But doctors at Queen Elizabeth hospital in Birmingham believe she would be able to talk once the tube is out, "may be in the next few days".
She is "not out of the woods but is doing very well", said Dr Dave Rosser, medical director of the University Hospitals Birmingham NHS foundation trust.
"She is able to understand, has some memory… is able to stand, write. It would be over-optimistic to say there is not going to be further problems, but it is possible she will make a smooth recovery," he added.
Malala awoke from a medically-induced coma on Tuesday and reportedly asked: "Which country am I in?"
She will need skull reconstruction surgery.