Introduction: Tube feeding, especially percutaneous endoscopic gastrostomy (PEG), is not commonly adopted in China, even though the ESPGHAN guideline recommends it as the preferred method for nutritional support in children with neurological impairment (NI) and inadequate oral intake. Objectives: The objectives of this study are to align the knowledge of healthcare professionals, patients, and families with current guidelines and improve their acceptance of PEG through standardized nutritional management of children with NI, with the goal of optimizing nutritional support for these children. Methods: This is a prospective, multi-center study recruiting children with NI and indications for tube feeding from five medical centers across China. Patients receive standardized nutritional care for 3 months, and their nutritional parameters are recorded before and after the intervention. Demographic and clinical data including diagnosis and tube-feeding-related gastrointestinal symptoms are collected and analyzed. Results: To date, baseline data collection for 25 children has been completed, with a mean age of 4.7years. Major diagnoses include cerebral palsy , hypoxic-ischemic encephalopathy , and brain tumor. Baseline nutritional assessment shows a mean Weight-for-age z-score (WAZ) of - 0.84 (-2.03, 0.58), with 6 children (25%) having a WAZ < -2, and a mean Height-for-age z-score (HAZ) of -1.08 (-2.19, 0.27), with 8 children (32%) having a HAZ < -2. Conclusions: Preliminary data demonstrate the high prevalence of significant nutritional risk and feeding challenges among children with NI, providing a necessary foundation for the subsequent systematic evaluation of the impact of tube feeding on nutritional improvement in these children.