Re. the gain of a pound: I can see how this would have been disappointing. However, it's normal for it to take some time (a matter of months) to start seeing good gains from tube feeding. It takes a while to get up to the rate and number of calories that will allow for gain, and sometimes the supplement has to be changed as well if the first one tried doesn't achieve the desired results. Nighttime feeds can also sometimes impact daytime appetite for a while. It's an adjustment process, and it's essential to not only have a good dr but a good dietitian backing you up. Emily only gained a small amount of weight the first couple months, and then things *really* took off the months after that. <img src="i/expressions/face-icon-small-smile.gif" border="0">
That was inexcusable that things went as far as putting your son under before realizing they didn't have the MicKey kit on hand to replace the peg. <img src="i/expressions/face-icon-small-mad.gif" border="0"> I would have been furious over this kind of incompetence!
I'm so sorry that your son is so discouraged by this and has pretty much just given up. Food had become such a struggle in our household. Fortunately, Emily has always been a great eater, but so much stress was surrounding mealtimes and pressure on what she was going to eat next that I worried over losing that, and worried we were setting her up for long-term unhealthy attitudes about food/eating. I would want to be sure your son understands that the better he eats and the healthier his weight is, the healthier his LUNGS will be... but obviously, making it a high-pressure situation is not going to help. Have you tried supplements like Scandishakes, Carnation, Boost, making high-cal/high-protein smoothies he can drink that might not fill him up as fast as a big plate of food would?
Once Emily started tube feeds they put her on a predigested formula high in MCT fat, which is easily absorbed by people w/CF. It has worked very well for her. They likely went straight to that for her since we'd already tried supps like Carnation, Scandishakes, etc without getting the results we needed. So getting something her body doesn't have to work hard at absorbing has been the right fit for her. Fortunately, insurance covers it.
Wishing you the best as you make this decision. I know it's not easy and once adolescence comes dealing with your child's feelings and cooperation in the matter really compounds it (I have a 13yr old son so can understand that!)