Insertion of Silastic Nasogastric Feeding Tube

Because your child cannot eat by mouth, or requires more calories to grow, you will be giving the child's feeding through a tube that is placed down the nose into the stomach. These instructions will tell you how to place the tube.
  • Cup of water
  • Feeding tube
  • Stethoscope
  • 5 ml syringe
  • Tape
  • Wash your hands with soap and water.
  • Assemble all equipment.
  • Insert the stylet into the tube so that the end of the stylet is near the end of the tube. Be sure the stylet does not come through the hole at the end of the feeding tube.
  • Measure the tube from the tip of the nose to the ear, then down to the breast bone (middle of chest). Mark this point with a marker. This length will allow the tube to go into the stomach.
  • Lubricate the tube by dipping in water. Do not use gels or Vaseline due to the danger of the material getting in to the lungs and / or clogging the feeding tube.
  • Insert the tube through the nostril until you reach the marked point. Small sips of water may be given to the child while passing the tube to help them swallow.
    • Withdraw the tube immediately if the child's color becomes blue or he develops breathing problems. (These are signs that the tube may be in the lungs and not the stomach).
    • It is normal to have some gagging/choking activity while inserting the tube. Your child might even throw up.
  • Once the tube is inserted to the mark, remove the stylet and cover one port with the adapter and check placement through the other.
  • You will not hear the tube placement if one port is left open.
  • When the tube is properly placed, tape the tube to the child's nose and face, being careful not to block the nostril.
  • Always confirm the proper location of the tube before starting the feeding. To check the location of the feeding tube, place a stethoscope over the stomach. Then, with a syringe, quickly insert 3-5 ml's of air into the tube while listening with the stethoscope for a "pop." The "pop" represents air rushing into the stomach. The feeding should not be started if the tube is not in the stomach. If the tube is not in the stomach, remove the tube and try to place the tube again. If your child is less than 5 pounds, use 1-2 ml's of air.
  • Now you are ready to use the tube for the feeding.
  • If the feeding is not begun immediately, use the adapter to cover the end of the tube until time to begin the feeding. The tube should be checked again before feeding is started to assure that it is still in the stomach.
  • Pinch the feeding tube with thumb and forefinger when removing the tube. This prevents formula from flowing into the child's lungs.
  • After removing the tube, rinse with warm tap water, while observing for leaks.
  • Always remove the stylet from the NG tube as soon as the tube placement is confirmed.
  • Never infuse formula through nasogastric tube when the stylet is in the tube.
  • Never reinsert the stylet into the nasogastric tube while the tube remains in the child.
  • Always save the stylet to the silastic tube. It will be necessary to have the stylet to reinsert the tube.
  • The tube can become stretched after several uses. If the stylet no longer fits into the tube, discard it and use a new one.
  • Always wash your hands before and after handling the tube.

Last Updated 09/2014