Nutrition Interventions for Children with Special Health Care Needs

Appendix n
Technical Aspects of enteral Feeding
(Tube Feeding)
Annette Pederson, MS, RD, CD
Types of Enteral Feeding
Appendix N
The types of enteral feedings, or tube feedings, are named according to the feeding
route used, the site where the feeding tube enters the body, and the point at which
the formula is delivered: nasogastric, nasoduodenal, nasojejunal, gastrostomy,
and jejunostomy. The decision as to which type of feeding to use is based on the
expected duration of tube feeding as well as physiologic and patient-related factors.
The types of tube feeding most commonly used are nasogastric and gastrostomy
feedings.
Nasogastric Tube Feeding
The nasogastric (NG) tube is a soft tube that runs through the nose and into the
stomach. Nasogastric feedings are typically used when tube feeding will be required
for a short time, i.e., less than three months, although in some cases it can be
used for several years. The major advantage of nasogastric, nasoduodenal, and
nasojejunal feedings is that unlike gastrostomy or jejunostomy feeding, placement
does not require surgery. Therefore, they can be started quickly and can be used
either for short periods or intermittently with relatively low risk of complication. If
the child is safe to feed orally, he can continue to practice feeding skills and improve
oral intake.
The disadvantages of NG feeding include nasal or esophageal irritation and
discomfort (especially if used long-term), increased mucus secretion, and partial
blockage of the nasal airways. Nasogastric feeding may contribute to recurrent otitis
media and sinusitis. Two additional disadvantages are the possibility that the tube
will perforate the esophagus or the stomach and the possibility that the tube will
enter the trachea, delivering formula into the lungs. If formula enters the lungs,
severe or fatal pneumonitis can result. Therefore, it is essential to confirm that the
NG tube is in the stomach before feeding begins (1,2,3).
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