Pediatric surgeons at MU Health Care are experts in placing and managing feeding tubes in infants and adolescents. Learn more about our weekly Gastrostomy and Feeding Access Program and services.

Sometimes medical or surgical problems prevent children from being able to eat and drink the nutrition they need to grow. At Children’s Hospital, our team of pediatric surgeons are experts in placing and managing gastrostomy and feeding access tubes. Most commonly, these tubes bypass the mouth, delivering carefully formulated nutrients directly to the stomach. This form of therapy, also called enteral nutrition, helps your child maintain or gain weight while in the hospital or recovering at home.

Every Tuesday, our feeding tube services are coordinated in a weekly Gastrostomy and Feeding Access Program that is dedicated to long-term care of feeding access treatments. The clinic setting allows you to meet with every member of our team and helps many expertly trained providers make informed recommendations on your child’s personalized plan.

Types of feeding tubes

All feeding tubes are made of thin, flexible silicon, although there are different types of feeding access, surgically placed into the stomach, the small intestine, or both, depending on your child’s needs. These tubes will not interfere with your child’s usual daily activities. They can still play, bathe and be a kid, even with a feeding access tube.

Gastrostomy Tube (G-tube): A G-tube is inserted through the abdomen directly into the stomach to help give your child the calories, fluids, and medications they need if they are not able to take them by mouth. We change G-tubes in our clinic and will also show you how to change them at home.

Jejunostomy Tube (J-tube): A J-tube is inserted through the abdomen directly into the small intestine (jejunum) to help give your child the calories, fluids and medications they need if they are not able to take them by mouth. Jejunostomy tubes are used in certain patients who have difficulty breaking down food normally in the stomach. Your team will help you understand the differences and explain our recommendation.

Gastrostomy-Jejunostomy Tube (GJ-tube): A GJ-tube is inserted through the abdomen with a single hub which divides into two separate tubes once inside the body. One tube goes directly into the stomach (the G-tube), which can be used for venting to release excess air or for feeding, depending on your child’s needs. The other tube goes into the small intestine, or jejunum (the J-tube), which is used primarily for feeding your child.

Follow-up care

We tend to see patients every three months unless otherwise indicated. At our visits, we will monitor and answer any questions about all the following:

• Skin assessments: We check and treat redness, rashes, infection, breakdown and granulation tissue.
• Tube fit assessments: We check the tube’s fit to prevent leaking, skin rashes, granulation tissue and discomfort. If needed, we will change the size of the G-tube and modify the home health orders.
• Growth and nutritional assessments: We assess growth and nutrition to make sure your child is growing appropriately and getting the nutrients they need to be healthy. We also look for feeding intolerances that could be avoided or treated. We will work with your child’s pediatrician and dietitian regarding growth and nutritional needs.
• Use of the tube and ability to graduate from the tube: We assess your child’s use of the tube and work toward treatment plans that will help your child ultimately graduate from the tube when possible.
• Education: One of our goals at each visit is to make sure you are comfortable with your child’s tube care and feedings. Things can change over time for each patient, so new questions may come up. We are here to help and to answer any questions you have along the way.
• Supplies: As part of your visits, we will coordinate with your medical supply company, sending orders to make sure you have the supplies you need at home including G-tubes, syringes and even formula.

Our team

Our team includes several team members who you may see during your visit, including our pediatric surgeons, pediatric nurse practitioner, team nurse and ostomy management specialist, and a dietitian. You may also see resident physicians during your visit along with our team. A child life specialist can also be available during the visit if needed to help your child feel more comfortable.

Pediatric Surgeon/Nurse Practitioner: These specialists will take a thorough history of your child’s condition since the last hospital or clinic visit and examine your child. They will also coordinate with other specialists and providers and consider recommendations made by other team members to make sure your child gets the best care possible.

Gastrostomy Tube/Wound Care Nurse: The gastrostomy tube nurse will help assess the size and fit of the G-tube, the skin around the tube, and will make sure you have all the supplies you need, coordinating with your medical equipment supplier. This nurse will also help with education about how to care for the tube at home.

Registered Dietitian: The registered dietitian is specially trained to assess nutritional needs and provide individualized care for our patients. During the clinic visits, the dietitian will assess your child’s growth and nutritional status, as well as feeding tolerance, and will adjust the feeding regimen based on these assessments and our recommendations.

Child Life Specialist: Specially trained Child Life Specialists help children feel comfortable in the hospital and let kids be kids, even when they are sick or injured. We can arrange for them to be in the clinic to help support your child during procedures by teaching coping strategies and using distraction techniques. These strategies include blowing bubbles, holding hands, relaxation, and imagery. Child Life specialists can be with children during procedures to focus on their emotional needs.