In community-based early intervention, children/infants with indwelling NGTs (nasogastric tubes) may come to us for services. They may have struggled for extended periods of time learning to PO feed while having NGTs for months. By the time we see them, there may already be onset of early aversive behaviors set in motion. Our job then is often to then unwind the negative learning. I recognize as I travel the US teaching that discharge to home on indwelling NG tubes is getting more common, including bridled NGTs and I am concerned. In my experience, those infants/children for whom this is a consideration clearly require the interdisciplinary perspective which the attached paper advocates.
A common concern as pediatric therapists is the potential impact of indwelling NGTs on the oral-sensory -motor system, both in the short term and the long-term. This perspective is shaped by those infants/children whom we follow after the decision is made and often present with sequelae from a well-intentioned plan. The challenge is always the risk-benefit ratio for each individual infant/child. This paper does a good job of articulating the importance of looking at the bigger picture. That is it can help the team, especially related to co-morbidities, to better profile those infants/children whose feeding issues are likely to truly be “short-term” versus thus whose medical history and co-morbidities suggest a more enduring feeding/swallowing problem. I hope this article informs your team’s practice.