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Better Transitions From NG Tube to Oral Feeding

Better Transitions From NG Tube to Oral Feeding 1024 683 Lauren Dembeck
Woman is spoon feeding a toddler

An intensive program helped 76% of children with nasogastric tubes transition to oral feeding, avoiding gastrostomy tube placement.

Some children with pediatric feeding disorder who require prolonged nasogastric tube (NG tube) feeding may be able to avoid gastrostomy tube (G-tube) placement through intensive multidisciplinary intervention, according to new research from Nationwide Children’s.

Nationwide Children’s operates one of only 16 intensive multidisciplinary feeding programs currently available in the United States, serving children with complex feeding challenges who have not responded adequately to outpatient treatment.

In a retrospective study published in Nutrition in Clinical Practice, investigators found that 76% of children who entered Nationwide Children’s intensive feeding program with an NG tube in place successfully had the tube removed within 1 year while maintaining adequate nutrition status. The findings challenge a longstanding belief at some centers that children with NG tubes may be poor candidates for intensive feeding therapy because the presence of the tube could worsen oral aversion or interfere with treatment.

“We had seen children come through the program with NG tubes who made enough progress that they were able to have the tube removed and never needed a G-tube placed,” says Rob Dempster, PhD, program director of the Comprehensive Pediatric Feeding and Swallowing Program at Nationwide Children’s and lead author of the study. “When we started talking with colleagues at other programs, many believed that wasn’t possible, and there was very little published evidence in this area. So, we decided to formally evaluate this approach in children with NG tubes.”

“These children have always existed,” says Praveen Goday, MD, medical director of the Comprehensive Pediatric Feeding and Swallowing Program at Nationwide Children’s and senior author of the study. “There just wasn’t a specific diagnosis. The consensus definition provided formal criteria for how we identify and define pediatric feeding disorder.”

Robert Dempster, MD

Robert Dempster, PhD

Dr. Praveen Goday, MD

Praveen Goday, MD

The study included 30 children with NG tubes who completed a 6- to 8-week intensive multidisciplinary intervention program between 2017 and 2022. Children attended three treatment sessions per day, five days per week, for 8 weeks with support from physicians, psychologists, dietitians, feeding therapists and other specialists.

The study team found that children who successfully transitioned off tube feeding tended to be more than 1 year old and were consuming a greater proportion of their nutritional needs orally by the time they completed the program. Importantly, many children continued progressing after leaving the program.

“About half of the children who ultimately weaned successfully didn’t fully come off the NG tube while they were here,” says Dr. Dempster. “The families left with a plan and the skills to continue building oral intake at home, and many children achieved full weaning during follow-up.”

The findings may help inform referral decisions for children with NG tubes who may be candidates for intensive multidisciplinary intervention before proceeding to G-tube placement.

 

This article appeared in the 2026 Fall/Winter print issue. Download the issue here.

Reference:

Dempster R, Evenson E, Gentile M, Arand B, Ahmed R, Garbacz L, Peters B, Neary M, Stefan B, Schellhaas S, Goday PS. Intensive multidisciplinary intervention while on nasogastric tube feeding prevents the need for gastrostomy tube placement: A retrospective study. Nutrition in Clinical Practice. 2026;41:1246-1252.

Image Credit: Adobe Stock (header); Nationwide Children’s (portraits)

About the author

Lauren Dembeck, PhD, is a freelance science and medical writer based in New York City. She completed her BS in biology and BA in foreign languages at West Virginia University. Dr. Dembeck studied the genetic basis of natural variation in complex traits for her doctorate in genetics at North Carolina State University. She then conducted postdoctoral research on the formation and regulation of neuronal circuits at the Okinawa Institute of Science and Technology in Japan.

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