Case study – tube feeding

Karen, an ELC practitioner, reflects on how she supported a child who needed to be tube fed.

Jonah’s mum was about to return to work after having maternity leave and she came to visit the nursery to see if she thought that we were going to be the right kind of setting for her son. It was particularly important for her to find out if we were going to be able to support his additional needs.

When Jonah’s mum told me about the gastrostomy tube I started to feel panicky – I wasn’t at all sure that I was prepared to take responsibility for what seemed like such an important need. I didn’t know anything about tube feeding and was concerned that I might get it wrong and cause him pain or damage him in some way – and if that happened, how might the parents react? However, when Jonah’s mum started to tell me about Jonah and the tube, I started to feel less overwhelmed.

Jonah’s mum explained that a gastrostomy tube is fitted under general anaesthetic into the stomach. The outside portion of the tube remains outside the stomach. The feed is commercially produced and supplies the nutrition that Jonah needs. Jonah needs three liquid feeds a day and the feed is inserted into the tube over a ten-minute period. If the correct procedure is followed, which includes flushing the tube before and after the feed is given, the chances of it blocking off are minimal. To keep his tube as safe as possible he wears a close-fitting vest, which closes with poppers over his nappy.

His mum demonstrated how to give the feed and it was very straightforward to do. Jonah hardly took any notice and carried on playing as the feed was being given. I started to see that besides needing the tube feed, Jonah was not different to any other toddler of his age. After discussing the possibility of offering Jonah a place with the other staff, we decided that we would offer Jonah a place for a trial period of a month to see if we could manage.

To help me learn more about tube feeding I looked on the website of the specialist children’s hospital that was looking after Jonah. I felt it was important to speak with a health professional to find out more about Jonah’s additional needs, so Jonah’s mum gave us the contact details of the community paediatric nurse, who agreed to come about to the nursery. Ian was very helpful and demonstrated the procedure to me, which, reassuringly, was exactly how his mum had shown me. Ian also asked the dietitian to give me a call to give advice about care of the tube, and this was another opportunity for me to ask questions.

Now Jonah is a lively little boy who is thriving and is now a normal weight for his age. He loves being at nursery and is very attached to us. I am really proud that we have managed to play such an important part in his development and have met his additional needs.