"G-tube" info, please?

[VocalMinority]

My 2-y-o son just pulled out a 2-y-o girl's G-tube, on the playground. I did not see the actual incident, but the other parents did. They both completely freaked out and were furious with me. I overheard the Mom say to the other couple they were with, "I can put it back in, but if it takes too long, it'll close up!" Both parents took their daughter to the bathroom and still had not emerged by the time I left, some 20 minutes later.

Their friend made a point of coming over to tell me that they tend to overreact and she thinks they shouldn't let their daughter play with other toddlers, unsupervised. (We were at a Chick-Fil-A, where parents can eat at tables pushed up against a window, overlooking a small play area. So you can see your child - except for moments when they're rounding a curve in a climbing tube, or inside that plastic tree - but it takes a few seconds to physically get to them, if there's a problem.)

My son said, "Mommy, there was a bump on that girl's tummy, so I just pulled it off!"

I would still like to know what a G-tube is? I'm familiar with N-G tubes. Is that what they meant, or was it something directly into her stomach, like my 2-y-o described? Do parents put it in for feedings, or does a doctor place it and it's supposed to be permanent? Was my son necessarily aggressive or mean, in removing it, or could it have happened easily, as the result of normal, impulsive, toddler curiosity?

In other words, was it appropriate that I only gave him a talk? ("If you see something unusual on another person's body, you can ask, 'What is that?', but you can't touch, because you might hurt them. When you pulled that bump on that little girl, it hurt her and now her parents are upset.") Or should I have made him sit in the corner, or leave the playground, like I would have if he'd hit another kid?

[quietmim]

A g-tube is similar to an ng tube in that it goes into the stomach to provide nutrition. It does go directly into the stomach. A doctor does place it initially in what is usually an endoscopic procedure. After this it can be reinserted pretty easily (how easily and the exact process depends on the type). The hole can close up if the tube is out for long enough. I think that time window IS longer than it takes to get to a bathroom.

Now in terms of how you should have reacted. I think this is an usual situation and a talk is in order. I don't believe this is the same as hitting. He couldn't have known this was a medical device and that he needed to stay away from it, and all that... I wouldn't discipline my little lady for something she couldn't possibly know anything about.

And now I am thinking of those other parents... It must be hard to know what is and isn't dangerous for their daughter and when the risk is unacceptable.

[AndVeeGeeMakes3]

My daughter has had a g-tube for most of her life. She's always been pretty insistent that no one touch it, but this has happened to her. The one thing that is important to know is that it DOES hurt, and it can tear the skin around the hole if the balloon, which is what holds it into the stomach, is full. Typically, though, a tube only comes out "easily" if the balloon is a bit deflated.

I'm pretty protective of my daughter and her tube. She also had a trach until she was 3 -- something that kids REALLY wanted to pull on -- and this is why I say that a simple talk may not be enough. I'd really really emphasize that such things (any med equipment at all) should never ever be touched. That it is very serious. I understand that your son meant no harm in doing what he did, but it is pretty serious, and could cause some pretty serious pain and possible trauma. It's true that the parents are likely to be able to get it back in before it closes up, but if that doesn't happen, it has to be surgically replaced. Which is a really big deal. We've thought before, because VeeGee was freaking out while we were trying to replace it, that we weren't going to be able to do it. Twenty minutes seems like a long time if it was working out.

Thanks for coming here to ask. I really appreciate your willingness to hear from us. I'm definitely not beating up on you, just want to underscore how important it is to teach boundaries on such things. It has really really bothered me when parents do not address their child's similar behaviour towards my daughter. I certainly would never want to shame them or use corporal punishment, but would really have liked to see the parents use it as a very serious teaching moment.

