Feeding Tubes for Nutrition and Medication
By John Lehman
Sometimes, depending on the severity of the disorder, children with cerebral palsy have difficulties feeding themselves. In these cases, a feeding tube may be necessary for your child to meet his or her dietary and nutritional requirements. Feeding tubes could also be used to allow your child an easier way to take their medications. Learn more about how feeding tubes can help children with cerebral palsy.
When is a Feeding Tube Necessary?
There are several factors your doctor will consider before recommending the use of a feeding tube, including calorie intake or prolonged lack of weight gain. If calorie intake is not the issue, your child’s medications could be the culprit, as some medications can lead to vitamin deficiencies. In any case, your child’s doctor will evaluate your child’s nutritional needs and determine whether a feeding tube is needed.
Types of Feeding Tubes
There are a variety of feeding tube types and devices. Before installation of a feeding tube, you should discuss all the options with your child’s physician.
- Mic-G Tubes – MIC G tubes are sometimes used as primary (initial) tubes. They have a balloon – subsequent tube changes can be done in the clinic or at home
- Mic-Key tubes – MIC KEYs are a balloon-type device as well. These tubes last anywhere from 3-6 months (depending on many factors).They are most often changed in the clinic or at home once families are comfortable with the process.
- Peg Tubes – A PEG feeding tube can last for 1-2years. You can discuss changing to a lower profile feeding tube after 3 months. Most children are admitted for daycare surgery to have the PEG tube removed.
- Bard buttons – A mushroom-type device that are most often changed in a clinic setting or operating room because we believe removing and replacing the device can be uncomfortable. Some children tolerate the tube changes in clinic without sedation, while others require medication to help them with the tube change.
- NG Tubes or Nasogastric – This tube is inserted through the nose and feeds into the stomach.
- Nasojejunal tube or NJ-tube: This tube is once again inserted in through the nose but it is guided further down past the stomach and into one of the upper parts of the intestine called the jejunum.
- Jejunostomy or J-tube: This tube is placed through the abdominal wall but instead of going into the stomach it goes directly into the jejunum.
What Makes Up the Formula?
Once the use of a feeding tube has been deemed necessary, the next step is determining what sort of food will be used. Your child’s doctor will likely consult with a nutritionist to decide on your child’s diet. There are a variety of options available for you. Doctors or natural food retailers can provide commercially made formulas designed to target specific deficiencies in your child’s diet. You can also make your own formula using a blender and ingredients your child’s doctor has deemed appropriate for your child’s dietary needs.
What is the Procedure?
The process of installing a feeding tube is known as gastrostomy. G-tube Placement Alternatives include:
- Stamm gastrostomy – open surgical procedure
- Janeway gastrostomy – laparoscopic procedure
- Percutaneous Endoscopic Gastrostomy (PEG) – endoscope or image-guided radiography to insure proper g-tube placement
Depending on how long the tube needs to be installed, the surgeon will either install it through the nose leading into the stomach or directly into the stomach wall. Patients are often put under anesthesia, so the procedure should be painless.
Is Using a Feeding Tube Safe?
Using a feeding tube on children is the subject of some debate. Some medical researchers suggest that their use can lead to complications, including choking, bacterial infections and accidental inhalation of the formula (aspiration). There is also the possibility of organ ruptures, depending on where the device was installed. Keep in mind that it will be necessary to regularly clean the point of entry and ensure your child does not disturb the tube.
Despite these risks, research has shown positive results from the use of a feeding tube for children with cerebral palsy. A study was conducted in 1999 to determine the survival rates of children with cerebral palsy who had surgically placed feeding tubes. Of the 61 children, 90% saw improvement in their quality of life. Although it can be hectic to keep up with the schedule of maintenance and nutrition monitoring, the work will pay off by providing your child with a long and healthy life.
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