February 26, 2018
Total parenteral nutrition (TPN) and tube feeding are two distinct methods of nutritional delivery for patients who are unable to meet their own nutritional needs. If someone is at risk of malnutrition due to an injury, disease, other medical condition, or a non-functional gastrointestinal system, supplemental feeding can help meet caloric and nutritional needs. Supplemental nutrition can be used on a short-term and long-term basis and can consist of partial or total feeding.
If you have been recently introduced to one or both of these concepts in relation to the care of your child or a loved one, educating yourself on the differences can be helpful. That’s why we’re happy to share the following guide to help you be more informed and engaged in this important aspect of care.
How TPN and Tube Feeding are Different
There are two primary methods that caregivers use to deliver nutrients to patients who are partially or totally unable to digest food. The first is enteral feeding which involves delivering food directly through a catheter or tube directly into the gastrointestinal (GI) system. The second is parenteral feeding, which is when nutrients are delivered directly into the bloodstream.
What is Tube Feeding?
Enteral feeding is also called tube feeding. The food is delivered in a liquid form through the tube, which can be inserted through the mouth, nose, or directly into the small intestine. Due to the fact that it is cheaper, less invasive, easier to monitor, and offers less risk of infection compared to forms of parenteral feeding, tube feeding is usually the primary method of nutrition for patients who cannot ingest food orally. Since it does require a functional GI tract, there are many patients who cannot benefit from a feeding tube and require nutrition directly injected into the bloodstream.
Types of Parenteral Nutrition
Parenteral nutrition is divided into two main types: total parenteral nutrition (TPN) and peripheral parenteral nutrition (PPN).
What is PPN?
PPN is usually used for patients on a short-term basis who do not require all of their nutrients through parenteral nutrition.
What is TPN?
TPN is a long-term method for delivering calories and nutrients directly into the bloodstream. This is done through an intravenous (IV) catheter inserted directly into the jugular vein or another large blood vessel.
TPN is commonly used for patients with paralysis of the GI tract, Crohn’s disease, chronic diarrhea, underdeveloped digestive systems, certain forms of cancer, and congenital defects in the digestive system.
Because TPN requires a permanent or semi-permanent IV catheter line, it must be carefully monitored for infection. The nutritional formulation must be carefully balanced for each individual patient, and blood levels must be carefully monitored. Additionally, TPN can come with the risk of embolism and vein thrombosis, which requires further monitoring and care.
Overall, the advantages of TPN vs tube feeding are highly situational. A physician will recommend one over the other based on the specific diagnosis. In most lower-risk cases of potential malnourishment, patients will use tube feeding. TPN will generally be used for patients with a non-functional or heavily impaired GI tract to ensure adequate nutrition.
Meeting the Nutritional Care Needs of Children through TPN or Tube Feeding
Newborns and young children dealing with a wide range of conditions, illnesses, and congenital birth defects may require either tube feeding or TPN to meet nutritional requirements. As with all patients, tube feeding is usually the preferred method if possible due to the lower risks and ease of delivery.
Newborns, infants, and small children may require TPN if there is abnormal bowel function, short bowel syndrome, or after surgery to remove a damaged or dysfunctional part of the GI tract.
Parents and other caregivers can be trained to deliver TPN at home with the use of specialized equipment. This will usually involve preparation of the nutritional formulation, and safe administration through the catheter. Patients receiving at-home TPN will require regular monitoring and analysis from a physician to ensure nutrient levels remain balanced and complications are not developing.
For many babies and children receiving at-home TPN or tube feeding, pediatric home care can help family and other caregivers find balance while ensuring that nutritional needs are being met safely. Pediatric home care professionals are trained in a full spectrum of services, including tube feeding, IV catheter maintenance, and accompanying patients to physician appointments.
Contact Care Options for Kids For Pediatric Home Health Care
It can be hard to balance your time between work, home, and caring for a child. That’s why our team of skilled professionals at Care Options for Kids is here to help.
Our home health care services offer support in the comfort of your home. We refer loving and competent nurses to provide customized care for families — from a few hours a day to around-the-clock supervision. Contact us directly to speak with a home health care professional or request a free in-home assessment. Together we can determine the best plan of action to keep your loved ones happy and healthy.
If you are considering pediatric home health care services, contact the caring staff at Care Options for Kids. Call today at (888) 592-5855.