Your Child's Nasogastric Tube: Pump Feeding

Note

Take care to keep the tube from becoming a strangulation risk to your child. Follow your healthcare team's advice on how to secure the tube safely.

Contact information to keep handy

Ask for phone numbers to call if you need help. Also, make sure you have the phone number for your child’s medical supply company. You’ll need to order more supplies for your child in the future. Write all of these phone numbers below.

Healthcare provider phone number: ____________________________________

Home health nurse phone number: _____________________________________

Medical supply company phone number: __________________________________

Types of feeding

There are 2 types of feeding with an NG tube. Your child may be have one or both types of feeding. They are:

• Continuous feeding. Liquid food is dripped slowly through the tube for part or all of a day. This type of feeding is only done using a pump. The amount of food to be given and time frame are often set on the pump for you. Don't change pump settings unless you’re instructed to do so.

• Bolus feeding. This is a meal-sized amount of liquid food given through the tube several times a day. Bolus feeding is given using a syringe or a pump. Your child’s healthcare provider or home health nurse will tell you how much liquid food to use for each feeding. You’ll also be told how often to feed your child.

For bolus feeding, fill in the numbers below:

Feed your child on this schedule: ____________________________________________

Give this much at each feeding: ______________________________________________

Checking placement of the tube before feeding

Every time you feed your child, you’ll need to make sure the NG tube is in the proper place. The end of the tube must be in your child’s stomach, not in the lungs or throat. To check if the tube is in place, you will draw some liquid from the stomach and test it. Do this check before each feeding.

The supplies you’ll need are:

• Syringe

• pH testing strips

Follow these steps:

• Wash your hands with soap and water.

• Attach the syringe to the end of the NG tube. Depending on the type of NG port your child has, you may plug in the syringe or twist it on. Make sure the other port of the NG tube is closed off.

• Pull back on the plunger of the syringe until you see liquid from the stomach in the syringe.

• Look at the color of the fluid. It should look clear or light yellow.

• Check the pH of the liquid from the stomach using pH paper. Stomach (gastric) pH should be 1 to 5 if your child is not taking a proton pump inhibitor or H2 receptor antagonist. There are other things that can increase pH. Follow your provider's specific instructions.

• If you are not sure the tube is in the stomach, don’t proceed with the feeding. Re-insert or gently move the NG tube as you were instructed at the hospital. Repeat the above steps to check for correct placement. 

• Remove the syringe from the feeding tube.

• Tape the tube securely in place along your child’s nose or cheek as you were shown in the hospital.

• Wash the syringe out with soap and water and allow to dry.

• Proceed with feeding as instructed.

Feeding your child

After checking placement of the tube, feed your child the amounts on the schedule as noted above.

The supplies you’ll need are:

• Liquid food

• Clean feeding bag with tubing

• Feeding pump

• 5 to 10 ml syringe (for flushing)

• Water (for flushing)

Follow these steps:

• Wash your hands with soap and water.

• Make sure the pump is in the STOP/OFF mode.

• Check the label and expiration date of the liquid food. Don’t use any can or bag of food if the expiration date has passed. Instead, get a new can or bag of food.

• Make sure the clamp on the feeding bag tubing is closed, if there is one Some tubes don't have clamps.

• Pour a little more than the prescribed amount of liquid food into the feeding bag.

• Hang the feeding bag on the pole above the pump. Make sure the feeding bag tubing hangs straight.

• Open the clamp on the feeding bag tubing slowly. Let a small amount of food run through the end of the feeding bag tubing. This clears air out of the feeding bag tubing. It also helps keep your child from having gas later.

• Load the feeding bag tubing into the pump.

• Close the clamp on the feeding bag tubing.

• Open the feeding port cap at the end of the NG tube.

• Connect the feeding bag tubing to the feeding port of the NG tube.

• Open the clamp on the feeding bag tubing.

• Check that the settings on the pump are correct.

• Turn the pump to START/ON.

• After the feeding, flush the tube with water as you were shown in the hospital.

• Disconnect the syringe from the NG tube.

• Close the feeding port cap of the NG tube.

• Never put medicines or pills down the feeding tube unless you were instructed to do so by your healthcare provider. This can lead to the feeding tube getting clogged and unusable.

Additional instructions: _____________________________________________________________

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When to call the healthcare provider

Contact the healthcare provider right away if any of the following occurs:

• You’re not able to place the tube.

• Your child has trouble breathing.

• The skin around the tube site has redness, swelling, leaking fluid, or sores.

• You see blood around the tube, in your child’s stool, or in the contents of the stomach.

• Your child coughs, chokes, or vomits while feeding.

• Your child’s belly looks bloated or feels hard when gently pressed.

• Your child has diarrhea or constipation.

• Your child has a fever  100.4°F ( 38°C) or higher.