People with feeding tubes are often limited in what they can eat or drink by mouth. However, some foods and liquids may be allowed depending on the type of feeding tube and medical condition. In general, people with feeding tubes can consume some foods and liquids by mouth for pleasure and nutritional benefit.
Can You Eat By Mouth with a Feeding Tube?
Many people with feeding tubes can still eat and drink by mouth to some extent. However, it is important to follow the recommendations of your doctor and dietitian. In some cases, eating and drinking by mouth may need to be avoided completely if there is a risk of aspiration.
Some general guidelines on eating and drinking with a feeding tube include:
- Only consume foods and liquids that are thin and easy to swallow. Thick, dry, crunchy or stringy foods should be avoided.
- Take small bites and sips and swallow carefully.
- Sit upright while eating and for at least 30 minutes after.
- Avoid using straws as they can increase swallowing air and the risk of bloating.
- Stop eating or drinking immediately if you experience coughing, choking or gurgly breathing after swallowing.
Some types of feeding tubes like nasogastric tubes may restrict oral intake more than gastrostomy tubes. Check with your medical team about any diet restrictions or precautions.
What Foods are Recommended with a Feeding Tube?
Certain foods are usually better tolerated than others for people with feeding tubes:
- Liquids: Water, juice, nectars, thin soup, milk, nutritional supplements.
- Pureed foods: Pureed fruits and vegetables, mashed potatoes, smooth yogurt, pureed meats.
- Soft, moist foods: Scrambled eggs, oatmeal, pudding, applesauce, cottage cheese.
Thinner liquids are often recommended over thicker liquids as they present less risk of aspiration. Room temperature or cooler foods may be better tolerated than hot foods.
Foods to Avoid or Limit with a Feeding Tube
Certain foods should typically be avoided or limited with a feeding tube:
- Crunchy foods: chips, nuts, raw veggies.
- Bread, rice, pasta.
- Tough, fibrous meats.
- Sticky or gummy foods: peanut butter, chewing gum.
- Fried or greasy foods.
- Spicy, highly seasoned foods.
- Carbonated drinks.
- Alcohol.
These foods can be difficult to swallow, increase risk of aspiration, or cause abdominal discomfort. Your doctor may approve some of these foods in moderation if swallowing function is adequate.
Oral Hygiene with a Feeding Tube
Even if you are not eating and drinking much by mouth, oral hygiene is still important when you have a feeding tube. To keep your mouth clean and healthy:
- Brush teeth at least twice daily using a soft toothbrush.
- Rinse mouth after meals and at bedtime with water.
- Use alcohol-free mouthwash to help freshen breath.
- Apply lip balm to prevent dry, cracked lips.
- Have regular dental checkups.
Good oral care helps prevent dental decay and gum disease, even if you have limited oral intake.
Reasons to Continue Eating and Drinking by Mouth
Though feeding tubes provide nutrition, continuing to eat and drink by mouth offers benefits like:
- Preventing swallowing problems: Keeping up swallowing helps maintain strength and range of motion in swallowing muscles.
- Oral stimulation: Taste and texture in the mouth provides sensory stimulation and enjoyment.
- Quality of life: Eating some foods you enjoy makes meals more pleasant.
- Socialization: Sharing a meal remains an opportunity for social interaction.
For these reasons, doctors usually encourage eating and drinking by mouth if it can be done safely. Some trial and error with different food textures may be needed to find items you tolerate well.
Potential Risks of Oral Intake with Feeding Tubes
While oral eating and drinking can have benefits, it also carries some risks including:
- Aspiration: Food or liquid enters the airway when swallowing problems exist.
- Infection: Oral bacteria enters the lungs via aspiration.
- Dehydration: Inadequate fluid intake if drinking is limited.
- Malnutrition: Not meeting all nutritional needs if oral intake is lacking.
- Tube blockage: Oral medications or thick liquids may clog the feeding tube.
To reduce risks, follow recommendations on restricted food textures, proper swallowing techniques, oral hygiene, and limiting high-risk foods and liquids.
Supplementing Foods for Increased Calories and Nutrition
People with feeding tubes often need concentrated sources of calories and nutrition. Some ways to supplement oral foods and liquids include:
- Adding butter, oil, cream or gravy to foods.
- Mixing in protein powder, grated cheese, or powdered milk.
- Blending in avocado, nut butters, or nutritional supplement drinks.
- Using full-fat dairy products like whole milk, yogurt, and ice cream.
Tube feeding formulas can also be used as oral supplements. Work with a dietitian to determine the best way to meet increased calorie and protein needs.
Incorporating Taste, Texture, and Socialization
Eating by mouth should involve more than just calories and nutrition. Meals provide enjoyment through tastes, textures, and social engagement. Some tips include:
- Focus on favorite flavors and seasonings.
- Vary temperatures: room temp, cool, warm.
- Try smoothies and shakes for different mouthfeels.
- Use dips and sauces to moisten foods.
- Share mealtimes with family when possible.
- Have meals in different settings: dining table, outdoors.
Do not force eating if overly fatigued. But make oral intake a pleasurable, engaging experience when able.
Sample Menu for a Feeding Tube Diet
Here is a sample one-day menu with feeding tube and oral intake:
| Time | Oral Foods and Liquids | Tube Feeding |
|---|---|---|
| Breakfast | 1⁄2 cup pureed fruit, thinning liquid | 200 mL formula |
| Mid-morning Snack | Nutritional supplement drink | |
| Lunch | 1⁄4 cup mashed potatoes, 2 oz pureed meat, thinned gravy | 200 mL formula |
| Afternoon Snack | 1⁄2 cup pudding | |
| Dinner | 2-3 oz soft fish, mashed carrots, thinning liquid | 200 mL formula |
| Evening Snack | 1⁄2 cup applesauce |
This provides nutrients from both tube feedings and a variety of soft, pureed oral foods and liquids.
Working with Your Healthcare Team
A healthcare team can help optimize your feeding tube diet:
- Doctor: Assesses swallowing function and approves oral foods.
- Dietitian: Recommends foods, meal plans, and nutritional supplements.
- Speech therapist: Evaluates swallowing safety and techniques.
- Nurse: Provides education on administering tube feeds.
- Dentist: Monitors oral health and hygiene.
Talk to your providers regularly about any changes needed to your oral diet or tube feeding regimen.
Frequently Asked Questions
Can I drink carbonated beverages with a feeding tube?
Carbonated drinks are generally discouraged as the air bubbles can increase risk of belching, bloating, and aspiration. Check with your medical team whether an occasional small amount may be tolerated.
What happens if food goes down the wrong pipe?
If you start coughing, gagging or experience breathing changes after swallowing, stop eating or drinking immediately. Try to remain upright and calm until the episode resolves. Seek medical care if symptoms persist as food/liquid may have entered the airway.
Can I eat and drink anything if I have a PEG tube?
No, oral intake should still be limited based on your swallowing ability, risk of aspiration, and other medical factors. A gastroenterologist and dietitian can advise on PEG tube diets.
Do I have to eat by mouth if I don’t want to?
Oral eating is highly recommended if medically appropriate, but cannot be forced. Discuss your concerns about safety, fatigue, enjoyment or other factors with your healthcare team.
How do I brush my teeth if I can’t eat or drink?
Good oral hygiene is still important. Use a soft brush and gently brush teeth, gums, tongue and roof of mouth twice a day. Moisten brush with water if needed.
Conclusion
Having a feeding tube does not necessarily prohibit oral intake. With some adaptations and precautions, many foods and liquids can be included for enjoyment and nutritional benefit. Work closely with healthcare providers to determine the optimal diet and oral routine based on your unique situation.
