What Is a Feeding Tube, and How Does It Work?

What Is Enteral Nutrition, Exactly?

Enteral nutrition is liquid nutrition that is delivered directly into the stomach or small intestine via a feeding tube. Enteral nutrition is recommended when a person cannot take in enough nutrition by mouth or if there is a medical problem involving the upper gastrointestinal tract. Even though you might not hear about it very often, enteral nutrition supports the needs of roughly 250,000 infants, children and adults seeking medical attention at a hospital, according to the American Society for Parenteral and Enteral Nutrition.

Enteral nutrition is used when a person:

• Has difficulty chewing or swallowing
• Recovering from surgery that interferes with eating, appetite or digestion
• Unconscious or in a coma
• Experiencing poor appetite or malnutrition
• Suffering from a digestive disorder or bowel obstruction

But enteral nutrition isn’t just for individuals who are hospitalized. More than 400,000 people living at home get their nutrition from a feeding tube. While some individuals may only require a feeding tube for a few weeks, others may need it for life.

How Does Enteral Nutrition Work?

When a person is unable to eat food by mouth, a tube-feeding formula can provide all the vitamins, minerals, protein, carbohydrates, fat and electrolytes the body needs, just like food. However, rather than entering the body through the mouth, this liquid nutrition is delivered directly to the digestive system through a feeding tube.

Feeding Tube Placement

A doctor can place a feeding tube as an inpatient or outpatient procedure. 

• Nasogastric tube placement does not require surgery. Nasogastric tubes are inserted by clinicians or caregivers who have been instructed on proper nasogastric tube placement.
  
  
• Nasoduodenal (or Nasojejunal) tubes are placed by a healthcare provider, and they do not require surgery. The physician will verify correct placement.
  
  
• Gastrostomy and jejunostomy tubes are put in by a doctor during surgery or at an outpatient clinic.

How Do I Choose an Enteral Nutrition Formula?

There are many different tube-feeding formulas to support all kinds of nutrition needs and health conditions. To help find the best formula for your unique requirements, your healthcare team will consider multiple factors, such as your:

• Age
• Body weight
• Health conditions or illnesses
• Type of feeding tube
• Ability to digest and absorb certain nutrients
• Special nutrition needs

What Types of Enteral Nutrition Formulas Are Available?

Most formulas are conveniently pre-packaged in ready-to-use cans or containers. But some are available in powder form to mix with water. Depending on your needs, your doctor will most likely recommend one of these three basic types of formulas:

• Standard formulas — Provide complete nutrition for people with healthy digestive systems.
  
  
• Semi-elemental formulas — Contain nutrients (such as protein or carbohydrates) that are broken down for easier digestion and absorption, making them ideal for people with digestive disorders.
  
  
• Specialized formulas — Designed for conditions requiring targeted nutrition such as diabetes, inflammatory bowel disease or kidney, liver or lung diseases. Based on a child’s nutritional needs, your doctor will assist you in selecting the right type of formula and method of delivery. Your doctor will specify how much formula to give for each feeding, and how many feedings are needed each day. To help you organize this information, here is a Tube-Feeding Nutrition Plan from our partners Abbott Nutrition Health Institute. 

Can I Make My Own Tube-Feeding Formula?

Recently, the use of homemade tube-feeding formulas made with blenderized whole foods has become popular.  Such formulas can provide some phytonutrients not found in standard commercial tube-feeding formulas.  However, they may not be nutritionally complete if poorly designed, according to an article in Today’s Dietitian.  Other potential problems include microbial contamination from inadequate food handling practices and increased viscosity, which can lead to clogging of feeding tubes.

Commercial formulas that incorporate real food ingredients, like PediaSure® Harvest™, provide complete nutrition and are a convenient alternative. Made with organic fruits and vegetables, PediaSure® Harvest™ combine the whole food goodness of a blenderized formula with the complete nutrition of a standard formula.

Getting the Support You Need

Living with a feeding tube is a big change, so allow time to adjust both physically and emotionally. Mealtimes, travel, socializing and even sleeping may all require different approaches.

It can be helpful to know that strategies and resources are available to help you cope, such as those provided by the Oley Foundation. The first key resource is your healthcare team. They can connect you with additional professionals, like registered dietitians and psychologists, who specialize in the challenges you may be facing.

But most importantly, don't be afraid to discuss what you're experiencing with your family and close friends, so that they can give you the support and encouragement you need.