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Enteral & Parenteral Feeding
By Caetyn Groner, MS, CCC-SLP
Some children with a laryngeal cleft may require alternative methods of hydration, nutrition, and medication administration when eating and drinking by mouth are not safe or adequate. Depending on a child’s needs, this may include enteral feeding methods, such as feeding tubes, or less commonly, parenteral nutrition delivered through the veins.
Enteral
There are several types of enteral feeding tubes that allow children to receive food directly into the gastrointestinal tract, bypassing the mouth. These enteral feeding methods provide your child with hydration and nutrition, while bypassing their eating and drinking difficulties. This feeding method also allows the consistent and safe administration of medications to your child.
Feeding tubes can provide supplemental nutrition (additional nutrition and hydration to what your child takes by mouth) or complete nutrition (all your child’s nutrition and hydration needs). Just like thickener, a feeding tube does not prevent a child from aspirating on their own secretions, such as saliva and reflux. Surgically-placed feeding tubes naturally carry additional risks related to surgery, the stoma, and maintaining and tolerating enteral feeds. Other risks and complications exist.
Parenteral
Total parental nutrition (TPN) delivers hydration and nutrition through the child’s veins. Most children with a laryngeal cleft will be able to drink thickened liquids and/or use a feeding tube to receive adequate hydration and nutrition. However, TPN may be needed temporarily in some cases, such as after an open laryngeal cleft repair. The details of TPN are beyond the scope of this article.