Diseases and conditions

Pediatric failure to thrive

What is pediatric failure to thrive?

Many medical conditions can require use of a feeding tube to provide food for a child. Some children, such as those with chronic diarrhea or liver disease, may be able to eat, but are unable to eat enough, while others with more serious ailments such as cerebral palsy may be unable to eat at all on their own. Signs that can tell a doctor that a child may require feeding support include excessive crying, excessive sleepiness, dehydration, and height/weight that do not match growth charts. Tests to determine if a child requires a feeding tube include a physical exam, a review of the history of the child’s medical and family medical history, bloodwork, X-rays, and swallow studies. If a child does require a feeding tube, there are now several minimally invasive options for parents to choose.

Treatment

Interventional radiology allows for feeding devices to be placed into the stomach without the need for surgery. This form of access is a preferred option for long-term feeding because there are no tubes coming out of the nose and mouth.

Gastrostomy tube (G-tube)

For children who need long-term feeding support, a G-Tube is often the best option. The treatment can be performed in two ways: The interventional radiologist threads a tube with a tiny “bumper” from the mouth to the stomach and then slowly pulls the tube so that the bumper sits against the wall of the stomach, holding it in place. The second method involves passing a tube directly from the outside into the stomach and using stitches to hold the tube in place. For both methods, X-rays are used to ensure proper tube placement.

Interventional radiologists often use only local anesthetics, along with anti-anxiety medications to help keep your child calm and pain-free during this treatment.

Gastrojejunostomy tube (GJ-tube)

Children who are not eligible for a G-tube, as described above, can benefit from the placement of a small intestinal feeding tube which goes into a part of the small intestine. The treatment for a GJ-tube is very similar to that for a G-tube, except the tube is moved further so that it drains into the small intestine instead of the stomach.

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