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.
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!