This book is the result of thousands of encounters with tube-fed infants and their families over the past four decades. The ailing and fragile children, suffering from a myriad of medical conditions acted as muses and mentors teaching more than could be expected. This book is addressed to medical professionals, early interventionists, pediatricians, child surgeons, nurses, dieticians, occupational therapists, speech and language pathologists (SLPs), feeding specialists, psychologists, physiotherapists, infant psychiatrists as well as parents. The medically fragile child (MFC) is the subject of the authors’ work when it is concerned with enteral nutrition support (ENS) by means of a feeding tube (ENT). As pediatricians and psychotherapists, they have been treating eating and feeding disorders of children since 1986 and with this book they pass on knowledge they have garnered over three decades. Over 5,000 children have been weaned off their feeding tubes. Tube weaning requires the evaluation of medical, nutritional, sensory, developmental, metabolic and growth-related findings. The review of the literature around this subject has provided a source of inspiration as well as critical self-reflection; the authors wish to offer their insight and ideas on how to approach child-led tube-management and tube-weaning to all healthcare professional involved in the management of these children.