When I started to research this article, I thought I could put in everything I wanted to say related to the gastrointestinal area. I needed to set my sights a little lower, though, or you would be reading a book right now. So in this article, I focused on Gtube types, care, placement, and helpful tips. In the future I hope to write about reflux, feeding orally, oral aversion, etc.
Now, many HIE babies come home from the NICU with a gastrostomy tube already placed. But there are times when you as a parent have more decision in the type of tube your child will get. I hope that I will provide you with some answers here.
Why have a gastrostomy tube at all?
If you're like me, the words "gastrostomy tube" and "your baby" really don't go together! When the NICU doctors first mentioned it to me, I had horrible visions of what it would look like. I really had no idea, never having seen one before. They didn't push for it after that, so we came home with an oral gastric (OG) tube down my daughter's throat and into her stomach. This is the same as a nasal gastric (NG) tube that goes in the nose and down to the stomach. Both often have to be replaced during the day when they come out from moving the baby around. You also use lots of tape, which can bother your baby's skin. This is very inconvenient and I can't imagine that it is pleasant for the baby. An OG or NG tube is not a long term solution for feeding. HIE kids generally have Gtubes due to dysphagia, lack of swallow or poor swallow that prevent them from getting needed nutrition.
What are the options for the types of G tubes?
So many doctors, so many different opinions on Gtubes. Many factors of type and placement of tube depend on the surgeon's preference. If you do not agree with his opinions, you may have to look around for a surgeon that is agreeable to your preference.
There are two basic kinds of gastrostomy tubes that are used. One kind is held in place by a mushroom shaped disc inside the stomach wall. Bard is one of the manufacturers of the "mushroom" variety. I have heard from experienced parents that replacing a Bard appears to be painful for the child. They "rip it out" as one parent explained, usually with no anesthetic. With a Bard it is harder for the child to yank the tube out and easier for the child to be active. However, in the case of most HIE kids, neither of these things is too big of a problem.
