Which of the following are reasons enteral feeding might not be chosen in hyperemesis gravidarum?

• A. Risk of aspiration
• B. Physical discomfort
• C. Aesthetics
• D. All of the above

Answer: (D)

In severe hyperemesis gravidarum, feeding through the gut might be avoided because several practical factors come into play. One major concern is the risk of aspiration: if a patient is actively vomiting or has impaired gastric emptying, placing a feeding tube and delivering formula can increase the chance that contents enter the airway, which can be dangerous. Another consideration is physical discomfort—the process of tube placement, ongoing irritation in the nose or throat, and the presence of a tube can be poorly tolerated in a patient already dealing with nausea, gagging, and vomiting. Additionally, aesthetics or psychosocial factors matter; having a feeding tube can affect body image, comfort, and daily functioning, which can influence a patient’s willingness to proceed with enteral feeding. Because all of these issues can limit safety, tolerance, and acceptance, they collectively make enteral feeding a less favorable option in some cases of hyperemesis gravidarum.