Tube Feeding

Whilst your baby is receiving neonatal care they may be fed using a tube in their nose or mouth.

On this page you can find information about tube feeding. For specific information about your baby please speak to a member of the nursing or medical team caring for your baby. 

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What is tube feeding?

 

Tube feeding is when breast milk or formula milk is given through a small tube that is passed through your baby's nose or mouth into their stomach. Types of tube feeding include:

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• Nasogastric tube feeding (also called an NG tube) - This is when a small soft tube is placed in the nose and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.

• Orogastric tube feeding - This is when a small soft tube is placed in the mouth and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.

 

Babies who are very premature or sick may need to be fed using parenteral nutrition (PN) at first.

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Why does my baby need to be fed using tube feeding?

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Feeding from the breast or bottle requires energy, strength and coordination. Babies that are born too early, too small or too sick at birth have a lower supply of energy and nutrients than those born at term and well at birth, it is therefore important that these babies are able to have small but frequent nutritional feeds in a way that doesn't impact their energy levels.

Preterm babies often can't coordinate sucking, swallowing and breathing until they reach 32 to 34 weeks' gestation. This will vary in all babies, some baby's may learn to coordinate sooner and others may take longer. Tube feeding will allow your baby to get some or all of their feeds in to their stomach in a safe way.

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Certain medical conditions can also mean your baby requires tube feeding for a period of time, for example:

• Birth defects that affect baby's mouth, jaw, throat, stomach, or intestines​

• Cardiac and lung conditions that cause extreme fatigue

• Post-operative feeding support

• Severe gastroesophageal reflux (GERD)

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How is a feeding tube placed?

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A feeding tube is gently placed through the nose or mouth into the stomach. The tube is then checked for the correct position by drawing back a small amount of stomach contents to check for an acidic pH reaction (you would only find this in the stomach). Sometimes an X-ray may be required to confirm the position.

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Can I be involved in caring for my baby if they are being tube fed?

 

Yes, the staff on the neonatal unit would like you to be involved as possible in the care of your baby. Staff can teach you how to give your baby tube feeds and can teach you how to:

• Check the tube is in the correct position before feeding

• Prepare the milk and fill the syringe that is connected to the feeding tube

• Position your baby correctly for tube feeds

• Give the milk slowly to support comfortable digestion

• Know what to look for during a feed.

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This can feel quite scary at first, but with practice you should gain confidence. If your baby is well enough to come out of the incubator, you and your partner can also have skin-to-skin contact with your baby during tube feeding. Skin-to-skin contact has lots of benefits for you and your baby, and helps parents to feel closer to their baby and more confident in caring for them.

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When can my baby stop tube feeding?

 

In time, you may notice your baby demonstrating feeding cues during a tube feed. For example, they may open and close their mouth, put out their tongue or suck their fingers during a tube feed. This shows that they might be ready to practice breastfeeding or bottle feeding.

If you are planning to breastfeed and your baby is well enough to come out of the incubator, giving them lots of opportunities to be close to the breast may help them to learn to breastfeed. During a tube feed may be a good time to do this. When they are more mature and interested enough, some babies will start licking milk and in time practice sucking. As your baby starts to take more breast and bottle feeds, they will not need as many top-ups of milk from the feeding tube. This will depend on your baby’s energy levels and their ability to coordinate sucking, swallowing and breathing.

Some parents have concerns about their baby changing from tube feeding to breastfeeding, as it is more difficult to measure how much milk their baby is having. Your baby will show signs that they are receiving enough milk, such as feeding cues and wet and dirty nappies. The healthcare team supporting you will monitor your baby’s feeding and will manage any top-ups that might be needed. Talk to a member of staff on your unit if you have any concerns.

 

 

 

What will happen if my baby needs to go home from the neonatal unit with a feeding tube?

 

 

If your baby is going home with a feeding tube, a member of unit staff will show you how to feed and care for the tube yourself. It may be you or your community neonatal nurse who will replace the tube when you go home. This will depend on your baby’s needs, your preferences, and the support the unit provides.

Support will always be available if you do not feel comfortable with replacing the tube yourself. If you have any questions or concerns, talk to the unit staff.