Tube to Breast
Navigating the Transition from Enteral Feeding to Breastfeeding
In this 5.5-hour, self-paced continuing education course, you will learn concrete skills to be confident to introduce and optimize breastfeeding with the goal of weaning enteral feedings.
Treating infants who are tube-fed can be intimidating and challenging.
This course covers the reasons why infants may need enteral tube feedings, key differences between continuous and bolus tube feedings that have implications for weaning, as well as ways to promote a positive introduction to breastfeeding.
Focus is placed on factors that must be in place before weaning enteral feedings and red flags that warrant further evaluation.
Ready to get started?
Learning Objectives for Tube Feeding CEU:
Participants will be able to:
- List at least three reasons why infants may need enteral tube feedings
- Identify key differences between continuous and bolus tube feedings that have implications for weaning
- Describe three ways to promote a positive introduction to breastfeeding for infants who are tube fed
- Recognize three specific things that must be in place before weaning enteral feedings for breastfed infants
- Identify three red flags when working on weaning enteral feedings with an infant that would warrant further evaluation from a medical provider
- Recall unique considerations between weaning an infant who is tube fed and a child who is tube fed
HERE'S WHAT'S INSIDE
RECORDED VIDEO Lessons
PDF Downloads
Recources
Let's Look Inside the Course
Infants who are tube-fed are complex — so don’t rush as you complete this CEU course. This course is self-paced. You can pause, replay, and watch the videos as many times as you’d like — which is especially nice since you may not always have an infant on your caseload who is tube-fed.
Module One (1 hour 11 minutes)
Tube Weaning Introduction
- Introduction
- Reason for Tube Feedings: metabolic, failure to thrive, oral aversion, sensory, medical, dysphagia
Module two (58 minutes)
Enteral Feeding Overview
- Comparison of tube feeding methods
- Promoting earlier discharge with NG tube
- NG-Tube or G-Tube decision tree
Module three (41 minutes)
Considerations for Breastfeeding
- Strategies for facilitating safe oral experiences at the breast
- Alternative feeding strategies (cup, paladai, spoon) with case video and images
- Clinical assessment to measure ongoing progress
- Case Study A: Infant with NICU admission
Module four (1 hour 18 minutes)
Breastfeeding & Tube-Feeding Interventions
- Tube weaning process: A stepwise approach
- Common barriers and strategies
- Considerations for continuous vs bolus feeding schedules
- Weighted feeding considerations
- Case Study B: 4-month-old former 28+3 week infant
Module five (1 hour 21 minutes)
Complex Cases & Conclusion
- Red flags, VFSS, FEES, dysphagia
- Case Study C: Infant with HIE
- Considerations for older infants/children
- Review of research for various weaning protocols
- Psychological impact on parents
Transitioning from tube-feeding to breastfeeding is possible for many infants with the right assessment, preparation, and interventions.
Course Instructor
Kelly Andrasik McLeod OTD, OTR/L, BCP, IBCLC, CNT
Kelly Andrasik McLeod is a doctorally trained occupational therapist who works as the advanced clinical specialist for the OT department at a large San Francisco Bay Area teaching hospital. She specializes in feeding and swallowing and developmental rehabilitation, for infants in the NICU and neonatal cardiac ICU. Kelly is a Certified Neonatal Therapist (CNT), is board certified in pediatrics (BCP) through AOTA, has her advanced practice certification in “Swallowing Assessment, Evaluation, and Intervention”, and is an International Board-Certified Lactation Consultant (IBCLC). Kelly’s doctoral capstone examined and promoted occupational therapy’s role in maximizing breastfeeding support and improving breastfeeding outcomes for medically fragile infants.
In addition to her clinical pursuits, Kelly is a passionate instructor for OT students, as an adjunct faculty member of KUMC’s post-professional OTD program since 2020, and for healthcare professionals, by providing continuing education courses through The Lactation OT and Coast Allied Health. She has also presented for the National Association of Neonatal Therapists, the National Association of Neonatal Nurses, Stanford's High Risk Neonatal Symposium, Occupational Therapy Association of California, the Stanford Design School, and internationally for Stanford’s NeuroNICU Outreach and the Teach to Heal program.
Kelly currently provides two online continuing education courses for healthcare professionals through The Lactation OT entitled “Reframing the Clinical Approach: Breastfeeding Assessment and Intervention for the Medically Fragile Infant” now with six additional specialty modules on high risk diagnoses and “Tube to Breast: Navigating the Transition from Enteral Feeding to Breastfeeding”.
Instructor Disclosures
AOTA Approved Provider, ASHA CE Approved Provider, IBLCE Long-Term Provider
Enroll NowFrequently Asked Questions
Who is this course intended for?
- Occupational Therapy Practitioners (OT & OTA)
- Speech Language Pathologist (SLP & SLP-A)
- Physical Therapy Practitioners (PT & PTA)
Are there prerequisites for this course?
There are no required prerequisites.
Can I count this course towards my 90 hours of lactation-specific education?
Absolutely! This course is approved for 5.5 L-CERPs. To receive credit for completion, each participant will need to complete a post-assessment with a passing score of at least 80% to ensure all learning objectives are met.
Information about AOTA CEUs
This course is approved for 0.55 AOTA CEUs for occupational therapy professionals
Participants will be required to:
- Complete the course in its entirety (100% of the course watched)
- Complete a multiple-choice post-assessment with a passing score of at least 80% (untimed test)
Information about ASHA CEUs
This course is available for 0.55 ASHA CEUs for speech language pathologists. To receive ASHA CEUs, participants will be required to:
- Ensure you are eligible to receive ASHA CEUs! Click here for more information
- Complete the course in its entirety (watch time is tracked by the learning management system)
- Complete the multiple-choice post-assessment with a passing score of at least 80% (untimed test, 3 retakes)
- There is no option for partial credit
Information for Physical Therapists
APTA does not approve individual companies and you will need to check with your individual state for online course requirements.
To best prepare you can save the following:
- The certificate of completion that will be provided
- List of references
- A copy of the assessment questions
How long will I have access to the course?
6 months from the purchase date.
What is your refund/cancellation policy?
Refunds must be requested within 14 days of purchase by emailing [email protected]. A full refund is available if no modules have been started. A partial refund is available once ANY portion of the course has been viewed. The amount refunded is at the sole discretion of The Lactation OT LLC. There is no refund available after 14 days of purchase OR if module one has been completed. Recipients will receive acknowledgment of refund requests within 3 business days. If the request is valid per the terms listed above, the refund will be processed within 7 business days. If for any reason the course is canceled by The Lactation OT before the course is started, a full refund will be provided.
How do I request special accommodation?
Please send us an email at [email protected] at least 14 days before starting the course with further details of your request.
IBLCE Long-Term Provider
5.5 L-CERPs
You can support families of infants who are tube-fed and facilitate the positive introduction of breastfeeding in many instances.
Having a deep understanding of enteral feeding and the red flags that may arise during weaning will help you provide the best outcomes for the infants on your caseload.
Medically Fragile Infant bundle (14 hours)
- Breastfeeding Assessment and Intervention for the Medically Fragile Infant
- Failure to Thrive, Suboptimal Weight Gain, and the Lactation Savvy Therapist
- Tube to Breast: Navigating the Transition from Enteral Feeding to Breastfeeding
