A feeding tube, also known as a gavage tube, is used to give nutrition to infants who cannot eat on their own. The feeding tube is normally used in a hospital, but it can be used at home to feed infants. The tube can also be used to give medication to an infant. The feeding tube can be inserted and then removed for each feeding. Or it can be an indwelling feeding tube, which means it remains in the infant for multiple feedings. The feeding tube can be used to give both breast milk and formula.
When does an infant need a feeding tube?
A feeding tube is used for infants who do not have the strength or muscle coordination to breastfeed or drink from a bottle. There are other reasons why an infant might need a feeding tube, including:
- lack of weight gain or irregular weight gain patterns
- absence or weak sucking ability or swallowing reflex
- abdominal or gastrointestinal defects
- respiratory distress
- problems with electrolyte imbalances or elimination
What happens during insertion?
During the procedure, your nurse will measure the length from your baby’s nose or mouth to their stomach. Your nurse will then mark the tube so it is just the right length for your infant. Then, they will lubricate the tip with sterile water or water based lubricating gel. Next, they will insert the tube very carefully into your infant’s mouth or nose. Occasionally doctors will insert the tube, but it is generally a procedure done by the bedside nurse. After it is placed, your nurse will check the tube for correct placement by inserting a small amount of air into the tube and listening for the contents to enter the stomach. This indicates the tube has been placed correctly. The most accurate way to test that the tube is in the correct place, without getting an X-ray, is to withdraw some of the liquid from your baby’s stomach and test the pH with a simple testing strip. This will ensure that the tube passed into the stomach and not the lungs. When the tube is inserted, it is taped to the nose or mouth so it stays in place. If your infant has sensitive skin or a skin condition, your doctor may use a pectin barrier, or paste, to make sure the skin doesn’t tear when the tape is removed. There are also devices that secure the tube internally by using cloth tape that passes behind the nasal bone. To confirm proper placement, your doctor may order an X-ray of your child’s abdomen to ensure that the tube is in the stomach. After the tube is firmly in place, the infant is given formula, breast milk, or medicine by injection with a syringe or through an infusion pump. You can hold your baby while the liquid moves slowly through the feeding tube. After the feeding is complete, your doctor will either cap off the tube or remove it. You should make sure your infant remains upright or inclined to prevent the feeding from being regurgitated.
There are very few risks associated with feeding tube use. However, it can be uncomfortable for the infant, no matter how gently it is inserted. If your child begins to cry or show signs of discomfort, try using a pacifier with sucrose (sugar) to provide relief. Other side effects include:
- slight nasal bleeding
- nasal congestion
- nasal infection
If you are feeding your baby through a feeding tube at home, it’s important to watch for signs of tube misplacement. Feeding through an incorrectly placed tube can lead to breathing difficulties, pneumonia, and cardiac or respiratory arrest. Sometimes the tube is inserted incorrectly or accidentally becomes dislodged. The following signs might mean there is something wrong with where the tube is placed:
- slower heart rate
- slow or troubled breathing
- blue tinge around mouth
It can be difficult to cope with feeding your infant through a feeding tube. It is normal to feel a sense of anxiety about not breastfeeding or bottle-feeding your infant. Many babies only need to use feeding tubes until they become strong enough or well enough to feed on their own. Talk to your doctor about the emotions you’re feeling. If you are feeling sad, your doctor can help you find support groups and can even evaluate you for signs of postpartum depression.