Problems transitioning from tube feeding to oral feeding

If children have been fed through tube feeding method due to swallowing and eating difficulties, they will need to transition to oral feeding when they are ready. This can be a long and complex process and some children may have difficulty in transitioning from tube feeding to oral feeding.

Our speech and language therapists can work with children with problems transitioning to oral feeding in order to help children and their parents with this process as safely and effectively as possible.

Tube feeding is a method where children intake their nutrients through a tube inserted into their abdominal wall or nose and through to the stomach. When they are ready, the child will be able to transition from tube feeding to oral feeding. Many problems may occur within this transition due to many factors such as, emotional issues, sensory issues and physical disabilities.

Tube feeding is caused when the child is unable to intake food orally in a safe and effective manner, this can be due to dysphagia caused by neurological or physical conditions. Before transitioning from tube to oral feeding the underlying condition must be identified and controlled. Problems with the transition itself may then occur and this may be caused by weak oral motor movements, sensory sensitivity or residual emotional feeling towards orally intaking food. For example, if a child has experienced unpleasant reactions to swallowing food before the tube was in place, they may still have some of these feelings psychologically.

Children with problems transitioning to oral feeding from tube feeding may experience many problems with their eating, drinking and swallowing that speech and language therapy can help with, including:

• Poor suck - swallow - breath cycle.
• Residual psychological and emotional feelings towards orally intaking food.
• Weak and non-practiced oral motor movements.
• Increased or reduced sensory sensitivity.
• Anxiety and stress surrounding meal times for the child and their families.
• Food refusal and aversions.
• Poor weight gain.

Speech and language therapy has several benefits for a child with problems transitioning to oral feeding and their family, including:

• Improve confidence and reduce anxiety for the family and the child.
• Improve oral-motor range and strength of movement.
• Promote weight gain.
• Monitor and promote child's safety.
• Improve swallowing function.

Speech and language therapists use various treatment and assessments to treat a child with problems transitioning to oral feeding, including:

• Monitor child’s progress and advise when transition from tube to oral feeding is appropriate.
• Assess and identify difficulties during transition from tube to oral feeding.
• Discuss with parents management options and goal setting.
• Therapy exercises to strengthen oral motor movements.
• Encourage child to see food as a pleasurable experience.
• Provide advice on recommended thicknesses and textures of food and fluids.
• Training and advice for parents on how to deal with child's difficulties.
• Putting strategies in pace to deal with sensory issues.
• Referring to other health professionals if this is appropriate and beneficial to the child.

To arrange a speech and language therapy assessment for a child with problems transitioning to oral feeding with one our speech and language therapists please call 0330 088 2298.

Some children who have been tube fed may have to transition to oral feeding. This can be a long process and may cause some problems for the child. The child may have problems transitioning to oral feeding due to, physical disabilities, neurological conditions, sensory sensitivities or residual feelings towards food. Speech and language therapy can help children with any of the problems that may occur when transitioning from tube feeding to oral feeding.

If your child has problems transitioning to oral feeding and you think they would benefit from seeing one of our specialist paediatric speech and language therapists, email office@sltforkids.co.uk or call 0330 088 2298.