What is a nasogastric tube?
A nasogastric tube can be used to feed your child when he is unable to eat or drink by mouth. It is called a nasogastric tube because it passes through your child's nose, down his throat and into the stomach. You may hear it called an NG tube.
Checking for tube placement
You must check the tube placement each time you insert the NG tube. Once it is in place, you must check to make sure the tube is in the stomach at least one (1) time each day. A good time to do this is when you have stopped the pump to change the feeding bag or to give medicines using the NG tube.
These steps will help you check the correct placement of the tube.
- Wash your hands well with an anti-bacterial soap (any soap that says deodorant or antimicrobial). See “Do you know… Clean hands” for guidelines.
- Pull back the plunger of a syringe to the milliliter (ml) mark designated by the CNS _______. You should have nothing but air in the syringe at this point.
- Connect the syringe to the NG tube. Place the flat side of a stethoscope over your child's stomach. While you listen through the stethoscope, slowly push the air into the NG tube. If the tube is in the right place, you will hear the air as it passes into the stomach (it sounds like a “burp”).
Another way for you to check for tube placement is to pull back on the plunger of the syringe. If stomach contents come back into the NG tube, the placement is correct.
If you are not sure that the tube is in the stomach, do not put the formula or any other liquid in the tube. Call or come to the hospital, so that the tube can be checked.
Giving continuous or cycled feedings
Follow these steps for giving continuous or cycled feedings to your child.
- Gather supplies in a clean work area:
- _____ ml of liquid formula (________________)
- Feeding container (bag or bottle)
- Pump tubing (if needed)
- Feeding pump
- Wash your hands with an anti-bacterial soap (any soap that says deodorant or antimicrobial).
- Remove the clamp or cap from the NG tube or disconnect the old pump tubing. Using the syringe,slowly push _____ ml of water into the NG tube. This is known as flushing the NG tube.
- If the tubing is attached to the feeding container, close the clamp on the tubing.
- Pour the formula into the feeding container.
- If the tubing is not attached to the feeding container, close the clamp on the tubing and attach it to the bag or bottle.
- Prime the tubing with formula.
- Connect the tubing to the pump according to the pump instructions.
- Connect the pump tubing to the NG tube.
- Check the rate on your feeding pump. Make sure it is set for the correct rate per hour. Follow this schedule:
- Give ______ml every hour for 24 hours.
- Give ______ml every hour between the hours of _____ and _____ or for ______hours.
- Start the feeding.
- Wash your hands again.
Things to remember
- To operate the pump, read the instructions for that specific pump. Follow the instructions you have been given.
- If your child is in bed during the feeding, be sure that you put his head and shoulders up on pillows.
- Watch your child for any signs of nausea, vomiting, diarrhea, stomach swelling, or increased irritability. Any one of these signs may mean that your child is not able to digest the formula at the rate it is running. If these symptoms occur, stop the feeding and call your child’s doctor right away.
- At the end of a cycled feeding, you will push _____ ml of water through the NG tube.
- You must flush the NG tube at least one (1) time each day with tap water to prevent the tube from becoming clogged. Usually, this is done at the end of a cycled feeding or after giving medicine through the tube. If your child is receiving continuous feedings or is not receiving anything through the NG tube, you may flush the tube one (1) time a day when it is easiest for you.
Changing the pump tubing and feeding container
Change the pump tubing and feeding container at least every 12 hours. Start with a new bag or bottle and tubing at the beginning of a feeding cycle. If the cycle is longer than 12 hours, the container and tubing can be changed anytime during the cycle, as long as it is not used for more than 12 hours.
Giving medicine through the NG tube
- Use the liquid form of each medicine whenever possible.
- Check with your pharmacist about whether your child’s medicine is offered in liquid form or if pills can be crushed.
- If you crush a tablet, make sure you crush it into very fine pieces. Mix it well with a small amount of warm water to make a thin liquid.
- The crushed medicine and water mixture can be pushed into the NG tube using a syringe.
- Always rinse the NG tube with _____ml of water before and after giving any medicine through it.
- Give each medicine separately. Do not mix medicines together. Rinse the tube with ____ml of water after each medicine.
- Do not add any medicines to the formula in the feeding container.
- Do not crush coated or time-released tablets or capsules.
The following will help you care for your child with special feeding needs.
- If the tube seems clogged (nothing can be pushed in or it is very hard to push in), please call or come to the hospital as soon as possible.
- Replace the NG tube as needed.
- If your child cries during the feeding, stop the feeding until he is quiet and comforted.
- Do not change the type or amount of formula without talking to your child’s doctor first.
If you have questions about the nasogastric tube (NG tube) or tube feeding, talk to your child’s doctor, nurse, or dietitian. Dial 901-595-3300 for the doctor or nurse. If you are outside the Memphis area, call toll-free 1-866-2ST-JUDE (1-866-278-5833). You can reach the dietitian by calling the Clinical Nutrition office at 595-3318.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).
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