Advice for Caregivers: Tube Feeding
Daily Care of the Tube
Typical Gastrostomy Feeding
When to Call the Doctor
Common Pump Problems
Daily Care of the Tube
Contact your health care provider regarding care instructions. See section on Complications of Tube Feeding.
- Wash hands with soap and water before feeding.
- Gather supplies needed for tube feeding. Feeding should be at room temperature.
- Inspect site for skin irritation or leakage.
- Check the tube for inward/outward migration.
- Clean site with plain water or simple soap and water in circular motion away from stoma site. Dry site. If needed, stabilize tube with gauze and tape.
Typical Gastrostomy Feeding
1. Position child with head higher than stomach, upright or on side. Use of infant seat, high chair or propping with pillow or wedge may be helpful.
2. Check residuals if recommended by physician. Attach syringe to feeding tube and pull back. If residual is greater than 50% of previous feeding, wait one hour and recheck. Return residuals to stomach. If there is still residual, contact physician. If residual is okay, flush tube with 10cc water.
3. Feed by appropriate method:
BOLUS FEEDING
- Syringe: Attach syringe to feeding tube, pour feeding into syringe. You may need to push with plunger to start flow. Control rate of feeding by raising or lowering syringe. Continue adding feeding solution to syringe until total feed given. You do not want air in tubing.
- Feeding Bag: Clamp tubing, fill bag and tubing with feeding. You may need to squeeze bag to start feeding. Control rate of flow with clamp. Hang bag from IV pole,
A feeding should take 15-30 minutes. If given too quickly, the child may experience sweating, nausea, vomiting or diarrhea.
CONTINUOUS DRIP
Clamp tubing on feeding bag and fill with feeding solution. Unclamp tubing and fill drip chamber 1/3 full, then fill remaining tubing with feeding solution to minimize air into stomach, clamp. Thread tubing through pump. Connect to feeding tube. Unclamp feeding tube and start pump. The home care supply company will have instructions on how to use pump. Feedings should not hang for more than 4-8 hours. On hot days, you can slip ice into the pocket of a feeding bag to keep feeding solutions cool.
Children can be cuddled or held during feeding. Including the child at mealtimes is encouraged. To distract the child while feeding or doing skin care play games or music, tell a story, offer toys, etc. Oral motor stimulation is recommended.
You may want to secure tube connections with tape so they do not come apart. Securing tube to clothing, out of reach of children is helpful. Tubing can tucked under clothing (onesies, overalls, tube tops and bandnets are helpful).
4. The feeding tube may be left in place, unclamped to allow the child to burp, about 10-30 minutes. If the child has a button gastrostomy, they will need a decompression tube to vent air. To prevent reflux, the child may need to remain with head elevated 30-60 minutes after feeding.
5. After feeding and burping are finished, flush tubing with 10 cc water. Close tube. Tuck gastrostomy under clothing.
6. Wash feeding set with hot, soapy water, rinse well and air dry. Feeding sets may be reused several times.
When to Call the Doctor
- If the skin around the gastrostomy is warm, tender, bright red - larger than a quarter
- If excess puffy red tissue is building up around stoma site or persistent bleeding around stoma site
- If there is excess leaking around stoma site or tube (soaking 2x2 gauze < 4 hours)
- If stomach contents are leaking through button
- If child has persistent vomiting, diarrhea or constipation
- The feeding tube is blocked and you cannot remove blockage
- The feeding tube is pulled out
- If the child has a temperature over 101 degrees F
Common Pump Problems
- The "START" button isn't pressed.
- The clamps aren't open.
- The tubing is kinked.
- The drip chamber too full. Or, it is not positioned correctly.
- The "Pause" is button on.
- The feeding tube is plugged.
See Section on Complications of Tube Feeding for more information.
Enteral Feeding Homepage
Gaining and Growing Homepage
More information contact: Joan Zerzan
Page reviewed: 3/16/2007