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Benefits of Tube Feeding for Chronic Kidney Disease

Some children with CKD may struggle to eat or drink enough for appropriate growth and development. Tube feeding can be a positive step towards making sure a child gets the nutrition and fluids they need.

Tube feeding can help to reduce the pressure on parents or caregivers. If a child is struggling to meet their nutrition needs, it can be reassuring to know they can supplement their diet with formula when needed. The feeding tube can be used in the short- or long-term. The medical team, especially the dietitian, is there to provide support and education about tube feeding.

Types of tubes

There are two main types of feeding tubes: a nasogastric tube (NG tube) or a gastrostomy (G-tube for short). The medical team will advise on which is preferable.

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    Nasogastric tubes

    Nasogastric tubes are normally for short-term use. They are long, thin tubes that are placed through the nose down the throat, and then into the stomach. A liquid formula is then given down the tube into the stomach. Healthcare workers, such as nurses, are trained to place the tubes and sometimes parents, guardians, or even older children are trained to insert them themselves. They can be placed in the hospital or at home and can easily be removed.

    Young boy with nasogastric tube

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    Gastrostomy

    If a child is more likely to need a feeding tube for a longer time, a G-tube may be considered. The child will need to come into the hospital for either an overnight or day procedure. The G-tube is inserted through a small hole in the skin of the tummy into the stomach. There are many different types of G-tubes; some are held in place by a soft plastic disc and others by a small balloon filled with water. The medical team will advise on which is best suited to each child.

    Young boy with a gastrostomy (G-tube)

Tube feeding methods

There are two main ways to deliver formula using a tube: bolus or pump feeding. In some cases, both may be used. The healthcare team will provide
training on feeding tube management and care.

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  • Bolus feeding

    Bolus feedings are given at regular times during the day. Usually, a syringe containing the formula is connected to the feeding tube and the formula flows in using gravity. The formula is given over a short period of time with a flush of water before and after the feeding. For an infant, this could mean 6-8 feedings a day in a similar pattern to regular oral feeding. For an older child the boluses could be given 5-6 times a day, in a similar pattern to mealtimes with snacks in between. One advantage of bolus feeding is that a child can eat and drink as much as he or she wants or is able to, and their remaining nutrition can be given using the tube. The tube feeding plan is designed to mimic a normal feeding pattern which helps the child make the connection between feeling hungry and then full. This means that the child may be more likely to be interested in eating and drinking when they start to eat by mouth again.

    Bolus feeds

  • Pump feeding

    The tube is connected to a feeding pump, and the formula is given over a longer time at a slower rate. The feeding pump can be set to give a certain amount of formula per hour. This method of feeding can be especially helpful if a child is feeling sick as the feeding can be slowed down to help improve symptoms. Sometimes if a child is eating during the day, but they are not able to eat enough, the feeding tube can be used to give extra nutrition overnight.

    Pump feeds

Types of formulas

There are many different types of formulas that can be given through a feeding tube. The formula or combination of formulas chosen by the healthcare team will depend on the child's unique nutrition needs based on age and other medical considerations. The formula can be a combination of products that are either a powder or a liquid. Human milk can also be given through a feeding tube. The dietitian will develop a personalized feeding plan to meet the nutrition needs of each child and the unique circumstances for each family.

Additional Benefits of Feeding Tubes

Children with CKD may need additional fluid or medicines they may struggle to take by mouth. Having a tube makes it easier to give extra fluid when needed. Liquid medicines can be given through the tube, so the child doesn't have to taste them.

Summary

Although tube feeding may seem overwhelming, it can be very helpful to support a child's growth and development. Regular contact with the dietitian is key to successful tube feeding in CKD.

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The content on this website is for educational purposes only and should not be considered to be medical advice. It is not intended to replace the advice of your healthcare team. Consult your healthcare team to determine which products are appropriate before making any changes to your diet.

 

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