[isisreturning]

my 3 yo dd has a g-tube, and i usually keep it taped down because i am afraid of it getting snagged on something or being pulled out by another child. my dd's g-tube has a water-filled balloon on the end that goes inside her tummy - the balloon is bigger than the hole and holds the g-tube in place. however, as the g-tube device ages, the balloon can get smaller and make it easier for the g-tube to come out. i hope that was the case for your situation, because otherwise your dc would have had to have pulled pretty hard to get it to come out (and that would have been pretty painful for the child with the g-tube).

that said, if another child pulled it out, i would not be upset with that child - how on earth would a youngster have any idea what a g-tube is unless he or she had been around them before? the talk you had with your dc sounds perfectly reasonable to me. "don't touch or pull on people's bodies or things attached to people's bodies" is a pretty good rule for all of us to follow!

my dd's g-tube came out in IKEA once. it took us a while to make our way to the emergency room (over 30 min), but they were able to reinsert a new one. it was unpleasant for my dd, but she got over it quickly. the worst case scenario is that the hole closes up and the child has to have another outpatient surgical procedure (under sedation) to have a new one placed. not a life-threatening emergency, but definitely a BIG hassle. (and the child would have to have an NG tube inserted through the nose for feedings until the surgery could be scheduled...)

[2boyzmama]

http://www.themomcrowd.com/tube-feeding-your-child Here's some pictures. I can certainly see where a 2 year old might see that and wonder what it is, and try to touch it, and accidentally remove it. I would not be "furious" unless I had already told the child not to touch it, and they did anyway (and even then, it's a 2 year old!! What do you expect?)

I think it's a fine line between keeping a special needs child safe from accidents like this and secluding them. Maybe this little girl can only play at play places like that under closer supervision, until she is able to guard her own tube. Maybe the parents should make more of an effort to make the tube less accessible when they plan to go to a play place.

I think what you told your son is perfect, he had no way of knowing, and your explanation sounds very reasonable (with lots of other applications too!) It's unlikely that he'll ever run across another toddler with a tube (that he notices, most tubes aren't easily visible) so there's no reason to go into a lot of detail about what it was unless he sees another and asks.

I do feel bad for the girl, no doubt it hurt!! I hope her parents were able to get it back in quickly. Finding that balance of protecting but not secluding is very hard!! We were recently at a Chick Fil A and a little girl there had an insulin pump and was wearing a small backpack. I was really worried watching her climb around, thinking that at any second one of the kids was going to snag the tubing that was coming out from under her shirt and running into the backpack. But I wasn't going to call my kids out and point it out to them specifically, so I just kept an eye to make sure that they weren't intentionally grabbing at it (they weren't, I don't think they noticed).

[aslmere]

At 2, my son used to pull his own button out to get out of things like nap and bed.
Yes, it can hurt. But it depends a lot on the little girl, the reason she has a tube, and her particular device. The button should not be easy to remove if the balloon that holds it in is inflated properly.

My son has lost a button going backwards down a slide before. After 6 years we have seen a lot, though never another child pulling it out before.
I don't know how I would react. But I probably wouldn't be angry, especially at a 2 yo. I would be annoyed and worried, but those are the risks you take with a g-tube.
Also we have had a button out for more than 12 hrs before. (when he was 2 and didn't want to go to bed) I didn't realize it was out until the next morning.
It did not take surgery to put it back in, the GI dr had the right tool to use to stretch it out and pop it back in. It was a little painful yes, but nothing like surgery.

[MotherWhimsey]

My kid has a tube (3 tubes actually!) and I wouldn't be mad if another child pulled one out. That's just kinda one of the risks you take letting your kid play like normal. Sometimes it hurts, other times it doesn't. Every single person in our house has accidentally pulled out a tube.

Kids are naturally very curious and they are obviously not going to know that it's anchored in the kid's stomach.

Most button style (which is what hers sounds like) have a balloon filled with water that holds them in the stoma. So sometimes that balloon pops or sometimes it comes out whole. Either way the parents should be able to put it back in in most cases.

Here's a button style tube (a little different than just a G tube, it's got two ports in it).

