A feeding tube is a medical device used to provide nutrition to people who cannot eat enough food by mouth. Feeding tubes allow liquid nutrition to be delivered directly into the stomach, the first part of the small intestine (duodenum) or the second part of the small intestine (jejunum).
Why would someone need a feeding tube?
There are many reasons why someone may require a feeding tube, including:
- Difficulty swallowing (dysphagia) due to stroke, neurological disorders, head/neck cancer
- Poor appetite, inability to eat enough to stay nourished due to chronic disease, cancer treatment side effects
- Abdominal obstruction or gut dysfunction preventing proper digestion and absorption of food
- Very limited ability to move or eat by mouth due to injury/illness
- Need for supplemental nutrition while recovering from major surgery affecting the digestive tract
Feeding tubes allow liquid nutritional formulas and medications to bypass mouth and upper digestive issues to provide sustenance and maintain weight when normal eating is not feasible.
What types of feeding tubes are used?
There are several different types of feeding tubes:
- Nasogastric tube (NG tube) – inserted through the nose, down the esophagus into the stomach. Used for short-term feeding needs.
- Nasojejunal tube (NJ tube) – inserted through nose into the jejunum. Used for feeding intolerance issues.
- Gastrostomy tube (G tube) – inserted surgically through the abdomen into the stomach. For longer term use.
- Jejunostomy tube (J tube) – surgically inserted into the jejunum. For feeding problems.
What kinds of feeding tube formulas are used?
There are many commercial formulas made specifically for feeding tubes. The most common types include:
- Polymeric formulas – contain intact proteins, carbohydrates and fats. Examples are Nutren 1.0 and Jevity.
- Modular formulas – made of individual nutrient components that can be adjusted. Examples are Addition Peptamen.
- Elemental formulas – contain proteins broken down into amino acids, basic sugars, and fats. Easier to digest. Examples include Vivonex Plus.
- Semi-elemental formulas – contain partially broken down proteins and simpler nutrient forms. Examples are EleCare and Neocate.
- Specialty formulas – for specific conditions like kidney disease or diabetes. Examples are Glucerna and Nepro.
The type of feeding tube formula used depends on the person’s individual digestive and nutritional needs.
How are feeding tube formulas administered?
Feeding tube formulas are administered using an enteral feeding pump or gravity/bolus feeding:
- Enteral feeding pumps – Formulas are delivered in measured amounts over a period of time from a bag through the feeding tube via an electronic pump that controls the rate.
- Gravity/bolus feeding – Formula is administered into the feeding tube from a syringe in specific amounts spaced throughout the day. Gravity helps move the formula through the tube.
Pumps allow better control over feed rates and amounts. Bolus feeding allows more mobility but requires periodically connecting syringes to the feeding tube.
What kinds of food can be given through a feeding tube?
Liquid versions of many foods can be administered through a feeding tube, including:
- Water – Important to stay hydrated.
- Fruit juices – Apple, cranberry, grape, pear nectars provide hydration, nutrition.
- Vegetable juices – Tomato, carrot, green juice blends add vitamins.
- Broths – Chicken, beef and vegetable broths for hydration, minerals.
- Thinned hot cereals – Oatmeal, cream of wheat and rice cereals provide carbs, protein.
- Thinned yogurt – For protein, probiotics. Greek yogurt is thick, may need thinning with milk.
- Pureed fruits and vegetables – Well cooked carrots, peas, pears, apples, prunes.
- Pureed proteins – Blenderized meats, cooked beans, lentils, tofu.
- Smoothies – Dairy, fruits, yogurt, protein powder combinations.
- Water-based puddings – Chocolate, tapioca, vanilla pudding.
- Milkshakes – Blended milk, ice cream, yogurt, fruit.
Most solids need to be fully pureed, strained or thinned to the consistency of a thick liquid before they can be safely given through a feeding tube. Pieces could clog the tube.
Are there any restrictions on what can be fed through a tube?
There are some limitations on what kinds of food can be given through a feeding tube:
- No thin liquids like plain water, coffee, tea, soda – risk of dumping syndrome
- No chunky solids or pieces – can clog tube
- No sharp, crunchy foods – could damage tube
- No extremely hot or cold foods – could irritate digestive tract
- No raw eggs, meat, fish – increased infection risk
- No excess added sugar, fat – may cause GI issues
Foods and liquids must be fully blended smooth. Speak with your dietitian about any potential feeding tube diet restrictions based on individual tolerances.
