Nasogastric (NG) Tubes

An NG tube (nasogastric tube) is a soft, thin, plastic tube that is inserted into one of your child's nostrils, down the back of the throat, and into the stomach. It is a way for children to get nutrition.

Advantages:

• Safe way to give nutrition and medicine.
• No surgery or anesthesia needed for insertion or removal.

Disadvantages:

• Tube is visible.
• Putting it in can feel uncomfortable at first.
• May cause a runny nose, especially at first or during a cold.

Your care team will insert the NG tube into your child's nose. The length and size of the tube needed depend on your child's size. Your care team will provide comfort measures for the successful insertion of the tube. Once the tube is successfully placed, it will be secured.

When a tube is placed for the first time or when a tube of a different size is inserted, the correct placement will be confirmed with an X-ray. If the same-sized tube is being reinserted, placement will be confirmed by pH testing.

• A minor nosebleed can happen when the tube goes in, as the tissue in the nostril is sensitive. This usually stops quickly.
• Rarely, the tube can go into the airway instead of the stomach. That’s why checking placement is so important.

A dietician will meet with you to ensure your child’s nutritional needs are met while using an NG tube.

There are three different methods of feeding with an NG tube:

• Bolus: Feeding with periods of time in between feedings
• Continuous: Feeding over an extended time at a slower rate
• Combination: Feeding using both the bolus and continuous methods.

Your Gillette care team will teach you which method to use.

How to ensure the NG tube is in the right position

Always check the tube before you use it. To do so:

• You will be given a paper measuring tape; use the centimeter (cm) as the unit of measurement. Use the paper measuring tape given to you; start at the nostril and measure to the tube hub. (See Image 2 & 3.) Refer to the after-visit summary for the correct tube length.
• If the tube length is different than the number listed in your after-visit summary, the tube may have moved.
  • Do Not Use the Tube.
  • Call Gillette Telehealth at 651-229-3890.

Safety Precautions

Always keep the tubing away from your child’s body. Watch small children to make sure they do not pull on the NG tube. 

When your child is getting a feeding:

• Place the tubing so it cannot get tangled around your child.
• Run the tubing through your child’s clothes or toward the foot of the bed.  

This helps prevent the tubing from wrapping around your child’s body as they move.

Use each feeding bag for one day (24 hours). After that, you can either wash the bag with warm, soapy water and let it air dry, or replace it with a new bag if your insurance covers one bag per day.

Bolus Feeding

1. Wash your hands.
2. Measure the right amount of formula.
3. Check the tube position.
4. Attach a syringe to the feeding tube.
5. Pour the formula into the syringe.
6. Raise the syringe above your child’s head and begin feeding (see Image 1). The syringe's height controls the speed.
7. Let the formula flow in slowly.
8. If the formula doesn’t flow:
   1. Start when your child is calm.
   2. Flush the tube with water using a different syringe.
   3. Reconnect the formula syringe and attempt bolus feed again. 
      A pacifier may help calm a young child and help connect sucking with stomach-filling. For older kids, distract them or let them help (like holding the syringe).
9. Keep adding formula until you give the full amount.
10. When finished, flush the tube with water.
11. Plug the tube when not in use.

Continuous Feeding with a Pump

1. Wash your hands.
2. Pour formula into the feeding bag and prime it by running the feeding through the tubing.
3. Set up the pump as instructed by the medical supply company. Make sure the rate is correct.
4. Check the tube position.
5. Connect the feeding bag to your child’s tube.
6. Turn on the pump and start the feeding.
7. Add more formula every 4 hours or per Registered Dietitian or doctor recommendations as the bag empties.
8. Place your child in a comfortable position, either upright or at an incline. Infants should be placed in an infant seat or be held. It is best not to feed your child when they are lying flat.
9. Watch your child closely for changes in breathing or behavior. Check the tube mark and length often. If the mark or length changes, stop the feeding and call Gillette Telehealth at 651-229-3890.
10. If there are breaks in feeding, flush the tube with water, then clamp or plug the tube when not in use.

Your Gillette care team will show you how to give medicine through the NG tube. Follow these steps:

1. Wash your hands.
2. Check the tube position.
3. Prepare the medicine.
   1. Use liquid medicine if you can.
   2. If you have pills, crush them and mix with water until dissolved.
   3. Draw the medicine into the syringe. Your Gillette Care team will teach you how.
4. Connect the syringe to the NG tube. Make sure it is firmly attached so the medicine doesn’t spill.
5. Give the medicine slowly. Push the plunger gently.
   1. If it feels stuck, stop. Remove the syringe and flush the tube with warm water.
6. Watch your child closely while and after giving medicine.
   1. If breathing or behavior changes, stop right away.
   2. If changes happen after giving medicine, check the tube position and call Gillette Telehealth.
7. Flush the tube with water. This keeps the tube from clogging.

This section outlines common questions you may have about your child’s feeding tube and what you can do. If you are unsure or the problem persists, call Gillette Telehealth at 651-229-3890.