This time last year I was agonizing over wheter or not to go ahead with a g-tube for Emily. She got hers in August last year, and I have never regretted it. YOu are right. It is a HUGE decision and I was so torn up over it. I worried that it would be a ton more work (It isn't). I worried that she would have a lot of pain and that it would slow her down (she has only occasional discomfort if granulation tissue builds up but that's an easy fix and doesn't happen much, and it hasn't slowed her down ONE BIT!!) I worried that people would stare and it and that she'd seem less "perfect" - I'll admit that that last one really did cross my mind...I hated the thought of something in my baby's tummy... (Well, today at the zoo she insisted on pulling her shirt up and showing people her button, and people looked, but she just said, "That's my extra button" and that was that...and it hasn't marred her beautiful appearance at all).
That's a lot of words to say, I know this is scary. But I don't think you'll be sorry you did it.
Her weight gain has not been as huge as we had hoped. She's gained maybe 10 pound over teh last 11 months, and we have yet to pass teh 30th percentile, but, she has been HEALTHY!!! I still would like her to be a more eager eater, but, now I know that she's going to get her calories and nutrition at the end of the day even if she only picks at her food all day long.
I think a 4-year old might have more troubles accepting the tube than my 2 year old did, but, once it's in and she can explain to people why she needs it I think she'll be ok. If you'd like, I can e-mail you some pictures of Emily and her tube so your little girl can see what it's going to look like. PM me and let me know if this is helpful. Also, ask your clinic for the g-tube DVD and booklet if they haven't given them too you already. They will show lots of kids with tubes so she can see that tubes are for all kinds of kids.
Just know that you are not alone in this...we were all scared, and most of us have had good results.