Indwelling feeding tubes
This general information is provided to help you care for a child with an indwelling feeding tube and is not specific to your child. If you have any questions, please call your doctor, home care nurse or dietician.
Introduction
This information is designed to help you properly insert and care for an indwelling feeding tube. It will also provide you with instructions for giving medications and feedings through the tube as well as how to deal with problems that you may have with the feeding tube itself or your child’s feedings. This information is important because it will help your child get the nourishment that he needs.
Supplies for insertion of feeding tube
Measuring for a nasogastric feeding tube
- Indwelling feeding tube (polyurethane tubes are changed once a month)
- Water soluble lubricant (Surgilube or K-Y Jelly)
- 5 ml syringe
- Tape or permanent marker
- Transparent dressing
- Scissors
- Stethoscope
- Tape measure
Insertion of feeding tube
- Wash your hands with soap and water or use an alcohol based sanitizer.
- Collect all of your supplies.
- If marking the length of the feeding tube with tape, cut a small piece now.
- There are two ways in which a feeding tube can be inserted — through the nose (nasogastric) or through the mouth (orogastric). Ask your healthcare provider which is the best method to use for your child.
- Measure the length of the feeding tube to be inserted:
o For a tube inserted through the nose into the stomach (a nasogastric or NG tube): Use the feeding tube to measure from the tip of the nose to the ear lobe and from the ear lobe to a point midway between the tip of the breastbone and the navel (belly button) (Fig. 1).
o For a tube inserted through the mouth into the stomach (an orogastric or OG tube): Use the feeding tube to measure from the corner of the mouth to the ear lobe and from the ear lobe to a point midway between the tip of the breastbone and the navel (belly button).
o Remember that as your child grows, this measurement will change.
- Mark this length with the small piece of cut tape or with a permanent marker.
- Lubricate the tip of the feeding tube with water-soluble lubricant. Never use Vaseline or any oil-based substance.
- Position your child as tolerated:
o Infant: Wrap your baby snugly in a blanket and place him on a safe surface with the head slightly raised. Allow him to suck on a pacifier and try to position him on his side. This can make the insertion of the feeding tube easier.
o Child: Position your child lying down with his head raised slightly and in a neutral or slightly flexed position to make it easier for the feeding tube to pass through. Have someone hold his arms, if necessary, when the feeding tube is being inserted.
- Gently insert the feeding tube into his nose or mouth with a firm steady force — directing the feeding tube towards the back of the nose for a nasogastric tube or towards the back of the throat for an orogastric tube — and then direct the feeding tube downward.
o Pause at the back of the throat and wait for your child to swallow.
o Keep inserting the feeding tube until the place on the feeding tube marked with the tape or marker reaches his nose (if placing a nasogastric tube) or his mouth (if placing an orogastric tube).
- Never force the feeding tube. If the feeding tube does not go in readily, remove it. Change your child’s position, lubricate the tip of the feeding tube, and try again. If placing a nasogastric tube, you may need to use the opposite nostril.
- Remove the feeding tube right away if your child is:
Cuddle and comfort your child for a few minutes and try again.
- Once the feeding tube is in, keep it in place with a small piece of tape until you check the tube's placement (see below).
- If the feeding tube is correctly in place, lay the next part of the tube along the outside of your child’s cheek — on the same side as the nostril through which the tube was inserted; or on the same side of the mouth that the tube is in (for an OG tube). Position the tube so that it is not pulling on his nostril or mouth.
- Tape the feeding tube securely with the transparent dressing.
- Using the tape measure, measure the remaining length of the tube from the nose or mouth until the end. Write down the measurement of this "extra tube length" and keep it handy; you will use it later to help make sure the tube is in the proper place.
- Hold and comfort your child.