Any ideas on what to do?

[Momof4]

I'm concerned for the child, she should be with a qualified medical professional or her parents and nobody else until she is well and thriving. Are you seriously still considering doing this?

[bright sparks]

For me this is not about the actual feed as with proper instruction it's not difficult, even remotely. Let me give you a couple of scenarios of when this child's "special need" will take you away from the other kids. When the tube gets pulled out and she is extremely upset because it hurt and/or uncomfortable.... Whether she pulls it a little, a lot, or all the way out you will have to console this child, clean up the mess and have to call the parents. How are you going to deal with this potentially common occurrence and still provide adequate care and attention to the others?

I also wonder if in a few weeks or a couple of months time there will be resentment based on how much extra time you have to give the child and the reoccurring times you are calling the parents to come and collect because another child has pulled the tube, or it has become caught? If it becomes regular, there's every chance the parents are going to become frustrated with you for not "paying enough attention" to their child in preventing the tube from being pulled or caught.

It's very different if the ratio is smaller but you have four other children who demand a lot of your attention which means the extra attention this child needs, is at the expense of the other children or even the special needs child's best interests and regardless of how nice this family is, if anything should happen big or small, the fingers will all be pointed at you. Walk away for goodness sakes. This isn't a reflection of your ability to safely and adequately feed the child, but the reality of the logistics of providing adequate care for all the children in your care. Just my two cents...

[momofnerds]

if this was my child I would take a loa from work or work part time or cut my hours.. I just couldn't imagine leaving my sick child with someone all day.

also, I don't think a child would pull the tube out because its attached to the belly and usually a shirt would cover it, I would be worried that I would pull it out by mistake doing a diaper change or the pants would rub on it and pull it out.

[bright sparks]

mom of nerds.... they will grab at it where it goes in the nose. I have lots of experience with this from working in acute care, and the sanest of adults find the dam things irritating. From the posts I have read, this feeding tube will go in via the nose and down into the stomach, not actually through the belly, hence why it is at risk for being pulled out. Also lets not forget we are talking about a 17 mth old. With lots of 1 on 1 this child will surely adapt and learn to cope well, but initially it will be a huge adjustment requiring one on one to constantly remind her not to touch and to make sure it stays clean. I shirt will likely cover part of the tube where the end will no doubt be taped underneath and out of the way in between feeding, but it will still be on the face and neck.

[abster]

There is no doubt that the child will pull out the tube and maybe on a daily basis (my son had ng for long time) it doesn't normally hurt them they are usually pleased with themselves lol... and going all day with not being tube fed is very common to get the oral aversion to be better. Continuous night feeds are very common so the child gets all their recommended intake for the 24hr period. So its not neglect for the child to not get tube fed for during the day :-)