Some children need a tube placed in their stomach (gastrostomy tube) to allow them to get adequate nutrition if they cannot take in enough by mouth or to allow them to take in liquids safely if they have a swallowing problem. There are several ways that these tubes can be placed. One is a Percutaneous Endoscopic Gastrostomy (PEG). With the child either asleep under anesthesia or with IV sedation, the endoscope (fiber optic tube) is passed through the esophagus (swallowing tube) and into the stomach. The stomach is then inflated with air through the endoscope. After carefully cleaning the abdomen, a place for the gastrostomy tube is identified, and at this spot a small needle is passed through the abdominal wall and into the stomach. A flexible wire is then passed through this needle and the needle is taken out. The flexible wire is grabbed using the endoscope and pulled out through the mouth. The gastrostomy tube is then attached to this flexible wire and pulled down the esophagus and then out the small opening that was made in the abdominal wall at the site of the needle puncture, leaving the bumper of the gastrostomy tube in the stomach, holding the tube in place. The entire procedure, after the child is asleep, takes only 5-10 minutes. The child will stay in the hospital overnight and usually the tube will be used for feedings the next day. The family is taught how to use and care for the tube before going home.