Nasal Gastric Bolus Feeding

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.

  • 5 ml syringe
  • Stethoscope
  • Breast milk / formula
  • 30 or 60 ml syringe
  • Wash your hands with soap and water  
  • Assemble all equipment  
  • Lay infant or child on his / her side with the head up or have child sit upright
  • 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 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. Patient with feeding tube.

  • 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.
  • Remove plunger from the 30 ml or 60 ml syringe. Attach the syringe to the NG tube. Pour formula into syringe. Fill to the amount ordered by your doctor.
  • Let the formula flow in by gravity. You may need to attach plunger and give a gentle push to get the flow started. Remove plunger and let formula flow in slowly over 10-15 minutes, or about the time it would take that amount by mouth.
  • Lowering the syringe can slow the feeding rate. Raising the syringe will speed up the feeding.
  • If your child begins to choke or gag, lower the syringe immediately and pour formula back into bottle. Help child clear vomit if any is present. Re-check tube placement. Resume feeding when child is ready at a slower rate.
  • When the feeding is finished, flush the tube with water to clear the formula from the tube. Kink the feeding tube and remove syringe. Put cap back on feeding tube securely. If your child is on fluid restrictions, check with the doctor or nurse before using water to flush the tube.
  • After feeding, rinse out the syringe with hot water and allow it to air dry.
  • If child's stomach becomes distended (puffs up) or if he / she becomes uncomfortable, stop the feeding and wait about one hour. If the stomach remains distended or if your child continues with discomfort after one hour, call your nurse or doctor.
  • It is important to allow your infant or child to have pleasant sensations during feedings, such as being held, sucking on a pacifier, sitting in a high chair and being part of family meals.
  • Ask your nurse or doctor 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.

If your child experiences any of the following after feedings, call the doctor.

  • Abdominal pain or discomfort
  • Vomiting or diarrhea
  • Stomach distention (puffs up)

Last Updated 11/2014