Nutrition Interventions for Children with Special Health Care Needs

Chapter 10
Section 2 - Problem-Based Nutrition Interventions
enteral Feeding (tube Feeding)
Annette Pederson, MS, RD, CD
Enteral tube feeding is used for infants and children who have a functioning
gastrointestinal tract but are unable to meet their nutrition needs orally. Conditions
that may require enteral feeding are numerous:
• Gastrointestinal disorders, such as disorders of absorption, digestion, utilization,
secretion, and storage of nutrients; and including anatomic disruptions such as
tracheoesophageal fistula
• Inability to meet nutrition needs orally or safely by mouth, including
neuromuscular disorders, such as muscular dystrophy, spinal cord defects, and
cerebral palsy or damage to the central nervous system that can cause oralmotor
problems
• Increased energy/nutrition needs due to cardiopulmonary disorders and other
conditions, such as cystic fibrosis, burns, cancer, prematurity, chronic lung
disease, catch up growth, and failure to thrive
Enteral feeding can play a role in both short-term rehabilitation and long-term
nutrition management. The extent of its use ranges from supportive therapy, in
which the tube delivers a portion of the needed nutrients, to primary therapy, in
which the tube delivers all the necessary nutrients. Most children who receive tube
feedings can continue to receive oral feedings to fulfill the pleasurable and social
aspects of eating. All infants and young children require oral-motor stimulation for
developmental reasons.
Tube feeding benefits the child by improving growth and nutritional status and
frequently improves the primary condition. By ensuring that the child’s nutrient
needs are being met, tube feeding can free the family from anxiety and therefore
improve quality of life. Additional benefits can include improved hydration, improved
bowel function, and consistent medication dosage. Tube feeding is an important
therapy for the child who cannot orally feed safely and needs to be fed by enteral
tube to protect his airways and prevent or decrease the risk of aspiration. Tube
feeding is a safer and less expensive alternative to oral feeding than total parental
nutrition (1).
There are disadvantages to enteral feedings. If a child has gastroesophageal
reflux, aggressive enteral feeding may increase his risk of aspiration or vomiting.
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