Tube Feeding Baby

Tube Feeding Baby

Tube Feeding Baby

Feeding tubes can be a lifesaver for babies who have trouble swallowing food or liquid safely. Learn more about the different types of feeding tube and reasons why some babies require tube feeding.

Types of feeding tubes

The type of feeding tube used generally depends on how long the baby is expected to require feeding support. There can be individually specific reasons why one tube may be selected over another. 

The 3 most commonly used feeding tubes include:

NG tube (nasogastric tube): An NG tube is inserted into baby’s stomach through his nose. The tube is either secured in place by taping it to his face or it can be inserted for each feeding. An NG tube is usually the option when tube feeding is required for short periods (not more than 3 months), e.g. a preterm baby or after heart surgery.  

G tube (gastrostomy tube also called PEG tube). A G tube is inserted into the baby’s stomach though the abdomen. A G tube is generally used when a baby is expected to require feeding support for longer than 3 months.

J tube (jejunostomy tube or PEJ tube). A J tube is inserted through the abdomen directly into the small intestine, bypassing baby’s stomach. A J tube might be chosen over a G tube in the case of severe gastroesophageal reflux due to delayed emptying of stomach contents.

Reasons babies/ infants are tube feed

Some babies require tube feeding from birth. Others start out feeding orally but are unable to maintain adequate growth due to an underlying physical cause or unresolved feeding problem. The following are reasons why a baby might require tube feeding. 

  • Sucking and swallowing problems due to prematurity or brain problems.
  • Birth defects that affect baby’s mouth, jaw, throat, stomach, or intestines.
  • Cardiac and lung conditions that cause extreme fatigue.
  • Post-operative feeding support.
  • Metabolic disorders that require an unpleasant tasting diet or medication.
  • Severe gastroesophageal reflux disease (GERD).
  • Failure-to-thrive* due to physical, social or behavioral reasons.   

* 80 percent of babies experiencing failure-to-thrive have no underlying physical cause. An unresolved feeding aversion can cause poor growth.

Advantages & Disadvantages of tube feeding


  • Prevents malnutrition and excessive fatigue.
  • The risk of aspiration while feeding is reduced.
  • The baby receives adequate nutrition without being pressured to eat more.


NG Tube

  • Insertion can be painful and distressing.
  • Bleeding of nasal passage, ulceration, laryngeal injury, and pharyngeal discomfort.
  • Nasal congestion.
  • Discomfort while swallowing.
  • Baby’s hands may need to be restrained to prevent him from pulling the tube out.
  • Baby may be viewed as sick or disabled by others.

G and J tubes

  • Involves a surgical procedure to insert, which may require a general anesthetic.
  • Irritation and leakage around insertion site.
  • Infection around insertion site.

Tube-feeding in general

  • Increased incidence of gastroesophageal reflux*.
  • Reduces baby’s natural instinct and desire to eat and drink.
  • Limits opportunities for baby to develop oral-motor skills required for sucking, chewing and swallowing.
  • Inhibits baby from self-regulating his dietary intake according to his growth and energy needs. [Others decide on how much baby needs.]
  • Limits opportunities for baby to develop positive associations with feeding orally and the reduction of hunger.
  • Baby may become insensitive to the internal messages of hunger and satiety
  • Tube dependence.
  • Financial burden. Baby is often under the care of a multiple health professionals, such as pediatrician, speech therapist, occupational therapist and dietician. Each requiring regular health visits while baby is tube feed.
  • High levels of anxiety for parents. 

Advantages outweigh disadvantages when a baby (or child) is unable to safely feeding orally due to a physical abnormality or medical cause.

* NG tube enables backflow of stomach contents more readily. Any tube-fed baby, regardless of the type of tube, can be suspectible to regurgitation of stomach contents if overfeed. 

Combining oral 

Most babies who are tube-fed have some level of ability to feed orally. When a baby has demonstrated his ability to feed orally but is not able to ingest enough for healthy growth, the parent may be advised to complement his oral feeding efforts with tube feedings.

In theory, combining oral and tube feedings sounds simple. Baby is first given opportunities to feed orally and once he has taken as much as he can he is then ‘topped up’ with additional nutrition through the feeding tube. The intended outcome is to support him to further develop oral-motor feeding skills so that he can eventually be weaned off tube feedings, or to support him to maintain the skills he already has.

In practice, successfully combining oral and tube feeding is challenging. It requires a delicate balance between providing enough nutrition via the tube to support healthy growth, but not too much so as to suppress baby’s desire to feed orally. In general, health professionals tend to err on the side of caution, and therefore are more inclined to overestimate rather than underestimate a child’s nutritional requirements. Without hunger as a motivator, the ideal of a gradual transition towards full oral feeding can become a gradual transition towards full tube feeding, and opportunities for baby to feed orally merely token offerings. 

