Feeding Tubes are Getting Softer, Smarter, and Safer

Enteral therapy supports millions of patients in hospitals and at home. Over the past five years, the market has expanded from a niche category to a mainstream one and keeps growing as care shifts from ICU to ward to living room. The global market for feeding tubes is currently valued at around $4.3 billion, with projections showing a path to $6.8 billion by 2031.¹ Notably, this growth will be spurred by a significant rise in home enteral nutrition needs.

For manufacturers of devices, these statistics are evolving into key priorities that pose significant questions: How can we improve the comfort of tubes while ensuring their durability? What wall configurations can improve kink resistance in smaller French (Fr) sizes? Can our tubes be employed with guided placement to enable faster confirmation? Which lumen shapes or surface treatments are effective in reducing clogging? What features characterize a design that is truly appropriate for caregivers and patients in a home setting? And where can we find evidence that these decisions lead to savings and efficiencies throughout the entire episode of care?

This article looks at the material shift that is already underway, explains the drivers behind it, compares the leading polymers, and maps current innovation. It concludes by addressing user pain points and cost considerations that influence design and sourcing decisions.

Moving from PVC to Silicone and TPU

Historically, polyvinyl chloride (PVC) has defined the feeding tubes category and continues to be shipped in large quantities for short-term tubes that need to meet strict price requirements. Yet, the market is asking for alternatives due largely to concerns that include plasticizer exposure as well as increased comfort for sensitive populations, including neonates, pediatric and geriatric patients, pregnant or lactating individuals, immunocompromised persons, and those who use long-term tubes. Numerous facilities are also engaged in PVC-free procurement in certain departments. This initiative, combined with an extended duration of home care, has shifted focus toward silicone and thermoplastic polyurethane (TPU).

Silicone initially gained traction in gastrostomy and pediatric uses due to its soft texture and excellent biocompatibility. Simultaneously, TPU has emerged as a choice material as engineers utilize it to manufacture thin walls that maintain lumen size and prevent kinking in smaller diameters. TPU is sufficiently rigid for insertion but becomes softer at body temperature, which helps to enhance comfort post-placement.

Both materials support thin-wall extrusion, multilayer coextrusion, and add-ons such as hydrophilic/antimicrobial features and radiopaque barium sulfate with printed markers. TPU also enables radio frequency (RF), heat, or solvent welding, while silicone assembles via primer-assisted adhesives. These are capabilities that can help to address concerns like kink resistance, placement verification, and clog reduction beyond what legacy PVC programs typically target.

Three forces further explain the shift to silicones and TPUs:

• Initially, the focus is on safety perception and policy. Worldwide efforts promote the use of safer connectors and improved placement verification, as hospitals aim to reduce the occurrence of sentinel events caused by incorrectly positioned tubes. Teams seek polymers and systems that support correct placement the first time with less reliance on X-ray confirmation.
• Second, moving from the hospital to the home. Payers push shorter hospital stays. Families expect comfortable, low-profile devices that snag less and flush well. Home users also value simple connectors and clear instructions. These needs are in line with softer materials and designs that resist clogging.
• Third, product innovation. Electromagnetic navigation, optical confirmation, and sensor-enabled tubes are paving the way for further advancements. A tube that includes guidance or monitoring requires a superior construction quality that can be difficult to achieve using conventional methods. More and more, TPU is becoming the foundation for these designs.

What Users Say They Need

In surveys conducted by Lubrizol, clinicians cite two problems with frequency. The first is misplacement, which happens in 2% to 5% of insertions.¹ Among those, serious lung injury can occur in a meaningful share of cases.

Clogging presents another challenge. Fine-bore tubes tend to become obstructed more frequently when used at low flow rates or with viscous formulas. Medical professionals want faster confirmations, reduced reinsertions, and designs that allow for easy flushing without the need for special protocols. ICU nurses, in particular, identify misplacement and reinsertion as significant disruptors to their workflow.

Materials science shows up again here as a critical tool. The surface finish of TPU is significantly affected by processing parameters such as extrusion temperature, draw-down, and post-processing. By tuning these parameters, engineers can create a smoother and more uniform lumen without increasing the wall thickness. In practical terms, thin-wall TPU can preserve the internal diameter (ID) for a designated French size while ensuring that the outer diameter (OD) stays compact. This could result in a higher flow rate for smaller profiles or improved long-term patient comfort, since a narrower tube typically leads to reduced tissue irritation.

