Enteral Feeding

Enteral feeding may be considered as a management strategy in response to concerns regarding feeding safety, adequacy, and efficiency.


  • Children who are enterally fed should receive oral stimulation and/or oral feeding when safe to do so with the support of the healthcare team.
  • Decisions about enteral feeding route will be made by the physician, dietitian, interdisciplinary team, and family.
  • Establish initial and ongoing feeding goals with the child and family that define the quality of feeding (i.e. whether it’s a positive experience), type of feeding, volume of feeds, and duration of tube feeding.
  • Breastmilk is the optimal choice for infants. When breastmilk is not available, a standard infant formula is recommended until 12 months of age. Specialized formula and home blended food for tube feeding may also be considered to meet the clinical needs of the child.
  • Enteral feeds can be administered by continuous, cycled, bolus, or intermittent, or a combination of these methods based on the needs of the child and family.
  • Enteral feeding is a process which requires ongoing monitoring and reassessment to support tolerance, oral intake progression, and weaning when appropriate.

For children with concerns of safety from oral feeding or who are unable to meet all their nutritional needs orally, additional nutrition support in the form of enteral nutrition may be required to optimize health and nutritional intake for growth and development (Corkins, Balint, Bobo, Yaworski, & Kuhn, 2015).

Enteral nutrition is the delivery of nutrients in the form of breastmilk, formula, home blended food, and other fluids directly into the gastrointestinal tract, via an enteral feeding tube (ESPGHAN Committee, 2010); (Corkins, Balint, Bobo, Yaworski, & Kuhn, 2015). 

When oral intake is not possible, enteral nutrition is the preferred method of feeding for patients who have a functioning gastrointestinal tract. Although not without risk, enteral nutrition is preferred over parenteral nutrition as it supports normal gastrointestinal function, has less risk of infectious and metabolic complications, and is more economical (Corkins, Balint, Bobo, Yaworski, & Kuhn, 2015).

Refer to: Figure 7 - Nutrition Support Decision Making Tree