Enteral Tube Program
Giving Your Child Continuous Nasogastric (NG) Tube Feedings
Your child is going home with a nasogastric (NG) feeding tube. An NG Tube is needed to give your child nourishment when he or she is unable to take enough food by mouth. NG feedings can be given by the bolus method or by the continuous method. A continuous feeding is given by pump over a long period of time, usually 8-24 hours. This information sheet gives you instructions on how to give continuous NG Tube feedings.
Preparation for Feeding
- Wash your hands.
- Gather the following items:
- feeding set
- feeding pump
- 30-60 ml syringe
- formula (at room temperature)
- small cup of water
- Pour enough formula for 4-8 hours into the feeding set. Do not touch the inside of the set.
- Allow feeding to run completely through the tubing to get rid of all air. Then clamp the tubing shut with the roller clamp.
- Place the tubing into the pump, and set the pump at the proper rate.
- Position your child with his or her head elevated. Place your infant in an infant seat or on a mattress with the head raised. Older children should lay on their right side. If necessary, wrap your child in a blanket so he or she is unable to pull the tube out.
- Always check for correct placement of the NG Tube before giving a feeding. (Refer to "Home Care Instructions for Inserting Nasogastric Feeding Tubes")“
Steps for Continuous Feeding
1. Tell your child what you will be doing.
2. Remove the cap or plug from the NG Tube. Be sure to fold over tubing so stomach contents are not able to leak out when uncapping.
3. Connect the set to the NG Tube.
4. Secure the tube to your child’s clothing. Place a piece of tape around the end of the tube. Pin the tape to your child’s shirt or pajama top.
5. Open the roller clamp of the feeding set.
6. Turn the pump on and watch to see that it begins to work.
7. Pause the feeding every 4-8 hours to flush the tube with water to prevent the tube from clogging. Use 10 ml for an infant and 30 ml for an older child.
8. When the feeding is finished, clamp the tube and disconnect the feeding set from the NG Tube.
9. Flush the NG Tube with 10-30 mL of water.
10.Reinsert the cap or plug into the end of the NG Tube.
11.Wash the feeding set with warm water and mild soap. Rinse well. Store in a clean area until the next feeding.
- Stop the feeding immediately if your child has severe coughing, blueness around lips, or difficulty breathing. Call an ambulance if his or her breathing or color does not improve right away.
- Wash your hands when preparing formula. Use clean bowls, measuring cups, and spoons.
- Always store formula in a clean container.
- When making formula from powder, make only enough for 24 hours and refrigerate. Discard any remaining formula 24 hours after mixing it.
- Ready-to-feed formulas can be used up to 48 hours once opened. Refrigerate after opening.
- Do not use unopened formula after the expiration date found on the side of the bottle or can.
- Replace the feeding bags as instructed by your home care company. You may want to write the date you change it on a calendar.
- Brush your child’s teeth, gums, and tongue at least two times each day.
- Give your infant a pacifier to suck on during feedings, if he or she will take it. If your child is unable to take anything by mouth, you may want to speak to your child’s doctor or nurse for guidance on oral stimulation.
- Hold and cuddle your child during feedings whenever possible.
- It is important to be able to hear your child while feedings are going. Use a baby room monitor (intercom) or have your child nearby.
- Your nurse will arrange for a home care company to deliver the supplies you need. Call your home care company before you need more supplies.
- Call your home care company if the pump stops working.
When to Call Your Child’s Doctor or Nurse
- Call if your child:
- is vomiting;
- complains of heartburn or appears uncomfortable with feedings;
- has diarrhea or cramping, or
- Call if you have questions or concerns.