Tube feeding is often administered in bed - a location not typically associated with eating or socialization with others. Tube-fed children who are absent from family mealtimes may fail to develop appropriate mealtime behaviors. Instead they demonstrate feeding misbehaviors such as crying, refusing to open the mouth, pushing food away, or total refusal to eat. Without proper management, these inappropriate behaviors result in a considerable increase in attention provided to the child as well as the opportunity for them to exert control over others. Feeding difficulties are a source of great stress to parents.
Many parents blame themselves or feel blamed by others when problems arise.
Although there is little scientific evidence regarding efficacy of the various methods, it is common practice to provide the infant with opportunities to practice oral-feeding skills through the developmentally appropriate use of a pacifier or teething ring, as soon as tube feedings are initiated. Tube feeding should be given while the infant or child is seated at a table at mealtime. Where possible, they should be given the opportunity to see, smell, taste and play with food while being tube fed. These experiences foster a positive association between being fed, food and the social enjoyment of being part of a family activity. An infant is safe and ready to feed orally if he has the ability to gag and reflexively protect his airway, and demonstrates rhythmic, non-nutritive sucking with even respirations and swallowing of secretions.