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An image of MIC-G tube in stomach

Only replace your child’s MIC-G™ g-tube if you have been taught how to do so by your child’s doctor or nurse.

If your child’s MIC-G™ g-tube falls out and you have not been taught how to replace it, put the g-tube back in the stoma and cover the site with gauze to soak up drainage. Tape the gauze in place and call your doctor or nurse at Boston Children’s Hospital right away.

At left: Figure 1.

Supplies you will need

  • sterile water or distilled water
  • MIC-G™ g-tube
  • 5 to 10 cc/ml slip tip syringe
  • water soluble lubricant (such as K-Y Jelly®). Do not use oil or petroleum jelly (such as Vaseline®).
Illustration of G-tube with labels
Figure 2

To replace the MIC-G™ tube, follow these steps

Note: Plan to change the MIC-G™ g-tube just before a feeding. This will help limit the amount of stomach contents that leak onto your child’s belly during the change.

  • Wash your hands. Remove the new MIC-G™ g-tube from the package (see figure 2).
  • Check the new MIC-G™ g-tube balloon for any leaks. To check for leaks, attach the syringe to the balloon port of the new g-tube and fill the balloon with water using a 5 to 10 cc/ml syringe. Remove the syringe and look at the balloon. Check and see if any water leaks from the g-tube.
  • Gently pull back on the syringe plunger to remove the water from the balloon of the new MIC-G™ g-tube. Keep the syringe attached and set to the side.
  • Attach an empty 5 to 10 cc/ml syringe to the balloon port of the MIC-G™ g-tube that is in your child’s stomach. Pull back on the plunger until all of the water is removed from the balloon. If you cannot withdraw any water, check that the port opening is clean and not clogged with formula, and that you have a tight connection between the syringe and MIC-G™ g-tube balloon port. Then try again to withdraw water.
  • Gently remove the old MIC-G™ g-tube from your child’s stomach. You might feel a little resistance (tug) when you do this. This is normal.
    • If the g-tube feels stuck, stop trying to remove the tube and call your doctor or nurse right away for instructions. Do not use the tube. You child may need to be seen to have the g-tube checked and changed.
  • If the g-tube is removed easily, then grease the tip of the new MIC-G™ g-tube with the water-soluble lubricant. Draw up the prescribed amount of sterile or distilled water (usually 3 to 5cc) into the syringe.
  • Gently put the new MIC-G™ g-tube into the stoma to the 4 to 5 cm mark on the side of the g-tube, and attach the syringe to balloon port.
  • Fill the balloon. Remove syringe.
  • Gently pull up on the MIC-G™ g-tube to position the balloon against the stomach wall. When you feel resistance, hold the tube in place and gently slide the disk down to the stomach surface. Wipe away any extra lubricant.
  • After the new MIC-G™ g-tube is in place, attach the syringe to the gastric port and pull back on the syringe to draw out any stomach secretions (juices). This will help you know the MIC-G™ g-tube is in the right place in the stomach.
    • If you are not able to withdraw any secretions, DO NOT USE the g-tube and call your child’s doctor or nurse. It is possible that the g-tube is not in the the right place.

Important tips

  • Always keep an extra MIC-G™ g-tube on hand. Your child’s doctor or nurse will give you a prescription for the tube. Give the prescription to your home care supply company.
  • MIC-G™ g-tubes usually last three to six months. Change or resize:
    • if there are any cracks in the tube
    • if water is missing from the balloon after two weekly balloon checks
  • It is helpful to keep a spare syringe, roll of tape, and lubricant with you in case the tube needs to be replaced when you are not home.
     

When should I call my child's doctor or nurse?

  • you have any questions or concerns about your child’s g-tube
  • you do not get stomach juices (secretions) back up the extension tubing after the g-tube change
  • the tube is clogged
  • the skin around the g-tube is red, swollen, warm, sore, or bleeding
  • the stoma has a strange smell
  • there is pus or drainage around the g-tube
  • your child has a fever of 101 degrees F, along with any of the problems above
  • your child throws up more than three times in 24 hours
  • the g-tube falls out and you cannot easily replace it
  • there is any redness or soreness around the skin that does not get better with routine skin care and dressing change
     

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:

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

If your child is followed by General Surgery:

  • 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., weekdays, holidays: Call the Boston Children’s page operator at 617-355-6369 and ask for the general surgery senior resident on-call.