If you work in a special education class or a day habilitation setting, more than likely you are teaching a student or an individual with complex needs including the use of a feeding tube.
February 8-12 is recognized as Feeding Tube Awareness Month which is a great opportunity to provide information on tube feeding in an educational setting. According to the Tube Feeding Awareness Foundation, there are over 300 conditions that require students and individuals to receive nutritional support through tube feeding.
What is a feeding tube?
A feeding tube is a device that is inserted in the stomach wall and goes directly into the stomach. It bypasses chewing and swallowing in a student or individual who no longer has the ability to safely eat or drink. This allows for students and individuals to receive adequate nutritional support.
A feeding tube is also used for students and adults who cannot take in enough food by mouth. Feeding tubes can be temporary or permanent .
Reasons to use a feeding tube
The student or individual may have a swallowing disorder or dysphasia. This means there is an increase risk for the student or individual to aspirate their foods or liquids into their lungs. Causes of swallowing problems include low-muscle tone, brain injury, genetic conditions, sensory issues, neurological conditions, cleft lip/palate and birth defects of the esophagus or stomach.
Types of Feeding Tubes
The gastrostomy tube (G tube) is placed through the skin into the stomach. The stomach and the skin usually heal in 5-7 days. This type of tube is generally used in people with developmental disabilities for long term feeding.
The nasogastric (NG tube) is inserted through the nose, into the swallowing tube and into the stomach. The NG tube is typically used in the hospital to drain fluid from the stomach for short term tube feeding.
Neurological and Genetic Conditions Requiring Tube Feeding
Some students and individuals with neurological and genetic conditions often require tube feeding due to gastrointestinal issues including constipation, reflux, and abnormal food-related behaviors. It For example, it is estimate that 11% of children with cerebral palsy use a feeding tube due to difficulty with eating, swallowing, and drinking.
The following are different types of neurological or genetic conditions that may require the use of a feeding tube.
Angelman Syndrome
Aspiration
CDKL5 Disorder
Dysphasia
Hydrocephalus
Microcephaly
PPD- Not Otherwise Specified
Trisomy 18
Spastic Diplegia
Traumatic Brain Injury
The following are articles on IEP and Accommodations:
IEP/Accommodations
Going to school with a feeding tube- http://www.tubefed.com
Accommodations and supports for children with pediatric feeding disorders- Kids First Collaborative
School-based accommodations and supports– Feeding Matters
Tube feeding at school: 8 tips to prepare your child and school staff– Shield Healthcare
Signs and Symptoms of Issues related to a g-tube
Complications due to tube feeding may include:
- constipation
- dehydration
- diarrhea
- infections
- nausea/vomiting
Aspiration
Aspiration can be caused by:
- reflux of stomach contents up into the throat
- weak cough, or gag reflux
- the feeding tube is not in place
- delayed stomach emptying
- The head is not raised properly.
Students should be observed for aspiration during feeding. The following are signs and symptoms of aspiration:
- Choking or coughing while feeding
- Stopping breathing while feeding
- Faster breathing while feeding
- Increased blood pressure, heart rate and decreased oxygen saturation.
The following are articles on signs and symptoms of aspiration during feeding
Life with Aspiration and a Feeding Tube
Pediatric Aspiration Syndromes