[VocalMinority]

Thank you for all the replies!

I understand the difficulty for the girl's parents, in figuring out how to balance protecting her and letting her play normally. I have Autistic teenage twins. Although they have no medical vulnerabilities (like a G-tube), the older they get and the more independent they want to be, the more I struggle to discern when to let them do the things normal kids their age do without parents and when to protect them from their own difficulties at reading social cues, solving problems independently and making well-reasoned decisions. On a certain level, that "protect v. let go" struggle is the crux of parenting, under any circumstances!

After reading everything you ladies gave me, I feel relieved that my son probably was not intentionally rough or hurtful to this girl. Also, since she did not cry or complain about it at all and was still playing with my son when her parents pulled her out of the plastic tree, hopefully it was one of those circumstances where the balloon was not properly inflated, allowing the tube to come out more easily, without much pain.

I do think the message got through to my toddler, as much as possible. When I got to the part about it hurting when he pulled the bump on the girl's stomach and her parents being upset, he put his head down, said, "I'm sorry!" and wanted to snuggle with me. I would have had him apologize to the girl, too, had we seen her again. But of course, that alone will not cure impulsivity in a 2-year-old. So it's a lesson to me, too, to take a closer look at the kids he'll be playing with, if I'm going to step away, and to remind him how to behave/not behave before he causes a problem.

[Lindsay1234]

Originally Posted by isisreturning

that said, if another child pulled it out, i would not be upset with that child - how on earth would a youngster have any idea what a g-tube is unless he or she had been around them before? the talk you had with your dc sounds perfectly reasonable to me. "don't touch or pull on people's bodies or things attached to people's bodies" is a pretty good rule for all of us to follow!

[Hopesmommy]

I wouldn't be upset with your son at all, but I would try to make him understand that it's best not to pull on things that are attached to other people in the future.

My son has a g-tube/button though, and I will say that yes, sometimes it can be hard to get it back in if it comes out, and yes, sometimes it does require surgery to put it back in if it's left out too long. That can be a problem when you have a child who has life-threatening reactions to anesthesia but has to have his tube.

I can totally see myself being in those parent's shoes. Every time that Liam's button has accidentally been pulled out it is very stressful for both of us. We've always been able to get it back in, but there's been a few times where is took a while and it was painful for him.

To be perfectly honest, I'm a little offended at the friend. So are these people just supposed to never allow their child to do anything? Never go anywhere? Should we just have those kids all institutionalized or something? Yikes! Okay, so maybe I'm overreacting a little now, but I think that's a little ridiculous.

But no, I wouldn't be upset with you or your child at all, but I might seem that way because I would be worried at the situation. I think you handled it just fine.

[Jessmomto2]

Originally Posted by Hopesmommy

I wouldn't be upset with your son at all, but I would try to make him understand that it's best not to pull on things that are attached to other people in the future.

My son has a g-tube/button though, and I will say that yes, sometimes it can be hard to get it back in if it comes out, and yes, sometimes it does require surgery to put it back in if it's left out too long. That can be a problem when you have a child who has life-threatening reactions to anesthesia but has to have his tube.

I can totally see myself being in those parent's shoes. Every time that Liam's button has accidentally been pulled out it is very stressful for both of us. We've always been able to get it back in, but there's been a few times where is took a while and it was painful for him.

To be perfectly honest, I'm a little offended at the friend. So are these people just supposed to never allow their child to do anything? Never go anywhere? Should we just have those kids all institutionalized or something? Yikes! Okay, so maybe I'm overreacting a little now, but I think that's a little ridiculous.

But no, I wouldn't be upset with you or your child at all, but I might seem that way because I would be worried at the situation. I think you handled it just fine.

[bandgeek]

I wouldn't expect a 2 year old to know not to pull at a g-tube. Did YOU even know she had one? If you didn't know then the parents are really, truly overreacting by being angry with you.

