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Medical Needs at School: Feeding, schools, nursing



Our daughter is g-tube fed at school at noon. The school nurse refuses to feed, and our school district pays for a private nurse to go in to feed her. Our daughter will soon need to be fed twice in school. Is there a law that states that schools are responsible for feeding the GT kids that are enrolled there? She is fed via a pump for approx 45 min. It would be a waste of money to hire a nurse for the entire day for only two feeds. I fear a battle coming on and would like to know my "legal grounds."

Answer of our experts

Yes, the school MUST provide G-tube feedings. First, the varying states have regulations on WHO performs these procedures but the school is responsible, during school hours IF the child is determined to have special education needs and IF the child requires specialized health care services DURING the day. Tube feeding, suctioning, colostomy care, ventilator management, catheterization, medications, etc. are all being done in schools now

There is no national legislation or regulations regarding who performs health care procedures. It is based on each state's Nurse Practice Act and state rules and regulations. Here in NH, teaching assistants (with training) are allowed to G-tube the children but NY, for example, has more strict regulations regarding the WHO

The question raised is a real big one and goes far beyond G-tube feeding. There are many cases facing lower courtspartly because of increased inclusion, there is a nursing shortage, fear of liability if something goes wrong, lack of knowledge and training, a re-defining of the traditional role of the school nurse, etc

Regarding paying the "feeder," be it an RN, LPN, CNA or other trained person, it usually is the responsibility of the "sending" school district unless there are specific contractual arrangements with the facility receiving the student. The school district may be able to collect Medicaid reimbursement for part of the cost if it is a nurse

MM/ TK 7-13-10

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Individuals with CdLS and their families need life-long care provided by healthcare providers and social services, who should educate themselves about CdLS.
Syndrome-specific and personalised care plans through shared decision-making should be offered to every individual with CdLS and their caregivers.


Feeding and Dental Difficulties

In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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