"Trans-pyloric feeding All infants with a trans-pyloric feeding tube require a gastric tube in place for aspiration, potentially drainage and possible medication administration (consult the Pharmacist or Neonatologist involved). Trans-pyloric tubes may be on free drainage but are not used for regular aspiration. Indications *Infants who are not tolerating gastric feeds. *Duodenal atresia - post-operatively *Infants who are at great risk for aspiration, e.g. gastro-oesophageal reflux receiving CPAP. Risk is minimised because the end of the tube is beyond the pyloric sphincter. Complications *Aspiration *Difficulty with tube placement *Perforation of the gut *Malabsorption Considerations *Trans-pyloric feeding may induce symptoms of malabsorption because the stomach is not able to aid in digestion e.g. frequent bowel motion, slow weight gain, necrotising enterocolitis. *Consider where medication is absorbed prior to administration (i.e. stomach or small intestines)"