Placing any pressure on a child to feed orally can also tilt the scales in favor of full tube feedings as this can cause the feeding experience to become unpleasant. When repeated, pressure to feed can cause a child to develop an aversion to oral feeding.

Written by Rowena Bennett.

© Copyright 2020. All rights reserved. Permission from author must be obtained to copy or reproduce any part of this article


There are no words to express our gratitude for all that Lindsay has done in supporting us through our daughter’s tube weaning process. Our baby now loves her bottles, and we enjoy her feeding experience. Our daughter was born at 29 weeks and was fed through the tube right from the start. Early on, we also discovered she was unable to swallow safely. Finally, at one month of age (corrected), we were allowed bottle feeds. However, our daughter would scream at the sight of a bottle, back arch, try to escape from my arms, and barely drink. Seeing our baby so distressed was one of the most traumatic experiences we have ever had as parents. We spoke to her medical team on a weekly basis. Now, I realize, how despite their best intentions, their feeding advice was not entirely correct (things we shouldn’t have done according to Rowena’s book). At the end, we researched and found BCA and Lindsay. I still can't believe how, under Lindsay's plan and amazing daily support, we saw a significant improvement in our baby's feeding behaviour within a few days. Lindsay's knowledge and experience helped us achieve something we thought was impossible. She showed great empathy and understanding, gave us confidence to trust our girl and ourselves. She also taught us how to REALLY LISTEN and UNDERSTAND our baby. Under Lindsay's guidance, we removed our daughter's NG tube within a week. If you are thinking of booking a consultation - just do it! It will be one of the best decisions you will make!


Sophie was diagnosed with severe IUGR. At 7 months old, shortly after a GI bug, she lost a little weight. The pediatrician had her admitted that day and an NG was placed. All her doctors kept saying she just needs the NG to “get over the hump,” until she drinks more independently. She started vomiting. She developed acid reflux, started on a med. 2 months into the NG, she began to refuse the bottles totally. It felt as if everything was just getting worse. We were terrified to move her. I felt sick to my stomach all the time with stress and worry. No one ever had reasonable answers for our questions. We saw sooo many specialists. I work as NP at one of the top hospitals in the US. Late one night, while desperate, I googled “bottle aversion” bc that seemed like the issue. We booked a consultation with Lindsay. It was truly the best decision we ever made for Sophie and our family. We are approaching 3 months out from starting the tube feed weaning program. Sophie is aversion free. I can’t even believe I’m saying that. She eagerly drinks her bottles now. The tube was removed two months ago. She is gaining weight. She’s now eating solids. She just LOOKS so much healthier. We are no longer waking her up around the clock and stuck at home connected to her heating pump. Our family has a life again. Sophie’s big sister actually gets to play with Sophie now as opposed to just telling me when her tubing is getting tangled in toys. And most importantly Sophie can truly be a baby.


Our son suffered nerve injuries at birth and was in the NICU for the first 3 months of his life. Due to all the medical interventions, he came home with a feeding tube & was 100% tube fed. He was diagnosed with severe acid reflux & was gagging & vomiting after almost every feed. He was clearly overfed but no one listened. Lindsay is amazing! She is so knowledgeable, informative, honest and genuine! Lindsay was really positive. The first few days of the weaning process were really tough. I think I have asked her hundred of questions & yet she answered every question & addressed every concern I had with empathy. By day 6 of the tube weaning process, we almost gave up as our son was losing quite a bit of weight but still not taking the volume we were hoping to see. Nonetheless, Lindsay believed in our son (when we didn’t!) that he can do it & she arranged for a phone consultation & extended her support for few extra days given that we have already come so far. This shows that she genuinely care & wanted the best for our son & she was right! By day 8, Isaiah was 100% orally fed. By day 11, he was taking up to 910ml (which was not possible even with tube feeding) and by day 13, he has regained the weight lost (during the tube weaning process) and even pulled his tube out himself! When I told the doctors that I stopped giving him Nexium & thickener & that his ‘severe’ reflux is gone & how he was having 100% oral feed without gagging or vomiting - they were utterly shocked!


Our baby was NG fed for 10 weeks due to her drop in weight. Her bottle volumes steadily declined once the NG tube was placed and she was drinking barely anything orally by the time we booked a tube weaning consultation. After less then a week, our baby was drinking happily and with reasonable volumes. It was a miracle. We really can't express in words the joy that we feel in being able to feed our baby again. Lindsay was remarkable in sharing her wisdom and reassuring us about our apprehensions prior to starting the program and during the program. My initial skepticism of this program has most definitely been replaced with resounding praise for Lindsay and the tube weaning program. All of Lindsay's suggestions and judgements are sound and trustworthy. If you're contemplating doing the program and you're skeptical or apprehensive, JUST DO IT!! You won't regret it!

Andrew & Mindy