This page deals with the practical issues of tube feeding at school. Most children with feeding tubes will also need an IEP or 504 plan to meet their needs in the school environment. Our page on Special Education discusses how these plans work, and which might be right for your child.
Tip: Train multiple people at the school to feed your child, just in case the regular person is absent or has an emergency.
Tube Feeding at School
Many kids are tube fed at school. Some kids are able to eat orally during their school day. But, either way parents must make sure that the protocols they set in place are being followed.
Write it into the IEP or 504 Plan
We have detailed information on IEPs and 504 Plans on our Special Education page. The IEP or 504 Plan is the appropriate place to describe a child’s tube feeding regime – from how they should be fed at school, be it via their feeding tube or orally. If your child needs assistance during meal-time, even for oral eating, it should be written into their IEP or 504 plan. Most schools will also require a doctor’s note, prescription, or set of instructions. For additional assistance, see also these guidelines: Resources for the Provision of Nutrition Support to Children in Educational Environments.
Give the school information on safe handling procedures:
Clean hands before venting a child or attaching an extension set
Wear gloves when appropriate
Make sure that tubing is out of the way during toileting/diaper changes
Ensure that tube sites are not touched by students
Many schools have strict policies on what they will do if a tube is pulled out. Make sure you understand the school’s policy. Some schools will have a nurse replace it, but many will not. Some will do nothing, while others will call 911 for paramedics. It is important for there to be clear directions on who to call (or how to proceed) in the event that this happens. Ideally, schools should have a trained staff member available to replace the tube immediately.
If children are active during the school day or receive physical therapy and there is going to be a possibility of sliding on the tummy or similar activities, you may want to consider protecting the tube site with an ace bandage or G-tube protective belt.
Additional Tips for School
Write down the instructions for your child’s feeding regimen. Be specific about volume being fed, over what period of time, etc. Offer to train staff – be it a nurse, nurse assistant or aide on tube feeding your child. Make sure at least two people are trained.
Many schools have rules about what feeding practices they will allow. Make sure you find out in advance any specific limitations your school district or school location has in place. Pump and gravity feeds are typically not a problem, but parents may encounter some issues with feeds given by syringe.
If you are sending in supplies, make sure they are clean and clearly labeled for your child. See if the school nurse or teacher will hold back-up supplies.
If you are sending in a venting tube to stay at school, make sure that you discuss cleaning with the school nurse, aide or staff. During the school year, you can ask that it be sent home so you can evaluate if it needs replacing.
Make sure that food or formula is in a cool pack with an ice pack if it needs to remain cool during the day.
If you are sending a pump and backpack, make sure that staff understand how to troubleshoot alarms. And, make it clear that turning the pump off and not feeding your child isn’t an acceptable solution.
If your child is an oral eater, provide any information to the teacher about food allergies, unsafe foods, and aspiration risks. You can state that only food you send in should be served to your child.
Talk to the teacher to find out if any foods will be used in art projects or if there are class cooking projects to determine what, if any, limitations your child may have from participating in those activities. Kids with allergies, or who cannot eat may need an alternate activity or materials.
If your child has a feeding pump, it may have to be turned off during bus rides. Make sure there is a dedicated person (and a back-up) who is responsible for turning it back on.
Feeding Tube Awareness also has a comprehensive School Training Presentation for school nurses, teachers, aides, and other school staff. It is available below as either a PDF or a Powerpoint Presentation.
Feeding Tube Awareness also has both a Field Guide and a Quick Guide for the Moog Infinity pump. The Field Guide shows how to operate the pump and navigate the full range of error messages, with easy-to-follow instructions and pictures. The Quick Guide is smaller, has all the needed instructions, and can be easily made into a small booklet for school, daycare, or caregivers.
Children are curious by nature and when given the right information from the right source, they can be very accepting of people with differences. We suggest considering giving a feeding tube presentation to children in the class. The following materials will help you create a presentation.
Here’s a basic format that can be used for contacting teachers or schools:
Dear Mr./Ms./Mrs. _____________,
Our family will be participating in Feeding Tube Awareness Week the week of February _________ in honor of our son/daughter/cousin/friend _______________________, who is dependent on a feeding tube. As part of a nationwide initiative, we would like to help spread awareness by doing a short presentation for your class about feeding tubes. We will explain what they are, why people need them, what they look like, and that feeding tubes are nothing to be afraid of. Our hope is that education will foster acceptance and understanding of children who depend on this lifesaving medical device.
If this is something you would be interested in, please contact me at ______________ to set up a day and time that would work for your class.
Explain that for many reasons, some people aren’t able to eat or drink enough to be healthy so they need a feeding tube in order to get all the nutrients and fluids into their bodies without eating or drinking.
Name the types of feeding tubes and go into whatever detail you feel is appropriate for the age group. It’s not necessary to explain all of these but these are the types of tubes: Nasogastric (NG), Nasojejunal (NJ), Nasoduodenal (ND), Gastrostomy (G), Gastrostomy-Jejunostomy/Gastric-Jejunal (GJ), Jejunostomy (J), Oral Gastric (OG)
Explain how each type of tube is inserted and what type of care & maintenance each one requires.
Why do people need feeding tubes?
Weak swallowing muscles
Severe food allergies
Physical disabilities (inability to feed oneself)
Cancer (including lack of ability or desire to eat due to effects of chemo/radiation as well as inability to eat due to having parts of GI tract removed because of cancer)