Abdominal and Digestive Home Care

Definition / Explanation

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 through the nose into the stomach. These instructions will help you learn how to feed your child through the tube.

You Will Need

• Feeding Pump
• Feeding Pump Administration Set with pre-attached bag
• IV Pole
• Formula
• Stethoscope
• 5ml Syringe

Preparing to Feed Your Child

• Wash hands with soap and water.
• Assemble all equipment.
• Insert nasogastric feeding tube according to the directions on the instruction sheet.
• Always confirm the proper placement of the tube before initiating the feeding. To check the placement 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. If you do not hear the air "pop", the feeding should not be started. Try repositioning your child and try again to check for placement. Tube placement must be confirmed before starting any feedings.
• Tape the tube securely to prevent accidental dislodging. The tube should be taped in a manner that the tube does not put pressure on the nose.
• Set up the enteral administration set according to the directions on the side of the pump or in the instruction manual.
• Attached the tube feeding administration set to the Farrell Valve if ordered by your doctor.
• Add formula to the feeding bag and prime the tubing
• Only 8 hours of formula or 4 hours of breast milk may be placed in the bag and any given time.
• Set the desired rate of infusion on the pump and desired amount to be given. (Example: Rate = 50 ml, Dose = 400 ml, volume to be infused).
• When the tube placement is confirmed in the stomach, attach end of the feeding set to the feeding tube and turn on the pump and begin feeding. Securely tape all connections.

General Information

• Never add new formula to formula already in the feeding bag.
• Change entire set-up every 24 hours.
• Irrigate feeding tube with 1-5 ml's of water before and after each feeding and before and after giving medications to prevent the feeding tube from clogging. If the feeding is continuous, irrigate tube every 8 hours.
• If your doctor has ordered a Farrell valve, keep the "Y" of the administration set/Farrell valve connection at the stomach level.
• If formula backs up, try irrigating the feeding tube with warm water.
• It is important to allow your infant or child to have pleasant sensations during feedings: hold during feedings, suck on a pacifier, sit in the high chair and be apart of family meals.
• Ask your doctor or nurse about therapy to help improve oral skills.
• Whenever you need to remove the nasogastric tube, remember to pinch the feeding tube with your thumb and forefinger. This prevents the formula from flowing into your child's lungs.
• If you remove the tube, rinse it with warm tap water while observing for leaks and allow to air dry.
• Always wash your hands before and after handling the tube and after each feeding or giving medication.

Call Your Child's Doctor

Call the doctor if:

• Your child has abdominal pain or discomfort
• Your child has vomiting or diarrhea
• Your child's stomach is distended (puffs up)
• The feeding doesn't go in

Rev. 8/06