Mealtimes are more than just moments for nourishment; they’re opportunities for connection, growth, and joy. However, for families managing tube feeding, mealtimes can feel different. There’s often a sense of isolation or pressure, especially when a child’s nutritional needs cannot be met through oral feeding alone. Tube feeding is a vital lifeline for many children, but it doesn’t have to diminish the beauty of mealtime bonding.
This blog post is dedicated to all the families whose children require tube feeding. It offers practical tips for creating positive mealtime experiences, helps normalize tube feeding, and explores how you can engage children, whether they’re infants or older kids, in enjoyable and meaningful feeding moments.
Why Tube Feeding is a Lifeline:
For many families, feeding tubes are necessary because oral feeding isn't a viable or safe option. Children may need tube feeding for a variety of reasons, including:
1. Prematurity: Infants born prematurely often have underdeveloped feeding skills, making it difficult or unsafe for them to take in nutrition orally. Tube feeding ensures they get the nutrients they need to grow and develop. Premature babies often lack the coordination to suck, swallow, and breathe simultaneously, which increases the risk of aspiration (food entering the lungs) (Arvedson, 2008).
2. Neurological Conditions: Children with conditions affecting the nervous system, such as cerebral palsy, or those recovering from neurological injuries, may struggle with swallowing or controlling oral motor functions. Tube feeding provides a way to ensure adequate nutrition without risking aspiration or choking (Cichero et al., 2013).
3. Congenital Disorders: Conditions like cleft lip/palate or craniofacial abnormalities may affect a child’s ability to suck or swallow effectively. Tube feeding can bypass these difficulties, ensuring the child still receives the nutrients required for growth (Rowell & McGlothlin, 2015).
4. Chronic Illness: Children with long-term conditions, such as cancer, cystic fibrosis, or gastrointestinal disorders, may struggle with oral intake due to fatigue, pain, or difficulty digesting food. Tube feeding can ensure that children receive sufficient nutrition even when they’re unable to take in food orally (Thoyre et al., 2012).
5. Food Allergies or Intolerances: Some children with severe food allergies or gastrointestinal conditions may not be able to tolerate certain foods. Tube feeding allows for precise control over the types and amounts of nutrients delivered, reducing the risk of allergic reactions or digestive distress (Shaker, 2013).
6. Failure to Thrive: In cases where children aren’t gaining weight or growing adequately despite efforts to feed them orally, tube feeding can offer a reliable way to ensure that they get the nutrients they need for healthy development.
In these cases, tube feeding isn’t a choice—it’s a medical necessity that supports the child’s health, wellbeing, and development.
Breaking Down Stigma:
Despite the critical role tube feeding plays in supporting children’s health, there can be a stigma attached to it. It’s not uncommon for parents to feel isolated or judged for using a feeding tube or even decide against one. But the reality is that tube feeding isn’t a sign of failure.
Normalising Tube Feeding:
Tube feeding can be a temporary or long-term solution, depending on the child’s needs.
It’s not a reflection of parental failure but a necessary tool for providing the right nourishment.
Tube feeding allows children with complex medical needs to grow, thrive, and actively participate in life.
It's essential to create an environment where tube feeding is seen as a valid, life-saving method. Parents need to feel empowered, not ashamed, for using feeding tubes as part of their child’s care.
My Experience with Tube Feeding and Supporting Transitions:
As a Speech and Language Therapist trained in Paediatric Dysphagia, I have had the privilege of working closely with infants and children who are currently tube feeding, as well as those who have a history of tube feeding. My role extends far beyond simply supporting the continuation of tube feeds. I am deeply involved in guiding families through the decision-making process of starting or weaning from tube feeding, ensuring the best possible outcomes for each child’s unique needs.
Over the years, I’ve collaborated with parents and medical teams to assess when tube feeding is necessary and when it might be time to consider transitioning to oral feeding. This process requires a detailed understanding of a child’s developmental milestones, feeding skills, and underlying medical conditions.
1. Supporting the Decision to Start Tube Feeding:
For some children, tube feeding is essential to meet nutritional needs safely. Whether due to swallowing difficulties, poor weight gain, or specific medical conditions, my experience allows me to work closely with families to assess the best path forward. I consider every aspect of the child's condition, from physical and oral motor skills to the emotional impact on the family. I support parents in understanding the role of tube feeding as a temporary or long-term solution, providing clear explanations and realistic expectations.
2. Assessing Readiness to Wean from Tube Feeding:
When a child is ready to transition away from tube feeding, the process must be handled with care, patience, and a tailored plan. This decision isn’t rushed. It’s about understanding each child’s individual readiness, which includes assessing their ability to handle oral feeds safely and their development of oral motor skills. I use a neurodevelopmental approach, carefully assessing the child’s ability to manage textures, volume, and coordination of swallowing before introducing any changes.
During this time, families are supported every step of the way, as we work together to establish positive, enjoyable mealtime experiences. From improving oral skills to enhancing sensory experiences with food, I help guide each family through the transition process. The goal is to ensure that the child feels comfortable, confident, and secure with oral feeding, gradually reducing the reliance on tube feeding.