Should dietary needs be tailored for feeding tubes?
Feeding tube diets should be carefully tailored to meet the individual’s nutritional needs, which may include:
- Adequate protein for wound healing if recovering from surgery
- Extra calories if underweight
- Reduced calories if obese
- Appropriate vitamins and minerals
- Sufficient fiber and fluids for bowel regularity
- Controlled carbs for diabetes
- Low electrolytes for kidney disorders
- Soft or low-fiber foods if intestinal issues
A doctor and registered dietitian will determine an appropriate formula and blends of foods to create feeding tube meals that provide balanced nutrition within restrictions of the underlying condition.
What are some sample feeding tube meal plans?
Here are some sample full day feeding tube meal plans:
Sample Meal Plan 1
| Breakfast | 1 cup pureed oatmeal with 1 tbsp brown sugar, 1 tsp butter, 1⁄4 cup whole milk |
| Morning Snack | 1⁄2 cup Greek yogurt blended with 1⁄4 cup apple juice |
| Lunch | 1⁄2 cup pureed lentil soup, 1⁄4 cup pureed carrots, 2 tbsp pureed chicken, 1⁄4 cup applesauce |
| Afternoon Snack | 1⁄4 cup vanilla pudding, 1⁄4 cup pear nectar |
| Dinner | 1⁄4 cup pureed beef, 1⁄4 mashed potatoes, 1⁄4 cup green beans, 1⁄4 cup water |
| Evening Snack | 1⁄2 cup milkshake with 1 scoop ice cream, 1⁄2 cup milk, 1⁄4 cup yogurt, 1⁄4 cup fruit |
Sample Meal Plan 2
| Breakfast | 1 cup blended oats, almond milk, banana, peanut butter |
| Morning Snack | 1⁄2 cup tomato juice |
| Lunch | 1⁄2 cup blended split pea soup, 1⁄4 cup pureed chicken, 1 tbsp olive oil, 1⁄4 cup applesauce |
| Afternoon Snack | 1⁄4 cup pudding, 1⁄4 cup cranberry juice |
| Dinner | 1⁄4 cup pureed tofu, 1⁄4 cup mashed sweet potato, 1⁄4 cup pureed spinach, 1⁄4 cup water |
| Evening Snack | 1⁄2 cup fruit smoothie with yogurt and milk |
Meal plans can be adjusted for individual nutritional needs and tolerances. Warm puréed foods may be better tolerated than cold in some cases.
What food precautions should be taken with feeding tubes?
Certain precautions should be followed when eating with a feeding tube:
- Strict handwashing and cleanliness to avoid infection
- Careful measuring and portioning of ingredients
- Thorough blending and straining to remove any chunks
- Checking food temperatures – not too hot or cold
- Proper storage and heating of food to minimize bacterial growth
- Flush tubes with water before and after feeding
- Watch for changes in bowel habits as potential warning signs
- Stay upright for 30-60 minutes after feeding
Follow all feeding tube diet instructions from your medical team. Monitor for any signs of complications and contact your doctor if concerns arise.
What are some common feeding tube diet tips?
Here are some helpful tips for eating with a feeding tube:
- Work closely with a dietitian to create a nutritious plan
- Keep variety in the diet with diverse flavors, colors, textures
- Focus on high protein foods for wound healing
- Stay hydrated – incorporate liquids throughout the day
- Add healthy fats like olive oil to prevent weight loss
- Consider homemade blends in addition to commercial formulas
- Divide daily calories into evenly spaced small “meals”
- Avoid adding too much sugar, salt, or fat all at once
- Incorporate digestive enzymes or probiotic foods if needed
- Make food the appropriate consistency – not too thick or thin
Eating through a feeding tube can still be an enjoyable experience with careful meal planning and awareness of proper feeding tube nutrition.
Conclusion
Feeding tubes allow nutrition, hydration and medications to be provided to those unable to take enough in orally. With some adaptations, many foods can be part of a feeding tube diet. Following safety precautions and working with healthcare providers to tailor dietary plans to individual needs is important. Creativity and flexibility when preparing feeding tube meals can help maintain quality of life.
