There are a number of reasons why children may have significant difficulties feeding and they may require nutritional supplementation via nasogastric feeding. If a nasogastric feeding tube is likely to be needed for a significant amount of time, say for instance greater than 6 months, then consideration is made for the possible formation of a gastrostomy.
A gastrostomy is a feeding button that goes directly into the stomach from the abdominal wall. Feeds via the gastrostomy are done in exactly the same way as they are done via a nasogastric tube but there is no tube coming out of the nose and irritating the mouth and throat of the child.
A gastrostomy button is placed via a general anaesthetic with a keyhole technique. Children generally stay in the hospital for about 2 nights after the operation and during this time we will take the opportunity to teach you about the care and management of the gastrostomy button. It is generally important before the operation to get an idea as to whether or not your child has significant gastro-oesophageal reflux.
If there is severe gastro-oesophageal reflux or any of the complications of gastro-oesophageal reflux such as recurrent chest infections, oesophagitis, or so much vomiting that we are not able to get enough calories in, and then a consideration might be made for combining the placement of the gastrostomy with a Nissen fundoplication. In the big picture however, most children are able to cope with just a gastrostomy alone.