Continuous Gastric, Jejunal, Nasojejunal or Nasogastric Tube Feeding with Feeding Pump and Farrell Valve

Because your child cannot eat by mouth or requires more calories to grow, you will be giving your child feedings through a tube that is placed in the stomach (gastric or nasogastric) or just past the stomach into the small bowel (jejunum or nasojejunum).
  1. Feeding pump
  2. Feeding bag
  3. Farrell valve
  4. Formula
  5. IV pole
  6. Stethoscope (for nasogastric tube placement only)
  • Wash your hands with soap and water.
    • Nasogastric tube: Insert nasogastric feeding tube according to instructions for nasogastric tube Insertion. Always confirm the proper location of the tube before initiating the feeding. To check the location of the feeding tube, place a stethoscope over the stomach. Then, with a syringe, quickly insert 3-5 cc'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.
    • Nasojejunal: The mark on the tube should always be at your child's nose. Before each feeding, check to make sure the mark is in the proper place. If the mark has moved more than two inches from the nose, the tube will need to be replaced.
  • Set up feeding pump with the feeding bag according to the directions on the side of the pump or on the feeding bag.
  • Set up the Farrell valve according to the directions on the package.
  • Add formula to the bag and run through the tubing.
  • Set the desired rate of infusion on the pump.
  • Begin the feeding by turning on the pump.

Caution: When Farrell valve is not working properly the pump occlusion alarm will not function. The formula will continue to back up into the Farrell valve. If this happens:

  1. Check tubing to see if it is kinked or clamped.
  2. Irrigate feeding tube (the feeding tube may be clogged).
  3. Change the position of the patient.
  4. Check the position of the Farrell valve tubing to see if it is in proper position.
  5. If all the above fail, call your nurse or doctor for further instructions.
  • Discard old formula from feeding bag each time before adding new formula. Formula is OK at room temperature for four hours. You can put ice into a pouch on the feeding bag if it is a warm day. If using breast milk, do not add more than four hours of breast milk to a feeding bag at any one time.
  • Change entire feeding set-up every 24 hours.
  • Irrigate feeding tube with 3-5 ml's of water immediately following each feeding and before beginning a new feeding to prevent the feeding tube from clogging.
  • While the feeding is running, you may hold the child, sit the child in a chair, or place the child on his side in bed with the head up. The child's head should remain up at all times during the feeding.
  • Call your doctor or nurse if your child has:
    • Discomfort
    • Vomiting, diarrhea
    • Stomach distention (swelling)

Last Updated 11/2014