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Theoretical Background

The main reason for enteral feeding (feeding by tube) is the coverage of an adequate nutritional intake in cases when oral feeding does not meet the required needs. There are different kinds of feeding tubes: NG-, PEG- and Jejujnal tubes, which are determined by their position in the patient’s body. Although there are many advantages of temporary tube feeding there also are some disadvantages.

Advantages of enteral feeding

Child in notube with a feeding tubeThe most important advantage of temporary tube feeding is its life-sustaining nutritional function. A sufficient enteral nutritional supply can help to ensure better thriving as well as the child’s general development in cases when oral intake is decreased or impossible for a predictable period of time. Children should benefit from this intervention so that they are able to recover and grow. A medical indication and the definition of clear goals are necessary before tube placement.

Disadvantages of enteral feeding

Unfortunately, in some cases, the intended positive effects on the child’s growth do not meet the expectations of caregivers and professionals. The result will be unsatisfactory weight gain, recurrent vomiting and often even at the price of reduced or stopped oral intake. Tube dependency is one of the main disadvantages.It is defined by the child’s inability or active refusal to start any oral activity and skills like wishing to touch and hold food, lick, bite and taste food in the absence of medical reasons for continuation of enteral feeding. This condition can lead to a co-dependence of the involved parents or caregivers. They get used to the tube feeds and most of the children forget or never learn to eat. A vicious circle can start and leads to parents and their child getting stuck in their “endless tube feeding situation”. Further commonly known negative side-effects are retching, gagging, tube dislocations, tube perforation, skin irritations, developmental delays etc..

Latest results on side-effects of enteral feeding

child with a feeding tube notube - child tubeIn a study of non-nutritional side effects data of 268 enteral fed children were analyzed in 2012. The sample was collected from 2009 and 2011 (36 months). Each patient suffered from at least two additional unintended side-effects like vomiting, retching, gagging, feeling of no hunger, sweating and granulation tissue, reflux and swallowing problems. All children evaluated in this study participated either in the Netcoaching or in other programs provided by NoTube´s specialists.

Conclusion

Before the decision for enteral feeding is made a thorough evaluation of pros and cons should be discussed by the medical team in charge and the child’s caretakers. Furthermore it is important to have an exit-strategy like Notube’s Netcoaching. The program is based on two core areas: to support the child’s autonomy and to help them get hungry.

It is also important to inform parents adequately.