. Some tubes are longer than others since the length depends on where it’s placed. The flexible tubes bring the food directly to where it needs to go, after it's transported through a bag or a syringe attached or inserted into a port commonly referred to as a “button.”
The bag is usually hung up on a hook, or a specialized backpack for mobility. The formula is then pumped through the tubing into where it needs to go. It should be a painless process. Depending on your child’s needs, they may have a bolus feeding schedule, which involves a meal-sized feed every few hours.
Some children may need smaller, more continuous feeds over a long period to help them digest the food better.
Some types of feeding tubes will need surgical placement, which means that the tube site needs some time to heal after a small incision. Although you can still use it to feed a baby, it needs the proper care to heal tightly around the tube, which will prevent any leaks.
Until that happens, your baby’s skin may be affected by any leaks, but there are ointments you can use to help with that.
You’ll want to look at comfortable, adaptive baby clothing that can fit around the tubing.
What Kind of Food Does a Baby Get Through a Tube?
Feeding tubes for older children and adults usually require specialized formulas, but generally, doctors prefer to give babies who need a feeding tube breastmilk. It may be fully breastmilk or partly breastmilk, but it is usually the first substance recommended.
However, formula is another suitable option. Sometimes babies may need a specialized formula, which can be made specifically for babies with allergies or babies who have difficulty absorbing fat.
Your doctor will determine what your baby’s nutritional needs are. They will help you figure out how to find a formula that your growing baby can tolerate. Every baby is unique, and some formulas affect babies differently than others.
If you are thinking about making homemade formula, it’s best to consult with your baby’s doctor and a dietician so that your baby gets all the essential nutrients. Be cautious about how you handle the homemade formula since it can go bad faster than store-bought ones.
Do I Need To Clean the Feeding Tube?
Since feeding tubes have a lot of formula going through them, they do need to be cleaned regularly to prevent the growth of bacteria inside the tube. However, you don’t need to worry about trying to figure it out on your own.
Before you take your baby home, the hospital staff will instruct you on how to clean the feeding tubes. First, you’ll likely practice with a baby doll that has a tube attached. After you’ve learned how to clean the tube properly, a nurse will typically supervise you while you clean your baby’s feeding tube.
When you go home, you will be provided with any necessary educational information to refresh your memory if needed. Once you’ve learned how to clean the tube, it will become an everyday and simple task.
Every day, you will need a clean feeding bag. After every feeding, you’ll need to use a syringe of water to flush out any remaining food in the tube. The other parts are often cleaned with warm soapy water.
What Are the Types of Feeding Tubes?
There are six major types of feeding tubes. Although every feeding tube performs the same function, each one has its own unique features that may suit the needs of one person but not another.
Gastric/Gastrostomy Tubes (G/PEG Tubes)
A G-tube is the most common type of long-term feeding tube. It’s placed directly into the stomach, either endoscopically or surgically.
There are two forms of the G-tube. One has a button-like device that is directly on the skin.
The other type of G-tube is commonly known as a PEG tube, named after the procedure that is used to put it in, a percutaneous endoscopic gastrostomy. PEG tubes tend to be longer. They are attached to a button-like device at the point of entry, but the tube extends further than the other option.
If an infant needs a feeding tube for longer than three months, they might have a G-tube unless they have a condition that requires a different type of tube. After everything is healed, the tube and button can be replaced at home.
Gastrojejunal/Trans Jejunal Tubes (GJ Tubes)
A GJ tube is another type of long-term tube. They’re very similar to G-tubes, but they have two feeding ports: one in the stomach and one that goes into the small intestine.
These tubes usually start off as G-tubes but receive an addition in the case that gastric feedings (feedings that go directly into the stomach) aren’t tolerated.
If gastric feedings bother a child, it could be better to feed the nutrients directly into their small intestine. These feedings are usually slower and are done over a period of 18 to 24 hours. They come in both the button form and long tube form.
Since this tube enters the small intestine, they need to be replaced by a doctor or an interventional radiologist at the hospital.
Nasogastric Tubes (NG Tubes)
NG tubes are usually short-term feeding tubes. Generally, they are only used for about one to six months. If there are other issues that prevent the use of other types of feeding tubes, a NG tube may be used for a longer period of time.
NG tubes are usually the first feeding tubes that your little one will use in the event of an airway blockage, digestive system issue, or other problem that makes it difficult for them to feed normally.
They are put through the nose and go into the stomach, bypassing the esophagus. They don’t require surgery to be placed, but that means that they are easy to take out, so NG tubes are usually taped to your baby’s face to prevent them from being pulled out accidentally.
This tube placement may prevent leakage from the feeding pump and other similar issues. NG tubes can often be replaced at home by parents or caregivers after some training.
Nasoduodenal Tubes (ND Tubes)
A nasoduodenal tube or ND tube is another type of tube that is fed through the nose. However, instead of ending in the stomach, they feed into the duodenum, the beginning of the small intestine.
These tubes don’t require surgery to be placed. Still, the process needs to be done in a clinic or hospital to ensure that the tube is fed into the duodenum.
Like a GJ tube, ND tubes are commonly well-suited for people irritated by gastric feedings who might experience acid reflux or bloating. Feedings should be done slowly over an 18 to 24-hour period. ND tubes tend to be more short-term. Unless there are other circumstances, they are used for one to six months.
Nasojejunal Tubes (NJ Tubes)
NJ tubes are also fed through the nose. But, instead of stopping at the stomach or the beginning of the small intestine, the NJ tubes extend farther into the small intestine into an area known as the jejunum.
Like the ND tube, NJ tubes should be replaced at a hospital or clinic. Even though they don’t require surgery, a doctor needs to make sure that the tube reaches the jejunum. It will help prevent irritation from gastric feedings, but feedings will have to be done over an 18 to 24-hour period.
Jejunal Tubes (J Tubes)
The final type of feeding tube that is sometimes used is the J-tube, which feeds directly into the small intestine. It’s sometimes referred to as a jejunostomy tube. It’s not super commonly used for either adults or children, but it is possible. It requires surgical placement by a healthcare provider to enable enteral feeding.
J-tubes may be able to be replaced at home, but it depends on the tube and the type of surgery used to place it. Your doctor should be able to educate you on how to replace the tube if it’s safe for you to do it at home.
Why Are There So Many Types of Feeding Tubes?
Each of these variations is helpful and necessary. For example, if your child has difficulty with gastric feedings, they will need a tube that feeds directly into their small intestine.
Also, temporary tubes like the NG, ND, and NJ tubes provide the same usefulness as a G-tube, but they don’t require surgery to place. Although the permanence of a G-tube is helpful for someone who needs a feeding tube long-term, if your child only needs a feeding tube for a short time, surgery would be unnecessary, and NG tubes could possibly be the better option.
Learning About Your Baby’s Needs
Even when life throws a curveball at you, it’s important to learn about the options you have and find the information you need about what your baby needs. We don’t expect our new babies to need feeding tubes, but if it does happen, it’s best to be prepared.
As parents, we want our little ones to have the happiest lives possible. Part of caring is understanding what our babies need, no matter what. We make sure they’re comfortable, whether it means making them adaptive-friendly Halloween costumes or cleaning a feeding tube.
Just like our growing bundles of joy learn to adapt to their new surroundings, we adapt to this new phase in our lives.
Sources:
Feeding Tubes: Types and Uses | Verywell Health
What to Know About Feeding Tubes for Children | Parents
Tube Feeding (Enteral Nutrition) | Cleveland Clinic
"Pediatric Tube Feeding: A Dietitian’s Guide for Caregivers" | EP Magazine
