Tube fed kids dont get hungry. It makes perfect sense really. If you were a baby or a young child, why would you want to eat and drink if you are always being fed via a tube? When a childs nutritional and hydration needs are always being met though Tube Feeding, an instinctual desire to eat for hunger and drink for thirst is removed.
Tube Feeding Dependency (FTD) is an undesired side effect of Tube Feeding. The child simply refuses to eat or drink. Tube Feeding can be either Nasal Gastric (a small tube into the nasal cavity down into the stomach) or a Gastrostomy Tube (a surgically placed tube through the abdominal wall directly into the stomach).
For many babies and young children, short-term Tube Feeding is a lifesaver and thank goodness for that! But our preoccupation with weight gain and growth charts can prolong the use of Tube Feeding un-necessarily, and can potentially create FTD.
More often than not Tube Feeding is a temporary medical tool used for various reasons. Such reasons can include but are not limited to; prematurity, poor sucking reflex at birth, cleft palate, aspiration risks from unsafe swallow, poor weight gain, reflux, virus complications or postoperative feeding needs.
When a child wont eat or drink enough, or at all, its extremely stressful for parents. Often a negative and pressured environment is created around eating, which is counter productive for the child. It can become easier for everyone involved in the childs care to continue Tube Feeding as the main source of nutrition.
More often than not the child does have the oral skills to eat and drink, and will do a little of both, but in combination with Tube Feeding, doesnt have the desire or need to completely maintain themselves through oral consumption.
Many children endure intense amounts of vomiting with both Nasal Gastric and Gastrostomy Tube Feeding, which only decreases the desire to eat, drink and swallow. Our child vomited multiple times a day for two and a half years with Tube Feeding.
After returning from a Tube Weaning Clinic in Graz, Austria (the other side of the world) we have not tube-fed him and he hasnt vomited since.
The Graz Model is a Tube Weaning Program run by a small team of dedicated experts in a Childrens University Hospital in Austria, Europe. For the last 15 years the team has treated 500 infants and children, with a staggering 96% success rate. The Graz Model is a three-week calorie reduction program. The numbers of tube-fed children in Austria since the program started is now 10% of the original numbers.
The program gradually reduces the calorie and fluid intake of the tube-fed child, while providing a supportive no-pressure environment to explore and play with food. Many of these children will be experiencing hunger and thirst for the first time.
Parents are educated in how to support and trust that their child will eat, by having food and drink, as well as emotional support, available all day. Weight loss is an unavoidable side effect of tube weaning. Once the child is able to consume enough to be happy, hydrated and active, the tube is not used and it is expected that over the following months the child will increase their intake and learn to self regulate and therefore start gaining weight.
A major problem in Australias current approach to tube feeding is that there is not enough understanding and recognition that;
1. Feeding Tube Dependency is a problem created by tube feeding;
2. Tube Feeding a child reduces a natural instinct and desire to eat and drink.
Comprehensive prevention and treatment programs must be established in Australias health system to enable Tube Feeding to be a short-term solution. If you break your leg it is treated with a cast. Once the cast is removed, the leg is rehabilitated to its normal strength and ability. The treatment for Tube Feeding should be the same.
The lack of recognition of FTD as a medical problem means that health professionals completely fail to develop adequate intensive rehabilitation strategies for tube removal, once the tubes purpose has been fulfilled. The majority of professionals expect that a child will eat when they are ready, or when they get to school and see other kids eating. This approach prolongs the Tube Feeding scenario unnecessarily, and at a high cost to everyone involved.