Question

Read from chapters 36 to 39 from your Textbook

II. Read chapter 39 and write a summary about alternative feeding techniques that may be used when food and fluids are withheld (NPO) from a child.

III. Review the conditions that necessitate nasogastric gavage, gastrostomy, nasoduodenal, or nasojejunal tube feedings.

IV. Guidelines for Nasogastric Tube feedings in children

Answer 1

1. ALTERNATIVE FEEDING TECHNIQUES FOR A CHILD WHEN NPO

• Nasogastric tube feeding: starts in the nose & ends in stomach
• Orogastric tube: starts in mouth and ends in stomach
• Nasoenteric tube: starts in the nose and ends in the intestine (subtypes are Nasojejunal & Nasoduodenal tubes)
• Oroenteric tube: starts in the mouth & ends in the intestine
• Gastrostomy: tube is placed through the skin of the abdomen straight to the stomach( types include PEG, PRG, & BUTTON TYPES)
• Jejunostomy tube: placed through the skin of the abdomen straight into the intestines (subtypes include PEJ & PRJ tubes)

2. Indications for nasogastric gavage

• Ill child who cannot take food orally
• Premature infant who is unable to suck or swallow
• Difficulty in swallowing
• Respiratory distress
• Severe malnutrition
• Unconsciousness
• Small bowel obstruction
• Intractable nausea or emesis

Indications for gastrostomy

• neurological swallowing disorders like cerebral palsy, multiple sclerosis
• Esophageal structure or atresia
• Esophageal cancer
• Gastric outlet or small bowel obstruction
• Major neck surgery
• Any condition which requires prolonged tube feeding

​​​​​​​Indications for Nasoduodenal/ Nasojejunal feeding

• Inadequate gastric motility or intolerance( gastroparesis, delayed gastric emptying)
• Partial gastric outlet obstruction
• Severe aspiration risk
• Esophageal reflux- coma lying flat
• After upper GI surgery