4.4 Alternative forms of feeding

If swallowing is too much of a risk and the person cannot safely meet their nutritional and hydration requirements by mouth, an alternative way of taking in food, drinks and medicines may be recommended.  This may be tube feeding via the nose (naso-gastric, NG tube) or directly into the stomach (percutanous endoscopic gastrostomy known as a PEG tube) following a surgical procedure.   

Alternative forms of feeding may also be known as enteral feeding which is the delivery of a nutritionally complete feed directly into the stomach.  These methods may be used as a supplement to oral intake, if safe to do so. 

This section contains some practical information and academic articles about alternative forms of feeding.  The information is likely to be of interest to:

·         Staff working in health and social care

·         Trainers delivering sessions about dysphagia

·         People with swallowing problems and their families and friends

·         Students studying health and social care.

See your doctor, dietician, nurse or speech and language therapist about alternative forms of feeding.

On-line resources

Chest Heart and Stroke Scotland produced a 6 page fact sheet about swallowing problems after stroke in July 2011.  This contains information about NG and PEG feeding. The fact sheet is available here.

Stroke4Carers contains a 9 minute film which shows the basic tasks and use of a PEG tube, see, link.. There are pictures of Nasogastric Tube Feeding (NG) and Percutaneous Endoscopic Gastrostomy (PEG), see link.

Articles

Lamont T et al (2011) Checking placement of nasogastric feeding tubes in adults (interpretation of x ray images): summary of a safety report from the National Patient Safety Agency. British Medical Journal, 342:d2586.  DOI:10.1136/bmj.d2586

Royal College of Physicians and British Society of Gastroenterology (2010) Oral feeding difficulties and dilemmas: A guide to practical care, particularly towards the end of life. London: Royal College of Physicians.   This report is available here.

White S et al (2011) Supporting patients with percutaneous endoscopic gastrostomy (PEG) in the community: developing a home enteral feed programme to avoid hospital readmissions.  Gut 2011;60:A96 DOI:10.1136/gut.2011.239301.199

This poster describes the aftercare patients with a PEG receive in Sheffield. See link.