G-Tube Transitioning

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By Kayla Brown, Student Occupational Therapist, McMaster University.

A gastric feeding tube (g-tube), provides a long-term solution for children who are unable to get enough nutrition through traditional feeding methods. This ensures that a child can get the nutrition they need to grow and develop. However, as time goes on, many children are able to transition off of the g-tube and receive the majority of their nutrients through oral feeding. This transition can be a challenging process for many kids, but there are multiple ways that an occupational therapist can help your child have a successful transition.

Depending on their feeding history, a child may have unpleasant memories or pain that they associate eating. These can be conscious or unconscious memories. This can cause the child to fear eating even if the issue that caused pain or discomfort in the past has resolved.  Occupational therapists take a gradual approach to introducing your child to food, which helps to provide a safe and comfortable feeding experience. This slow and steady approach helps a child learn to view eating as a safe and enjoyable activity.

Although we don’t often think about it, chewing and swallowing requires a fair amount of strength and endurance from the muscles of the lip, jaw and tongue. Just like your leg muscles need regular exercise to stay strong, the muscles we use to eat can become weak if they are not used for an extended period of time. An occupational therapist can develop an exercise program to strengthen the muscles involved in feeding, and to help the child learn or relearn how to safely chew and swallow food.

If a child has been getting nutrients through a g-tube for an extended period of time and has not been using their mouth to explore different foods, eating can be an overwhelming experience for the child’s senses.  The different textures, tastes, and smells involved in eating may feel like more than a child can handle.  An occupational therapist can develop a plan to gradually introduce the child to these different sensory experiences so that they become comfortable with more stimulation over time.  In addition issues with sensory stimulation from food, the child may also be unable to sense where the food is in their mouth, which leads to swallowing difficulties and food rejection.

In addition to helping your child develop feeding skills, an occupational therapist can help you as a parent to learn how to best support the child during this transition to oral feeding.  He or she can provide education on which foods are safe to try, strategies you can use to decrease your child’s stress during mealtime, and help you set realistic goals and expectations.  In order to help your child to have a safe and comfortable experience, the occupational therapist may start with non-food items to teach chewing and proper use of the jaw, and then move on to food as skill develops.

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