In pediatric patients with cystic fibrosis, which condition is NOT a contraindication to nasogastric tube feedings?

• A. Chronic sinusitis
• B. Chronic otitis
• C. Pancreatic insufficiency
• D. Need for long-term nutrition support

Answer: (C)

Pancreatic insufficiency is not a reason to avoid nasogastric tube feeding in children with cystic fibrosis. It reflects a digestive enzyme deficiency, not a mechanical or infection-related barrier to placing or using an NG tube. The goal of NG feeding in CF is to meet high energy needs when oral intake is inadequate, and enzyme replacement can be used to optimize digestion of the feeds. Chronic sinusitis and chronic otitis, while CF-related issues, do not automatically preclude tube access, and needing long-term nutrition support is typically an indication for NG feeding rather than a contraindication. So pancreatic insufficiency does not prevent NG feeding, making it the not-a-contraindication choice.