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Your child is going home with a gastrostomy (g-tube) feeding tube. A g-tube is needed to give your child medicine or food when he or she is not able to take enough food by mouth. G-tube feedings can be given by the bolus method or by the continuous method. A continuous feeding is given by a pump over a long time, usually eight to 24 hours. This information sheet gives you instructions on how to give continuous feedings through a PEG or MIC-G™ tube.

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Figure 1: MIC-G™ in stomach.

Getting ready for feeding

  • Wash your hands.
  • Gather these items:
    • Feeding set
    • Feeding pump
    • 30-60 ml syringe
    • Formula (at room temperature)
    • Small cup of water
  • Position your child sitting up. For an infant, use an infant seat or a mattress with the head raised.
  • Pour enough formula for four to eight hours into the feeding set. Do not touch the inside of the set.
  • Let formula 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.

Steps for continuous feeding

  • Tell your child what you will be doing.
  • Wash the area around the end of the g-tube. Remove the cap or plug from the g-tube.
  • Connect the feeding set to the g-tube and then unclamp g-tube.
  • Open the roller clamp of the feeding set.
  • Turn the pump on and watch to see that it starts to work.
  • When the feeding is finished, clamp the tube and disconnect the feeding set. Attach the syringe, then unclamp and flush the g-tube with water, using 5 ml for an infant and 10-30 ml for an older child.
  • Clamp the g-tube and then insert the cap or plug into the end of the g-tube.
  • Wash the feeding set with warm water and mild soap. Rinse well. Let it air dry and then store in a clean area until the next feeding.

Important tips

  • Wash your hands before mixing formula. Use clean bowls, measuring cups, and spoons. If you are using cans of formula, wash the top of the can before you open it.
  • Always store formula in a clean container.
  • When making formula from powder, make only enough for 24 hours and refrigerate. Throw away any leftover 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 formula after the expiration date found on the side of the bottle or can.
  • Stabilize the g-tube to the belly surface with tape to avoid pulling and tension at the g-tube site.
  • Replace feeding sets as instructed by your home care company. You may want to write the date you change it on the calendar.
  • Brush your child’s teeth, gums and tongue at least two times each day.
  • It is important to be able to hear your child while feedings are running. Use a baby monitor or have your child nearby.
  • Your nurse or doctor will help arrange for a home care company to deliver the supplies you need. Call your home care company to make sure that they have your child’s appropriate prescriptions with refills.
  • Please contact your home care company when you are getting low on supplies so that they may send more before you run out.
  • Call your home care company if you have any trouble using the feeding pump.

Call your child’s doctor or nurse if:

  • Your child has severe coughing, blueness around lips, or trouble breathing. Stop the feedings and call an ambulance if his or her breathing or color does not get better right away.
  • Your child throws up during the feedings
  • Your child complains of heartburn or appears uncomfortable with feedings
  • Your child has diarrhea or cramping
  • You have any questions or concerns

Who can I call if I have questions?

Please call the GI office at 617-355-6058 if you have questions or concerns. Our GI nurses can help you with all types of PEG tube questions:

  • From 8 a.m. to 4:30 p.m. weekdays, a nurse in the GI clinic will be available to help you.
  • Weekdays after 4:30pm, weekends, and holidays, you can use the same number to reach a GI doctor on-call for urgent questions or emergencies.

If your child is followed by General Surgery,

  • From 8:30 a.m. to 5 p.m. weekdays, call the General Surgery outpatient nurses at 617-355-7716 or 617-355-7704.
  • Weekdays after 5 p.m., weekends, and holidays, call the Boston Children’s page operator at 617-355-6369 and ask for the General Surgery Senior Resident on-call.