When your child has a feeding tube, there are a number of people who may be on your healthcare team. Your child's team may be just a doctor and a nurse, or could include a nurse practitioner, a registered dietitian and other specialists. It may be confusing to figure out what each person does and how to work with them to help your child. Your child's healthcare team may include some of the following types of professionals:
A pediatric gastroenterologist is a doctor who has completed specialized training and experience in pediatric gastroenterology to be able to treat children with digestive, liver or nutritional problems. Pediatric gastroenterologists also treat bleeding, swallowing problems, or other problems encountered in the intestines. They have extensive expertise in managing nutritional problems in children, including placement and management of feeding tubes, intravenous nutrition and diagnosing and treating infants, children, and teens with liver disease.
Pediatric Nurse Practitioner (PNP) are Registered Nurses who have completed a formal education program that gives them additional expertise in child healthcare. National certification as a PNP requires a master's degree in nursing.
PNPs can work in private clinics, community clinics, public health clinics, school health clinics, specialty clinics, and hospitals. Some PNPs choose to gain specialized skills that help them care for specific categories of patients, such as orthopedics, neurology or children with special healthcare needs.
You may not have a Pediatric Nurse Practitioner (PNP) on your child's healthcare team, but you will have an RN — who will likely be your main point of contact when you call your child's doctor with a question or a problem. You will likely get to know your child's RN very well, and he or she will be a valuable resource for you.
If you have a Registered Dietitian (RD) on your child's healthcare team, he or she will be your main source of nutrition information. An RD is a nutrition expert who has met academic and professional requirements, and may also hold additional certifications in specialized areas of practice such as pediatrics, renal nutrition or diabetes education. Your RD will be able to help you understand your child's nutritional needs and goals, answer specific questions about tube-feeding formula and feeding schedules, and provide you with information about your child's growth.
A Speech-Language Pathologist (SLP) has a range of expertise and may be working with your child not only on articulation and speech, but on feeding and swallowing problems. If your child is able to take any formula or food by mouth — or if that is a goal for your child — an SLP will likely be a part of the healthcare team.
A pediatric physical therapist is trained and educated to provide children with physical rehabilitation programs. These therapy programs can help assess your child's range of motion, muscle strength, neurological function, motor control and posture, and help to improve strength and movement. If your child needs help in this area, a physical therapist will likely be a part of the healthcare team.
Occupational Therapy (OT) focuses on the physical as well as the psychosocial needs of children. Occupational therapists can help with swallowing disorders, upper body strength and range of motion, sensory problems, assessment of equipment needs for your child, upper body splinting and casting, improving endurance, developmental assessments and alternative methods for pain and nausea management.
A respiratory therapist is trained in providing care specifically for children who need breathing support such as oxygen therapy, breathing treatments or more advanced management for children on ventilators. A respiratory therapist can help manage children with asthma, cardiopulmonary disease, neurological disorders or other conditions that might impair a child's ability to breathe. They can also work with the speech therapists to help children who have tracheotomies regain communication skills.
Pediatric pharmacists are licensed professionals with at least five years of specialized pharmacy education. They often have completed advanced degrees in pharmacy (Pharm D) and residency programs. They will advise other members of the healthcare team about which medications to use and how to use them, or counsel families directly to help them use their medication correctly. They will also make sure that your child's medication regimen will not result in any harmful drug interactions — this is especially important if your child is on many medications at once.
Remember, not all of these healthcare professionals may be a part of your child's healthcare team. Make sure you write down all the people that will be part of your child's team because each of them will be valuable in answering your questions and helping your child get the best care possible.