3. Ongoing Support and Education:
I provide continuous education and resources for families, whether tube feeding is ongoing or a child is transitioning to oral feeding. This ensures parents feel empowered to make informed decisions about their child’s feeding journey. The support includes guidance on tube management, comfort during feeds, and troubleshooting any difficulties with feeding. For families moving towards weaning, we implement strategies to slowly integrate oral feeding while maintaining adequate nutrition.
Having worked with a variety of medical teams, therapists, and families, I am able to offer a holistic and evidence-based approach to tube feeding. My experience includes not just the technical aspects of tube feeding, but also addressing the emotional and psychological elements of the process, ensuring that the feeding experience remains a source of connection and nurturing for both the child and their family.
Whether your child is currently tube fed, or you’re exploring the possibility of transitioning away from the tube, I am here to offer expert guidance, support, and encouragement throughout the journey. My extensive background in both the medical and emotional aspects of tube feeding provides families with a well-rounded, empathetic approach to feeding that can make a real difference.
Tips for Including Tube-Fed Children in Mealtimes:
1️⃣ Bring Them to the Table:
Inclusion is key. Position your child at the table during mealtime, even if they’re not eating orally. This simple act fosters a sense of belonging and builds positive associations with mealtimes. Being part of family meals helps children feel connected to the experience of sharing food, even if they can’t participate in the same way as others. Research has shown that participation in family mealtimes has positive emotional and developmental benefits, even when the child is not yet eating orally (Arvedson, 2008).
2️⃣ Sensory Exploration of Food:
For younger children or those not yet ready for oral feeding, allow them to touch and explore food textures (under safe and supervised conditions). This sensory exposure helps reduce the fear or discomfort some children might feel toward food. It’s an important first step toward developing a positive relationship with food.
3️⃣ Social Modelling:
Children learn by observing those around them. Eating alongside your child helps them understand that mealtimes are social events, not just opportunities to eat. Children who observe their parents enjoying food are more likely to show interest in food over time (Birch, 1987). This modelling approach is critical for building curiosity about food in a relaxed, no-pressure way.
4️⃣ Descriptive Language:
Use descriptive language when discussing the food at the table. Words like “crispy,” “sweet,” or “smooth” can spark curiosity in children, even if they’re not yet eating. Describing food in this way helps children engage with the sensory properties of food without the expectation that they will eat it right away.
5️⃣ Positive Reinforcement:
Focus on non-oral aspects of mealtime, such as bonding, laughter, and conversation. Avoid placing pressure on your child to eat. Instead, emphasise the social and sensory experience of food. Positive reinforcement should centre on the enjoyment of the experience, not the act of eating.
Positive Oral Experiences for Infants:
For infants on tube feeding, building oral skills and positive associations with food is still possible and should be encouraged.
Oral Exploration: Provide safe, clean teething toys or soft cloths for oral exploration. This helps stimulate oral motor skills while being pressure-free.
Taste Sensory Activities: With the guidance of a medical professional, try introducing small tastes of breast milk or formula on a clean pacifier or spoon to encourage curiosity about flavours.
Cuddle Time During Feeds: Maintain skin-to-skin contact and eye contact during tube feeds to promote bonding and positive feeding experiences.
Introducing oral experiences early, even in a non-eating context, supports future oral feeding goals when the time is right.
When to Seek Specialist Support:
While tube feeding is a vital solution for many families, transitioning from tube feeding to oral feeding can be a complex process. If you’re considering transitioning your child to oral feeding, or if you're struggling to find positive mealtime strategies, a feeding specialist can help.
An appropriately certified feeding therapist can assess your child’s developmental stage, offer tailored strategies for oral exploration, and support the transition from tube to oral feeding when it’s appropriate. They also help with sensory integration and oral motor skills development.
Conclusion:
The road to feeding can be different for every child, but every step forward—no matter how small—is progress. Tube feeding plays a crucial role in many children's lives, ensuring they receive the nutrition they need to grow and thrive. By creating positive, inclusive mealtime experiences, you are supporting your child’s growth, development, and emotional wellbeing.
As a feeding specialist, I am here to offer support and guidance for families navigating these challenges, whether that means embracing tube feeding or exploring a gradual transition to oral feeding.
Looking for more tips and personalised support?
Explore my services or book a consultation at www.milktomealtime.com. Let’s work together to create meaningful mealtime moments for your family.

References:
Arvedson, J. C. (2008). Assessment of pediatric dysphagia and feeding disorders. Developmental Disabilities Research Reviews, 14(2), 118-127.
Birch, L. L. (1987). Role of experience in the development of children's eating behaviour. Journal of the American Dietetic Association, 87(9), 36-40.
Cichero, J. A. Y., et al. (2013). Dysphagia: Foundation, theory, and practice. Wiley-Blackwell.
Rowell, K., & McGlothlin, J. (2015). Helping Your Child with Extreme Picky Eating. New Harbinger.
Shaker, C. S. (2013). Cue-based feeding in the NICU: Using the infant’s communication as a guide. Neonatal Network, 32(6), 404-408.
Thoyre, S. M., et al. (2012). Feeding outcomes for infants with neonatal dysphagia. Journal of Pediatric Gastroenterology and Nutrition, 55(3), 323-331.
Guts UK, (2025) Feeding Tube Awareness week. Accessed www.gutscharity.org.uk
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