Silicone boasts a long history of safe use inside the body, and for these reasons, it remains popular for low-profile gastrostomy “button” devices as well as sensitive skin applications. The trade-offs involve reduced kink resistance in very thin walls and greater challenges during bonding or assembly processes (silicone might require the application of primers, adhesives, or mechanical interlocks). For comfort that lasts, silicone is excellent. However, for ultra-slim, high-flow shafts, designers might require reinforcements, thicker walls, or hybrid constructions.

PVC continues to be a budget-conscious choice that is simple to extrude and bond, making it ideal for limited production runs or in scenarios having significant cost constraints. Nevertheless, it tends to be stiffer than silicone or TPU, which can translate to reduced comfort for patients.

Giving Value Analysis Teams What They Need

The first step in feeding tube design is a short set of questions.

• Who is the patient group?
• Where will the device be used?
• What performance priorities matter most?
• What economic limits are setting the boundary?

Establishing these criteria simplifies the process of comparing the unit price of each material with the potential savings it may provide. The cost per foot influences numerous tenders, and on a straightforward unit basis, PVC is difficult to surpass. Silicone generally costs about twice as much as TPU, which usually falls in price between silicone and PVC. These anchors initiate the discussion, but they do not end it.

When you factor in the expense of X-rays for verification, the costs associated with unplanned replacements due to blockages, and the additional nursing time, for example, the equation shifts. Guided placement can minimize the need for films and reduce delays. Increased flush volumes and smoother lumens can help decrease restarts related to clogs.

Analyst models indicate that integrated guidance and connected solutions can yield returns within 12 to 24 months, primarily by reducing the number of radiographs and reinsertions. To assist teams in linking their design decisions to costs, two practical steps can be implemented.

1. Tie features to efficiencies. For example, EM guidance may be associated with a reduced number of radiographic confirmations, thin-walled lumens contribute to a decreased risk of blockage, and low-profile buttons are connected to a lower incidence of accidental pulls in pediatric cases.
2. Establish an outcomes ledger. Track the time required for placement confirmation, how long the feeding lasts, the occlusion rate, and the reinsertion rate for every cohort. This documentation can help the clinician champion make a strong case during the value analysis.

What to Build Next

There are clear signals for feeding tubes that are softer to wear, easier to place, and easier to keep open, and teams can act on this in three ways.

1. Improve the placement workflows—Provide tube kits that are suitable for EM guidance or optical confirmation. Implement a clear protocol to ensure first-pass success without the need for additional confirmations.
2. Enhance the lumen—Utilize thin-wall TPU or high-purity silicone to safeguard the internal diameter in smaller French sizes. Aim for robust flushes and sleek inner surfaces. Evaluate the incorporation of hydrophilic or antimicrobial properties into the material as appropriate.
3. Home design (and future developments)—Using low-profile buttons reduces the risk of snags, and the thin-wall strength of TPU, along with in-body softening, results in small, comfortable profiles that prevent kinking. Boost connectivity with TPU-based “smart” tubes that include sensors (like position, pressure, and impedance) or conductors for future features, such as allowing the system to identify early occlusions.

Each step is in sync with what’s needed clinically and financially, adhering to the most recent regulations and the priorities of health care professionals, which stress the importance of safer placements and incident prevention.

The groups that link these options to clinical effectiveness and more convenient home care will spearhead the upcoming phase of adoption. Ultimately, this is the work that matters most to patients as it makes care easier and more comfortable for those who use these devices every day.

Reference

¹ Enteral Feeding Tubes 2025: Softer, Smarter, and Headed Home, AlphaSense research report, August 6, 2025.

Monika Kriete is technical marketing manager for Medical Solutions at Lubrizol, covering the EMEA region. Her role blends technical service and business development, including on-site trials, material selection consulting, and TPU workshops, while driving strategic growth and identifying new opportunities in the European medical market. She holds a Master’s degree in Material Science and was working at Covestro and several research institutes prior to her role at Lubrizol.

Cristina Acevado is the strategic marketing director for Medical Solutions & Engineered Polymers. Prior to joining Lubrizol, she served as the business director for the Medical segment at Ascend Performance Materials, where she led the successful launch and growth of the company’s medical business. She began her career at Ovik Healthcare (formerly Milliken & Company), where she held strategy, product, and innovation leadership roles in both Milliken Healthcare Products and Milliken Chemical. Acevado holds a Bachelor of Science in Chemistry from the University of Puerto Rico, a Ph.D. in Organic Chemistry from Purdue University, and an MBA from the Kenan-Flagler Business School at the University of North Carolina.