Dalal Alkhamees
Pediatric Dietitian
Ministry of Health, Al-Amiri Hospital
When does your baby need tube feeding?
- Weight Problems: Baby is not gaining weight, and not having proper growth as babies in his age.
- Unable to take nutrition requirement orally (by mouth): Having difficulty in oral feeding, such as chocking, aspiration (food enters the lungs), which may lead to serious infections, and difficulty in swallowing.
- Digestive System Problems: The digestive system is unable to digest or absorb nutrients, which can lead to huge nutrient losses.
- Increased nutritional Requirements: Burns, heart diseases, etc.
Goals from Tube Feeding Support
- Nutrition requirements (calories, protein, fat, vitamins, minerals and water).
- Optimal growth
- Minimize digestive system symptoms.
What is Enteral feeding?
Providing optimal nutrition by feeding through the tube directly into the stomach or duodenum (the first part of the small intestine) or jejunum (the part below the duodenum) or by stoma, which is an opening in the abdomen that is attached to the digestive system.
Patients with cleft lip or cleft palate have no specific guidelines on tube feeding; as they are treated the same as other patients.
A different feeding route is personalized for each baby. Depending on his case, it is either through a tube from the mouth to the digestive system, or from the nose to the digestive system or via stoma, an opening through the abdomen directly to the digestive system.
Starting plan
Step 1: After the physician, the speech and swallowing therapist, and the dietitian make a decision to use enteral feeding for the baby, the feeding route is decided according to each patient’s case in a personal manner.
Step 2: It is the dietitian’s role to calculate the baby’s nutrition requirements (calories, fat, carbohydrate, protein and water) individually according to the patient’s age, symptoms, and needs.
Step 3: The Dietitian chooses the appropriate supplement formula for the baby.
Step 4: Design the feeding and holding hours, it is either through:
a) Feeding by the pump machine.
b) Bolus feeding by syringe.
c) Cycles, feeding either by syringe or pump machine.
Types of formula
- High-Calorie Formula - Pediasure, Nutrini, Infatrini, Similac High Energy, etc.
- Cow Milk Allergy - Nucate, Elecare, Novalac Allernova, etc.
- Digestive Problems - Modulen, Pediasure Peptide, peptamen etc.
- Kidney Problems - Renastart, etc.
- Liver Problems: Heparon Junior, etc.
- Epilepsy: KetoCal
- Metabolic Problems: Galactomin, Monogen, etc.
It is very common that mothers get worried regarding having a tube inserted inside their children’s bodies, however, the medical team wants to assure the safety of the baby. In such cases, the short-term benefits outweigh the long-term consequences.
It may be scary at the beginning, but once the mother had learned how to feed the baby before discharge, it will get easier and more comfortable.
References
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