DO YOU KNOW...

Troubleshooting feeding tube problems

 

If the feeding tube is damaged

It is important to check your child’s feeding tube often to make sure everything is in the right place and working correctly. Check to make sure all the parts are working and the tube is not torn or split. Parts that do not work correctly or break during use might need to be changed. Call your St. Jude team if you notice any problems.

If your child has a low profile tube (button), you might be trained to change it. If so, you can change the button if your child has had it for more than 6 weeks. Only change a gastric button. If your child has a gastrojejunal button or had the button put in less than 6 weeks ago, call your St. Jude team. A health care professional needs to change gastrojejunal buttons and buttons that have been in place for less than 6 weeks.

If the balloon leaks

It is important to check the balloon that helps hold your child’s feeding tube steady at least one (1) time each month. “Do You Know… Skin Care and Dressings for Feeding Tube Sites” has instructions for checking the balloon. The balloon is made of silicone and usually lasts several months. But, many things can affect how long it lasts. These include medicines, stomach acid, the amount of water in the balloon, and how the tube is cared for. Signs of balloon problems include more drainage from the stoma and a tube that looks like it fits
loosely.

A low profile tube (button) balloon holds 5–10 ml of sterile water. Your child’s balloon holds ______ml of sterile water. If your child’s balloon has less water than it should, add sterile water until it holds the amount written above. “Do You Know… Skin Care and Dressings for Feeding Tube Sites” has instructions for filling the balloon. Check the balloon the next day to see if it is still full. If not, it might have a leak. If the amount of water has gone down, change the tube the way you were trained. See “Do You Know… How to Replace a Feeding Tube That Comes Out” for guidelines on replacing a low profile tube (button).

The water in the balloon should be clear or yellow. Only use a slip tip syringe to check the balloon. Never use a Luer Lock syringe because this can damage the one-way valve of the balloon port.

Add water to feeding tube

If the feeding tube gets plugged

Medicines or liquids can plug your child’s feeding tube if it is not flushed out correctly. It is important to flush with enough water before, after, and in between giving medicines. It is also important to flush the tube every 4–6 hours on continuous feeds and 3–4 times a day with bolus feeds. You should flush with enough water to clear the tube of any contents seen in the tubing. If your child’s tube is not being used, flush it a few times each day to keep it from getting plugged.

If your child’s tube does get plugged, you can try to flush it with 5–10 ml of warm water by allowing the water to flow down in a syringe attached to the feeding tube by gravity. If you hold the syringe above your child’s stomach, the liquid will flow into the tube by itself.

If this does not work, add 5–10 ml of warm water to a 60 ml catheter tip syringe with the plunger in place. Attach the syringe to the tube and use a gentle push-pull motion. This might loosen the plug. Do not pull hard on the plunger of the syringe. Pulling hard could damage the tube or your child’s stomach lining.

Push plunger
pull plunger

If you cannot unplug the tube by doing these things, call your St. Jude team. They can prescribe a medicine to help loosen the plug.

Do not use soft drinks, fruit juices, or tenderizers to unplug the tube. This can damage the tube and cause future plugs. Do not put anything into the tube to try to unplug it.

If the tube comes loose

Feeding tubes sometimes become loose. If your child has a conventional gastrostomy tube (G-tube) or gastrojenjunal tube (GJ-tube) with a retention disc that rests on the skin, the tube might loosen if the disc moves slightly up the tube (away from your child’s body).

To fix this, gently pull the tube up until you feel resistance. The resistance means the balloon inside your child’s body is touching the inside of the stomach wall. Then, push down on the retention disc gently until it is just resting on your child’s skin. You can leave a space about as thick as a dime between your child’s skin and the disc. Do not push the disc more tightly against the skin, because this will make it press on the skin too much.

 

If your child’s low profile tube (button) seems loose, check the balloon.

Your child’s tube should have no less than ______ml of sterile water in it. If there is less than this amount of water in the balloon, read the section above called “If the balloon leaks.” If the balloon has the least amount of water in it, add another 1 ml–2 ml. This might help the tube fit more tightly against your child’s skin. You should have a space about as thick as a dime between your child’s skin and the bottom of the button. Make sure the tube is not too tight against the skin when you add water, because this could cause too much pressure on the skin.

If the tube is still loose after adding water, talk to your St. Jude team. Your child might need to be measured for a tube that fits better.

It is important never to put more than 10 ml of water in the balloon for any button (even less if your child has a 12 French button). If your child has a 12 French button, never put more than 5 ml of water in it.

Questions?

To learn more about troubleshooting tube problems or if you have questions about anything covered in this handout, please talk to your child’s clinical nurse specialist.


 

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).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1  (الهاتف النصي: 1040-595-901-1).