Doctors sometimes need to place special feeding tubes in very sick newborn babies to help them get nutrition. This study tested whether adding air to the stomach would help doctors place these tubes in the right spot more often. Researchers compared two groups of 11 babies each—one group received the air technique and the other didn’t. Surprisingly, both groups had the same success rate of about 45%. The study found that the air technique didn’t make a difference, and both methods were safe for the babies.

The Quick Take

  • What they studied: Whether blowing air into a baby’s stomach helps doctors place feeding tubes in the correct position past the stomach into the small intestine
  • Who participated: 22 critically ill newborn babies in a hospital’s intensive care unit, ranging from 27-28 weeks old at birth, weighing around 1000 grams (about 2.2 pounds)
  • Key finding: Both the air technique and the regular technique worked equally well, with about 45% success rate in each group. This means the air technique didn’t provide any advantage
  • What it means for you: If your baby needs a feeding tube, doctors can use whichever technique they’re most comfortable with—the air method doesn’t offer extra benefits. However, this was a small study, so larger research may provide more definitive answers

The Research Details

This was a randomized controlled trial, which is considered one of the strongest types of medical research. Researchers randomly divided 22 sick newborn babies into two equal groups. One group (11 babies) received the new technique where doctors pumped air into the baby’s stomach before placing the feeding tube. The other group (11 babies) received the standard technique without the air. All babies were in a hospital’s intensive care unit and needed feeding tubes because their stomachs weren’t tolerating regular feeding well.

The researchers used X-rays to check if the tubes were placed correctly. A successful placement meant the tube reached the third or fourth part of the small intestine (duodenum), which is past the stomach. They compared how often each technique succeeded and looked for any problems that occurred.

Both groups of babies were very similar in terms of birth weight, how early they were born, and their age when the procedure was done. This similarity is important because it means any differences in results would likely be due to the technique, not differences between the babies.

This research matters because feeding tubes are critical for helping very premature and sick babies survive and grow. When babies can’t digest food normally, doctors need reliable ways to place tubes in the right location. If the air technique had worked better, it could have become standard practice. Understanding which techniques actually work helps doctors make the best choices for their patients.

This study is a randomized controlled trial, which is a strong research design. However, the sample size is quite small (only 22 babies total), which means the results might not apply to all babies everywhere. The study was conducted in one hospital, so results might differ in other settings. The researchers did a good job of making sure the two groups were similar before starting. The fact that both groups had identical success rates (45%) is interesting and suggests the air technique truly doesn’t help, but a larger study would provide more confidence in this conclusion.

What the Results Show

The main finding was that both techniques had exactly the same success rate: 45.4% in the air insufflation group and 45.4% in the regular group. This means that in both groups, the tube was placed correctly in the small intestine less than half the time. The difference between the groups was zero, which is statistically significant in showing there’s no advantage to the air technique.

When tubes weren’t placed in the duodenum (the first part of the small intestine), they sometimes ended up further down in the jejunum (the middle part of the small intestine). This happened in 27.7% of babies in the air group and 9.1% in the regular group, but this difference wasn’t statistically significant enough to be considered meaningful.

Two babies experienced serious complications during the study: one developed necrotizing enterocolitis (a serious intestinal infection) and one had a jejunal perforation (a hole in the intestine). However, neither of these problems was caused by the tube placement procedure itself—they were separate medical issues.

The study found no significant differences between the two groups in terms of birth weight, gestational age (how early the babies were born), or how old the babies were when the procedure was performed. This confirms the groups were well-matched. The rate of tubes ending up in the jejunum instead of the duodenum was higher in the air group (27.7% vs 9.1%), but this difference could have been due to chance given the small sample size. No complications were directly related to either tube placement technique.

Previous research has explored various techniques to improve feeding tube placement in newborns, with mixed results. Some studies suggested that certain positioning methods or techniques might help, but this study found no benefit from the air insufflation method. This adds to the growing body of evidence that simpler, more straightforward approaches may work just as well as more complex techniques. The findings suggest doctors shouldn’t feel pressured to use the air technique if they’re not already doing so.

The biggest limitation is the very small sample size of only 22 babies. With such a small group, it’s hard to detect real differences if they exist. The study was done in only one hospital, so results might be different in other hospitals with different equipment or staff experience. The success rate of 45% in both groups is relatively low, which raises questions about whether either technique is optimal. The study doesn’t explain why the success rate was so low or what factors might improve it. Finally, because this is a small study with equal results in both groups, we can’t be completely certain the air technique truly offers no benefit—a larger study might find different results.

The Bottom Line

Based on this study, there is no strong evidence that the air insufflation technique improves feeding tube placement in newborns. Doctors can use whichever technique they’re most experienced with. However, this is a small study, so these findings should be considered preliminary. Parents should discuss tube placement options with their medical team, as individual circumstances may vary. Confidence level: Moderate (due to small sample size)

This research is most relevant to neonatal doctors and nurses who care for very sick, premature babies. Parents of babies in intensive care who need feeding tubes should be aware that doctors have options for tube placement, and the choice between techniques may not significantly affect success rates. This doesn’t apply to older children or adults, as feeding tube placement is different in different age groups.

Feeding tube placement is typically assessed immediately after the procedure using X-rays. If a tube is placed successfully, babies can usually begin receiving nutrition through it within hours. If placement is unsuccessful, doctors will attempt again or try a different approach. Benefits of proper nutrition delivery can be seen over days to weeks as babies gain weight and develop.

Want to Apply This Research?

  • If your baby has a feeding tube, track daily feeding tolerance by recording: amount of milk/formula given, any residual (milk left in stomach), signs of feeding intolerance (vomiting, bloating), and weight gain. Note the date the tube was placed and any repositioning attempts.
  • Work with your medical team to establish a feeding schedule that matches your baby’s tolerance. If your baby shows signs of feeding intolerance, document these observations to share with doctors. Ask your care team which tube placement technique they’re using and why.
  • Monitor your baby’s weight gain weekly, track feeding volumes and tolerance daily, and maintain a log of any complications or concerns. Share this information with your medical team at each visit to help optimize your baby’s nutrition plan.

This research applies specifically to critically ill newborn infants in intensive care settings and should not be applied to other age groups. Feeding tube placement decisions should always be made by qualified medical professionals based on individual patient needs. This study is small and preliminary; parents and healthcare providers should discuss tube placement options with their medical team. The findings do not constitute medical advice. Always consult with your baby’s doctor or neonatal specialist before making any decisions about feeding methods or tube placement techniques.