Aside from all that, I don't consider a pulled tube to be an issue at ALL. Sometimes it can be painful for the child, although with a healed site it usually isn't. It takes about 5 minutes to pop it back in. If it isn't put back in, they may have to stretch the stoma and/or do surgery, but that only happens if you don't put the tube back in right away. As a parent of a kiddo with a tube, I always make sure I have a replacement kit with me so that I'm not stuck without a way to get it back in. WORST CASE SCENARIO is that they'd have to pop the balloon, stick it back in her, and put tape over it until they could get her in to get a new one (or run home for a new one). Even if they didn't have a syringe to replace it, she wouldn't be at risk of her stoma closing up.

My DD has a GJ tube which requires a trip to the hospital to have it replaced in radiology and even with the inconvenience of that, I don't get mad when her tube gets pulled because it is just a normal part of life when you have a kid with a tube. It WILL happen from time to time and it's not usually anyone's "fault".

[hannahgrace]

My son has a G-J tube, which like the PP said, requires reinsertion at the hospital in radiology. We try to have our son be as "normal" as possible and he plays with other kids. If another child pulled out his tube, I would hope I would react with grace, however, depending on my stress levels, I may react in a not so loving way. Just being honest here. I would not judge that mom for getting angry. Having a medical needy kid is just stressful. Its hard to balance normalacy that you want your child to experience and the fact that your kiddo has special needs.

[anj_rn]

I would not be happy, because I would never want my child to be in pain. That being said, I think a firm discussion with your child is sufficient. You might need to remind him the next few times you go to a playground. The mom was probably just reacting to a very stressful situation. I think that it is great that the child gets to play with others, although the button is very tempting, so I would make sure it was covered up.

My daughter has pulled out her tube and her button (once with the ballon inflated, I am sure it hurt, but it did not cause permanent damage. Very rarely does it require surgery if put in quickly, but most parents are warned not to delay reinsertion and if they can not get it in to go directly to the ER. The idea being to get something in the stoma before is closes.

[deenota]

Hi all,

First time posting here, just found this post through searching.

Just to the OP, even though this is LONG ago. The biggest thing we have had to teach our four kids(including a toddler with a g-tube) is personal space. Thankfully our kids haven't accidentally or 'on purpose' pulled out her tube... However, I am sympathetic to the other parents ONLY because a g-tube can literally close up in a matter of minutes and if your doc is in surgery, out of the office or it is after hours, it costs an arm and a leg to get the ER to replace a g-tube. Many insurances will not cover the full cost(including our insurance) because they can file it under "medical neglect". Yes really-apparently my daughter heals very well at her g-tube site... Her tube fell out overnight without us knowing it, and had to be taken to the ER at 4am, and we were charged over $700 out of pocket because of the way the insurance felt about it.

While i get that you son was not intentionally being malicious, this could have been a very costly situation-g-tube sites can start closing within minutes-I am assuming they probably had to take her to the doctor considering the amount of time it was taking them? it literally takes less than 30seconds(maybe a minute if the kid is being hostile) to put the tube back in.

[USAmma]

I am sorry this happened for both parties involved. It must have been awful for you and scary for that family. My child had a gtube and I too would not be angry at your son for pulling it out if he did it to her. My oldest (no tube) used to pull out other kids's pacis out of curiosity and impulsiveness and I can see how a curious child would pull out a gtube at that age, too. 

I was protetive of my child's tube and never had it exposed in plain sight. Was always under a onesie, and usually taped into place as well. If I had a child with an exposed device such as a trach (breathing tube) I would be following that child around until they were old enough to manage it themselves. When she started school and had her tube, I put her in jumpers to prevent any accidental pulling and the teacher had a talk to all the kids not to push or pat any tummies, without pointing out my daughter specficially. 

At least you know that probably even if this other family had to go to ER to get the tube replaced, its probably not life threatening. Unpleasant but a child can live on IV fluids for whatever until they get the tube  back in.