How to Transition From Tube Feeding to Eating by Mouth

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist
04/10/17  1:31 PM PST

The transition from tube feeding to eating by mouth can be a slow process. Make sure you do it right by taking a step-wise approach and enlisting the help of your healthcare team.

1 Talk to your doctor.

Talk to your healthcare professional about your wish to resume oral intake. Include family members and caregivers in the discussion. They should be part of the team that can help you in the transition.

2 Make sure it’s safe.

  • Your doctor will want to make sure it’s safe for you to eat by mouth. He may refer you to specialists, such as a speech-language pathologist and a registered dietitian nutritionist (RDN).
    • A speech-language pathologist can evaluate your swallowing ability. This will help determine if it’s safe for you to eat and if there are certain textures that are safer than others. Oral intake can increase your risk of aspirating, or inhaling foods and liquids into your lungs, which can potentially lead to pneumonia.
    • An RDN can assess and monitor your nutritional intake of both formula and oral intake to make sure you’re meeting your needs for calories, protein, fluids, vitamins and minerals and other important nutrients.

3 Transition from tube feeding slowly.

  • Your dietitian may recommend that you continue to use tube feeding while you gradually increase the amount of food and liquids you consume by mouth. This may mean switching from continuous feeds to cyclic or intermittent feedings. This allows more time for eating by mouth and also helps to increase your appetite.
    • With cyclic feedings, you may reduce the number of hours your feeding pump runs. For example, you might run formula through the pump for a few hours at night while you try eating during the day.
    • If you are on intermittent feedings, you may either run the feeding pump for a short period, such as 1-2 hours a couple times per day, with a break in between for oral intake.
  • When you start to eat and drink more by mouth, your dietitian may recommend that you take a specified amount of tube feeding after meals only if you don’t eat much at a meal. For example, if you eat less than half of lunch, you may need to supplement it with can of formula through the tube so you don’t miss out on vital nutrients.
  • When you are safely able to consume at least 75% of your calorie needs by mouth for at least a few days, your dietitian may try discontinuing the tube feeding.
  • Eventually, you may be able to supplement your meals with an oral nutrition supplement instead of using your tube. Some people continue to flush the tube with water, not only to prevent clogging of the tube, but also to meet hydration needs.

transition from tube feeding

4 Keep a log.

  • Write down everything you eat and drink at meals and snacks and include amounts of each food and beverage.
  • Keep track of how much formula you take in a day through the tube.
  • It’s also a good idea to keep track of your weight during this time.

5 Tell your healthcare professional if you experience any issues as you increase your oral intake.

These may include:

  • Swallowing issues, such as coughing or gagging
  • Gastrointestinal issues, such as nausea, gas or bloating, diarrhea or constipation
  • Weight changes (up or down)

6 Be patient.

It may take more than one attempt to transition to oral intake. Hang in there!

DISCLAIMER: This information is designed for customer use only and does not represent the advice of a medical health professional. Please contact your doctor for explicit advice on your prescription and/or feeding program.

Reference: ASPEN Safe Practices for Enteral Nutrition Therapy JPEN 2016

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Comments

15 comments

  1. I have been on a feeding tube for 75 days after a cancer Surgury and would like to see more articles or comments from others who share my experience and are ready to transfer back to normal eating habits.it is getting real hungry out there.

    1. Hi Percetia. Thank you for your question. First, please contact your doctor for explicit advice on your feeding program — there is no general time-table that works for everyone when it comes to removing feeding tubes. Second, in case you missed it, this is stated in the above article: “When you are safely able to consume at least 75% of your calorie needs by mouth for at least a few days, your dietitian may try discontinuing the tube feeding.” If you would like more information about the transition, we would recommend this informational sheet from Regions Hospital. In it, they write, “When you are able to eat for a week without using your feeding tube and your weight is stable call your care team to discuss the possibility of having your tube removed.” Please keep in mind that every body is unique and your doctor and dietitian will be able to speak better to your situation — we are not medical professionals. Best of luck! -Aimee, Shield HealthCare

  2. I want a transition from tube feeding to mouth feeding, i am a cancer patient undergone surgery and now cured.
    I can take water and my liquid feed, as I was taking through tube, now through mouth, i can swallow and I can sip and take little quickly. Is it time to start oral/mouth intake?

    1. Hi Sanat. We are so happy to hear that you are cured and ready to begin eating by mouth again. Since you feel ready to make this transition it is important to talk to your doctor right away. Your medical team will determine if it safe to return to oral feeding and will assist you through the transition.
      -Sarah, Shield HealthCare

    1. Hi Peggy. That is a good question. I am happy to hear that you are able to comfortably eat by mouth! Since your appointment is still a month away, contact your medical office as soon as possible to discuss this new development. Thank you for reaching out and I wish you the best!

  3. My husband has Parkinson’s. He had it like 6 years now. Well 22 days ago he aspirated on me. Doctor said the Parkinson’s was in his throat. Ok so he can’t hardly swallow anymore. So they put a feeding tube in him. So do you think he will be able to eat again bye mouth. Plus he’s 68 years old. An he loves food .

    1. Thank you for reaching out to us, Rhonda. Only his doctor will be able to determine what the safest feeding method is for your husband. Speak with his medical team to discuss his current and future feeding plans.

  4. After rupturing her esophagus and getting surgery, My sister is being feed from the feeding tube at nighttime from 8pm-8am, she’s able to eat soft foods, my question is, once the tube is remove what kind of food should she start with and for how long!

    1. Hi Regina,
      Without knowing your sisters full medical history, it’s difficult for me to give a specific recommendation. In general, however, she will benefit from high calorie, high protein, soft foods.
      Good luck,
      Mary

  5. Hello. I’ve been hospitalized for two weeks due to hypovolemia, dehydration and acute pancreatitis. I am being sent home with a feeding tube to rest my pancreas further. How long does it take to rest the pancreas? How long do you think it will be before I can resume eating regular food?

    1. Hi Maria. Thank you for reaching out. That will be a question for your doctor/medical team as they know your case best. When your pancreas is rested enough and you are able to resume eating typically, they will let you know.

      We wish you the best and hope you feel better soon.
      -Sarah

  6. My mom has a feeding tube but is also able to eat and drink some food. When she drinks the liquid comes out around the peg tube. The doctor doesn’t know why this is happening, so does anyone have a reason/solution to stop the leaking around the tube?

  7. Hi my daughter is 18 months old she was born with a blockage in her intestines’ she has had several surgeries and is on a feeding tube final the issue was fixed around 7 months ago she is finally home and she has been going to speech therapy ounce a week since march this year to learn how to eat. We are trying everything we can to get her to eat she will lick ice-cream have a lick of chocolate sometimes a piece of baby snack but wont take food or a bottle with milk. I really want to know if i missing any tricks or steps i can do without forcing her. In the hospital she used to take a bottle and suckle from mom. she just started to crawl she saying names and understanding. I used to give her medicine by month with a syringe and we never noticed any issues with swallowing. We did change her feeds 180ml for an hour and 3 hours off. Please if you have any ideas that can help I would greatly appreciate it thank you

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