317 - Nasogastric Tube versus Gastrostomy Tube Feeding in Neonates Discharged from the NICU

Publication Number: 3306.317

muppala Prasanth raju, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Vandana Pothala, Baylor scott and white, Temple, TX, United States; Niraj Vora, Baylor Scott White McLane Children's Medical Center, Leander, TX, United States; Ashith Shetty, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Venkata Raju, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; Ram R.. Kalagiri, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States; raza Bajwa, Baylor Scott and White, Temple, TX, United States; madhava (. Beeram, Baylor Scott and White Health, Temple, TX, United States; Vinayak Govande, Baylor Scott White McLane Children's Medical Center, Temple, TX, United States

Background: Feeding difficulties are highly prevalent among infants discharged from the Neonatal Intensive Care Unit (NICU), especially those born prematurely or with complex medical conditions. Many infants require enteral nutrition via nasogastric (NG) or gastrostomy (GT) tubes at NICU discharge. GT tubes involve surgical risks, potential prolonged hospitalization, and developmental concerns, while NG tubes provide a less invasive, cost-effective alternative limited by dislodgement, aspiration, and caregiver burden.

Objective: To compare post-discharge feeding progression, time to full oral feeds (>90% oral intake), tube removal rates, growth velocity, and healthcare utilization between NG and G-tube groups within 6 months.

Design/Methods: Retrospective matched cohort study (2018-2025) of 96 infants (48 NG, 48 G-tube) discharged with primary tube feeds. Groups matched 1:1 by gestational age (±2 weeks), and primary diagnosis. Outcomes included days to full oral feeds, tube removal by 6 months, weight gain at 3 months (g/kg/day), ED visits, readmissions, and tube complications. T-tests, chi-square, were performed; P< 0.05 defined significance.

Results: NG tubes were associated with significantly faster feeding progression and earlier tube independence. Specifically, infants with NG tubes achieved full oral feeds (>90% oral intake) in a median of 48 days (IQR 30-75) compared to 118 days (IQR 88-152) in the G-tube group (P < 0.001). By 3 months post-discharge, 77% (37/48) of NG infants reached full oral feeds versus only 33% (16/48) in the G-tube group (P < 0.001). Similarly, tube removal by 6 months was achieved in 85% (41/48) of NG infants compared to 50% (24/48) with G-tubes (P < 0.001). GT infants gained more weight at 3 months (21.8 ± 2.9 vs. 18.6 ± 3.3 g/kg/day, P=0.08), trending but not significant. Fewer ED visits in GT group (5 [25%] vs. 10 [52%] in NG, P=0.06).
Similar ED Visits for feeding issues 9 (19%) in GT vs. 8 (16.6%) in NG, P=0.07. Slightly lower readmissions in GT (7 [15%] vs. 6 in NG, P=0.30). Significantly more tube dislodgement (>1 event) in NG (12 vs. 5 [10%] in GT, P< 0.001).

Conclusion(s): NG tubes facilitated significantly faster achievement of full oral feeds and tube removal by 6 months, with persistent differences in dislodgement rates. G-tube advantages in growth and acute care utilization did not reach statistical significance in this cohort. Larger, multicenter studies are needed to confirm these trends, assess long-term neurodevelopmental and quality-of-life outcomes, and refine clinical decision-making algorithms for tube selection at discharge.

Table 1. Baseline and Short-Term Feeding Progression Metrics


Table 2. Short-Term Growth and Clinical Outcomes