How Gastrostomy Tubes Are Used to Help Preemies

A premature baby in an incubator.

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A gastrostomy tube, also called a G-tube, is a feeding tube that goes through the abdominal wall into the abdomen. G-tubes are used for long-term tube feedings in infants, children, and adults who are unable to eat or who can't eat enough.

There are many reasons why a premature baby might need a G-tube. Most preemies have trouble eating at first, but gain strength and coordination as they grow. By the time they leave the NICU, they are breastfeeding or bottle-feeding well. Other preemies have complex medical problems that make it hard for them to eat well. Some reasons why a preemie might need a G-tube include:

  • Long-term ventilation: Babies who need to be on a ventilator for a long time won't be able to eat until they have a tracheostomy. Even then, it may take a long time for these babies to learn how to eat well.
  • Oral aversion: Premature babies in the NICU receive a lot of unpleasant stimulation to their mouths. Intubation, suctioning and poor feeding techniques can cause babies to develop an oral aversion that prevents them from eating enough to grow and gain weight.
  • Neurologic disorders: Cerebral palsy or other neuromuscular disorders can cause sucking and swallowing problems that make it hard for babies and children to eat enough food to grow well.
  • Difficulty gaining weight: Failure to thrive, BPD, and genetic disorders can all make it hard for babies to gain weight for a variety of reasons. If your baby isn't growing well despite all of your best efforts, long-term tube feeding may be the solution.

How Gastrostomy Tubes Are Placed

There are two main ways that G-tubes are placed in children: surgically or with an endoscope. The surgical procedure can be done laparoscopically or as an open surgical procedure. It's more common to place gastrostomy tubes with an endoscope in a procedure called percutaneous endoscopic gastrostomy, or a PEG procedure. Feeding tubes placed like this are often called PEG tubes.

Like all medical procedures, there is a risk of complications from G-tube and PEG tube placement. Most complications occur within the first months after surgery, but they can occur as long as the tube is in place. Complications include:

  • Leaking around the site
  • Redness and skin irritation
  • Dislodgement of the tube
  • Infection

How Do I Care for My Baby's G-Tube?

Before you leave the hospital with your baby, you'll learn how to care for a G-tube or PEG tube and how to give tube feedings. You'll learn how to keep the skin clean, how to flush the tubing to prevent clogs, and what to do if the tube comes out. This is a great time to ask any questions you have about gastrostomy tube care and feeding your baby.

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  • KidsHealth from Nemours. "Gastrostomy Tube (G-Tube)."​.
  • McSweeny, M., Jiang, H., Deutsch, A., Atmadja, M., & Lightdale, J. (Nov. 2013). "Long-term Outcomes of Infants and Children Undergoing Percutaneous Endoscopy Gastrostomy Tube Placement." Journal of Pediatric Gastroenterology and Nutrition. 57: 663-667.​
  • Minar, P., Garland, J., Martinez, J., & Werlin, S. (Sept. 2011). "Safety of Percutaneous Endoscopic Gastrostomy in Medically Complicated Infants." Journal of Pediatric Gastroenterology and Nutrition. 53: 293–295

By Cheryl Bird, RN, BSN
Cheryl Bird, RN, BSN, is a registered nurse in a tertiary level neonatal intensive care unit at Mary Washington Hospital in Fredericksburg, Virginia.