Feeding when a tracheostomy tube is in place

​​A tracheostomy tube can affect your child's ability to safely swallow food and liquid. This is because the tube can:

• weaken the reflexes of and muscles around the larynx (voice box)
• reduce the effectiveness of coughs to clear any food or liquid that enters the trachea
• cause the upper airway to become desensitized to food or liquids (because air is travelling through the tube instead).

How can I tell if my child has difficulty swallowing?

If your child has a swallowing problem:

• they may choke and/or cough while eating or drinking
• they may refuse to eat
• they may have excessive drooling
• their lungs may sound congested
• some food may be found in the tracheostomy secretions
• there may be large amounts of watery secretions from the tracheostomy tube
• they may have frequent respiratory infections.

How will my child’s health-care team confirm if my child can feed by mouth?

If it was safe for your child to eat and drink by mouth before the tracheostomy tube was inserted, an occupational therapist or speech language pathologist will examine them to assess if and how a tracheostomy tube insertion has changed this.

The assessment might include:

• observing how your child swallows different consistencies of liquids and/or solids
• assessing your child's vocal cord movement
• doing a videofluoroscopic feeding study.

Using the results of the assessment, your health-care team will work with you and your child to develop a suitable feeding plan. Your child may need a gastrostomy tube​ (G tube or GJ tube​)​ to help them get enough nutrients.

If my child can eat by mouth, how can I make sure they do so safely with their tracheostomy tube in place?

If your child is able to eat by mouth, suction the tracheostomy tube before they have any food or drink. Suctioning before eating can often prevent the need for suctioning during or after meals, which may cause coughing and could result in vomiting. 

It is also important to have your child drink enough liquids during the day to stay hydrated. Hydration will help thin and loosen the secretions, making them easier to clear through coughing and suctioning.