Tube feeding is a complex topic that is often depicted by untruths or misnomers. Below, Karen Dilfer, MS, OTR/L, and AZ+A Feeding Specialist, explores the truths about feeding tubes, hunger, and the journey toward a healthy connection with food.
Truth: Feeding tubes are necessary for many children. Sometimes a child needs a feeding tube to survive.
→ Tube Feeding can be important/necessary for certain kids at certain times.
→ It is okay (and even good!) for a child to have a feeding tube
→ We need to remember why a child has a tube and why it is important
While no parent ever wants their child to have a feeding tube, a feeding tube may help them remain safe while they heal and grow. Also, no family expects that their child will have a feeding tube, but a feeding tube can be a useful tool that helps a child receive hydration and nutrition during an illness or medical procedure. Feeding tubes give children time to grow and heal.
Appetite Truth: If a child is fed through a tube, there is a good chance that the child will not want to eat by mouth.
This is a good thing.
→ It means that when a child is receiving nutrition via tube, they are nourished, and their body is satiated.
→ Parents don’t need to worry if their child is not interested in eating by mouth while they are tube-fed.
→ Parents do not need to “get their child to eat” while they are tube-fed.
Children who are tube-fed receive their nutrition straight to their stomachs. It makes sense that a child does not want to eat by mouth because the child is not hungry.
Eating is an internally motivated activity – if a child is not hungry, most likely, that child will not want to eat a quantity of food. This is a GOOD thing in most cases. When children eat in response to hunger, they learn to regulate their energy intake. We know that eating in response to hunger is how children begin to create a healthy relationship with food.
Hunger/Hunger Induction Truth: A child who has been tube fed can learn to eat by mouth.
Often, hunger is the key factor that helps a child learn to eat by mouth. When a child feels hungry, this provides the internal motivation that the child needs to see themselves as an eater. It may take many days to respond to hunger.
→ We need to help a child learn their body’s internal signals and feel the hunger in a way that makes sense to their body, without it being too overwhelming for the child.
→ A tube-fed child will probably not respond to hunger by eating by mouth right away (at least initially).
When a child’s team begins to reduce the number of calories through that child’s tube, it may take a number of days for that child to begin to understand and respond to the sensation of hunger.
During this time, we can support children emotionally and respond to their verbal and non-verbal communication by honoring it and responding in a supportive manner.
When a child begins to experience the process of hunger induction, a child may start to show interest in mouthing their fingers or toys or foods. Some children become very happy or very cranky (hangry!) when they begin to experience hunger.
Feeding Tube and Vomiting Truth: Children with feeding tubes should not vomit.
→ A feeding tube supports growth and helps a child remain safe while not swallowing or eating by mouth.
Vomiting is a traumatic experience that can cause long-term pain and create a feeding aversion. Tube-fed children should feel good. A feeding tube should support a child’s growth and help them have the energy they need to thrive. If a child is constantly vomiting, that child is learning that tube feeding does not feel good, and they will learn that they do not want to put food into their mouth or eat.