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Caloric intake via feeding tube

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Question

My 4 month old daughter is fed through a g-tube that is controlled by a feeding pump. How do I calculate her formula increase as she gains weight? She is currently between 8.5 and 9 pounds and is 20 inches long.

Answer of our experts

For a child under age 2, there are a lot of considerations taken into account when changing a tube fed formula or increasing a feeding rate.  A registered dietitian or pediatric gastroenterologist would be the best person to actually make the recommendation of a  rate change.  They would take into consideration presence of GERDS (too high a rate can potentially increase reflux), child’s rate of current growth, child’s placement on the growth curve, catch up growth needed, and formula specific information such as is the formula at full strength, is it calorically still appropriate, is it well tolerated at the current rate, would the child be getting adequate water if the rate was increased, etc.  We realize a parent is anxious to continue to see weight gain but for the best result please discuss your concern and ask for a recommendation from one of the health professionals mentioned above.

DP/TK 7-13-10

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Recommendation(s)

Feeding and Dental Difficulties

R12
In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
R13
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
R14
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
R15
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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