Understanding Tube Feeding

Understanding Tube Feeding

Enteral Feeding is a new world to navigate. We're here to help you get prepared and comfortable.

Nestlé Health Science Peptamen Junior®, is designed to help families and caregivers navigate the wealth of tube-feeding information found on the Internet. As you continue to do all that you can to help your child, we understand that there will be questions and concerns along the way. That’s why we’ve pulled information and resources to support you; so you can embark on this journey as comfortably as possible.

Your Healthcare Team

Tube feeding a child is often a team effort. Aside from your family and friends, you’ve got your healthcare professional to rely on. Here’s a quick overview of what a typical healthcare team may be comprised of, along with the specifics of who does what.

A Pediatric Gastroenterologist is a doctor who has completed specialized training and experience in pediatric gastroenterology to be able to treat children with digestive, liver or nutritional problems. Pediatric gastroenterologists also treat bleeding, swallowing problems, or other problems encountered in the intestines. They have extensive expertise in managing nutritional problems in children, including placement and management of feeding tubes, intravenous nutrition and diagnosing and treating infants, children, and teens with liver disease.

Pediatric Gastroenterologists are medical doctors who have had:

  • At least four years of medical school
  • Three years of pediatric residency training
  • Three years of additional training in pediatric gastroenterology, hepatology and nutrition, including medical research and treatment of infants, children and teens with digestive, liver and nutritional disorders
  • Certification in pediatrics from the American Board of Pediatrics
  • Certification in gastroenterology and nutrition from the American Board of Pediatrics Sub-board in Pediatric Gastroenterology

Pediatric Nurse Practitioner (PNP) are Registered Nurses who have completed a formal education program that gives them additional expertise in child healthcare. National certification as a PNP requires a master degree in nursing.

PNPs can work in private clinics, community clinics, public health clinics, school health clinics, specialty clinics, and hospitals. Some PNPs choose to gain specialized skills that help them care for specific categories of patients; such as orthopedics, neurology or children with special healthcare needs.

You may not have a Pediatric Nurse Practitioner (PNP) on your child's healthcare team, but you will have an RN — who will likely be your main point of contact when you call your child's doctor with a question or a problem. You will likely get to know your child's RN very well, and he or she will be a valuable resource for you.

If you have a Registered Dietitian Nutritionist (RDN) on your child's healthcare team, he or she will be your main source of nutrition information. An RDN is a nutrition expert who has met academic and professional requirements, and may also hold additional certifications in specialized areas of practice such as pediatrics, renal nutrition or diabetes education. Your RDN will be able to help you understand your child's nutritional needs and goals, answer specific questions about tube-feeding formula and feeding schedules, and provide you with information about your child's growth.

A Speech-Language Pathologist (SLP) has a range of expertise and may be working with your child not only on articulation and speech, but also on feeding and swallowing problems. If your child is able to take any formula or food by mouth — or if that is a goal for your child — an SLP will likely be a part of the healthcare team.

A Pediatric Physical Therapist is trained and educated to provide children with physical rehabilitation programs. These therapy programs can help assess your child's range of motion, muscle strength, neurological function, motor control and posture, and help to improve strength and movement. If your child needs help in this area, a physical therapist will likely be a part of the healthcare team.

Occupational Therapy (OT) focuses on the physical as well as the psychosocial needs of children. Occupational therapists can help with swallowing disorders, upper body strength and range of motion, sensory problems, assessment of equipment needs for your child, upper body splinting and casting, improving endurance, developmental assessments and alternative methods for pain and nausea management.

A respiratory therapist is trained in providing care specifically for children who need breathing support (such as oxygen therapy), breathing treatments or more advanced management for children on ventilators. A respiratory therapist can help manage children with asthma, cardiopulmonary disease, neurological disorders or other conditions that might impair a child's ability to breathe. They can also work with the speech therapists to help children who have tracheotomies regain communication skills.

Pediatric Pharmacists are licensed professionals with at least five years of specialized pharmacy education. They often have completed advanced degrees in pharmacy (Pharm D) and residency programs. They will advise other members of the healthcare team about which medications to use and how to use them, or counsel families directly to help them use their medication correctly. They will also make sure that your child's medication regimen will not result in any harmful drug interactions — this is especially important if your child is on many medications at once.

Remember, not all of these healthcare professionals may be a part of your child's healthcare team. Make sure you write down all the people that will be part of your child's team because each of them will be valuable in answering your questions and helping your child get the best care possible.

Download Printable Healthcare Support Team Sheet

When visiting or talking with your child's healthcare team, sometimes it's hard to know what questions to ask. That's why it's always a good idea to come with a list of prepared questions. Here are a few suggestions:

Growth Questions

  • Is my child’s growth on track (weight and height)?
  • My child appears to be underweight. What should I do?
  • My child appears to be overweight. What should I do?
  • How and when should my child’s bone density be evaluated?

Formula Questions

  • How do I know if my child is still on the right formula?
  • Why does my child need extra calories?
  • Why does my child need extra protein?
  • How can I tell if my child is getting all the vitamins and minerals he or she needs?
  • How can I tell if my child is not tolerating the formula?
  • Is a blenderized formula suitable for my child?

Feeding Questions

  • Why are bolus feeds recommended for my child?
  • Why is a continuous feed recommended for my child?
  • Where can I find more information about feeding pumps?
  • Can my child still drink and/or eat by mouth?
  • How can I make tube feeding easier for my child and our family?
  • Tube weaning: How will I know when it's time?

Other Questions

  • What should I do if my child is vomiting every day?
  • What should I do if my child is irritable or uncomfortable after feeds?
  • Could this be a sign of feeding intolerance?
  • What should I do if my child looks bloated after feeds?
  • What should I do if my child frequently has diarrhea?
  • What should I do if my child frequently is constipated?
  • How will I know if I should change my child's feeding schedule?
  • How can I tell if my child has a food allergy?

Download Questionnaire

To help you and your doctor monitor and evaluate your child's progress with tube feedings, keeping a daily diary may help you feel more in control. Use our diary to help track your child's home tube-feeding progress over the course of each week.
Download Daily Diary

Tips, Tools & Resources

Maintaining Personal Health

Tips for keeping your mouth, nose or tube site healthy while tube feeding.

Let's "Break It Down"

Facts about protein and peptides.

Go for the Goals

Use this worksheet to help track your prescribed tube-feeding schedule.

Quick Links

Additional resources on tube feeding, caregiving and more.

Tube-Feeding Troubleshooting

Helpful Information for navigating problems such as clogs.


A variety of taste options for those who consume Peptamen® formula orally.