Pediatric Enteral Nutrition

What is Pediatric Enteral Nutrition?

Enteral nutrition uses feeding tubes to deliver nutritious formula to your child’s body either several times a day or continuously. Certain medical conditions can limit your child’s ability to eat and drink through their mouth. Enteral nutrition helps doctors get children the nutrients they need when eating and drinking through the mouth becomes unsafe, uncomfortable, or impossible.

Enteral feeding can be recommended for a child for a variety of reasons, including:

• Serious weight loss or struggling to gain weight
• Severe lack of appetite
• Feeding and swallowing disorders or delays
• Severe food allergies
• When a child’s mouth, esophagus, or stomach does not form properly in the womb
• Conditions that cause a child to breathe in food when eating

What are the benefits of Pediatric Enteral Nutrition?

Enteral nutrition helps children who cannot eat enough food by mouth to stay healthy get the vitamins, protein and minerals they need. That way, they can grow up healthy and strong. This method of nutrition can help save lives.

What are the side effects of Pediatric Enteral Nutrition?

Possible side effects from your child’s enteral nutrition include nausea, vomiting, diarrhea, constipation, stomach cramps, and bloating. Contact your child’s doctor if they have any of the following:

• A temperature of 100.5°F (38.1°C) or higher
• Diarrhea for more than one day
• Tube dislodgement
• A clogged tube
• Redness around tube
• Yellow or green drainage around tube
• Vomiting formula

At Children’s Health, we will help educate you and your child on how to clean and care for their feeding tube properly so your child can avoid any problems with it.

What to expect with Pediatric Enteral Nutrition

Enteral nutrition requires placing a feeding tube in your child’s nose or abdomen. This procedure is very minor, but it’s important to know how to support your child before, during and after.

The tube through the nose is called a nasogastric tube. We can place a nasogastric tube without sedating your child. In fact, your GI team will teach you how to replace and change the nasogastric tube safely at home.

The tube is the abdomen is called a gastrostomy tube. Placing a gastrostomy tube requires surgery.

What to expect before Pediatric Enteral Nutrition

Before a surgical team places the feeding tube, your child’s care team will walk you through what their surgical preparation will look like. This includes what your child can eat and drink and what medications they can or cannot take, leading up to the day of the surgery.

Before the procedure, your child will go under anesthesia. Your child’s care team will also help walk you through that process ahead of time.

What to expect during Pediatric Enteral Nutrition

Our team uses four types of feeding tubes for enteral nutrition:

• Nasogastric (NG) tubes go into your child’s nose and down their throat so the formula can travel to your child’s stomach without them having to chew or swallow.
• Gastrostomy tubes (G-tubes) attach to your child’s abdomen to deliver food directly into your child’s stomach. Doctors fit your child with a G-tube during a minor surgical procedure.
• Jejunostomy tubes (J-tubes), like G-tubes, are placed onto your child’s abdomen. However, these tubes deliver food directly to the upper part of your child’s intestine, which is called the jejunum and is situated just beyond the stomach.
• Gastrojejunostomy tubes (GJ-tubes) are inserted into the stomach and have and opening that goes into the stomach and part of the small intestine called the jejunum. This allows medications and nutrients to be placed in either the stomach or the jejunum.

Placing G-tubes and J-tubes can also involve endoscopy, a procedure where a surgical team uses a narrow bendable tube with a built-in light and camera to place the feeding tube.

What to expect after Pediatric Enteral Nutrition

After our team inserts a tube for your child, we will give you and your family clear instructions on how to care for it. Your child’s doctor will also tell you what kind of tube feeding formula to use.

Our specially trained gastroenterologists, dietitians and wound ostomy nurses will develop your child’s individual feeding schedule and daily calorie intake. We always put children receiving enteral feeding on a schedule that best fits their individual needs.

How do I prepare my child for Pediatric Enteral Nutrition?

How can I support my child emotionally before having a feeding tube placed?

Children are often afraid of surgery. Our team is here to help keep your child at ease before, during, and after their feeding tube placement. You can help your child prepare for the procedure by talking them through the benefits of their new nutrition plan if they are old enough to understand. You can also assure them that they will have special medications to help them relax or even not remember the procedure.

What are the prep instructions for Pediatric Enteral Nutrition?

There are certain food and medication limitations that come with going under anesthesia. Your child’s care team will walk you through those. Your child’s care team will also give you specific preparation instructions tailored to your child’s treatment and overall health before you come in for the placement procedure.

What are the Child Life services for Pediatric Enteral Nutrition?

Our Child Life team educates families about G-tubes before their insertion. They aim to familiarize parents and children with the concept of G-tubes and enhance their comfort level. Child Life specialists also play a crucial role in supporting patients during their inpatient stay, even after the procedure.

What questions should I ask my provider about Pediatric Enteral Nutrition?

• Will my child need to spend the night at the hospital after having a feeding tube placed?
• Are there other treatment options for my child?
• What medications should my child stop taking before Pediatric Enteral Nutrition?
• How soon will I be able to see my child after they have their feeding tube placed?