Care of a Feeding Tube Site

Individuals who have trouble swallowing or cannot take food or medication by mouth are sometimes given feeding tubes. A feeding tube can go into the nose and down to the stomach or through the skin in the abdomen and into the stomach or small bowel. Some of the names of these feeding tubes are gastrostomy tubes, PEG lines, nasogastric tubes, and gastrojejunostomy tubes.

Liquids or foods that have been made into a thick, smooth soup consistency (pureed), along with medications, may be given through the tube. There are several ways to give the liquid food (formula), and there are several kinds of prescribed formulas. Your caregiver will arrange for you to get nutrition in the right amounts for you.

EQUIPMENT NEEDED FOR TUBE FEEDING

  • A 60 mL syringe.

  • Formula suggested by your caregiver or dietician.

  • A specific plug to put into the feeding tube tip during the times when you are not getting food or medications.

  • A feeding pump or a place to hang your food container (an IV pole or a wall hook) so it can operate by gravity while you are getting your feedings. You attach the tube from the food container to the end of the feeding tube. Your caregivers will help you with these supplies or tell you where to get them.

PROCEDURE FOR TUBE FEEDING

  1. Wash your hands before touching the equipment, food, medications, or the site (where the tube enters your body).

  2. Check the tube placement before starting the feeding by removing the plug in the end of the feeding tube and attaching a syringe to the feeding tube. Pull the plunger back and you will usually see some yellowish or greenish fluid. This tells you the tube is in the correct place. Note the amount and gently push the residual back into the tube.

    • Ask your caregiver if there are instances when you would not start tube feedings depending on the amount or type of contents withdrawn from the stomach.

    • If gastrointestinal (GI) contents do not show when you pull back on the plunger, measure the length from the stoma site (the opening in your body made for feeding) to the end of your feeding tube. If this different from the previous measurement, you should call your caregiver.

    • If at any point the feeding tube seems blocked, use your syringe and pull back on the plunger. If this does not work, try to gently force some warm water through the tube. If none of these methods work, call your caregiver. It is important not to miss your medications, food, or water.

  3. If everything with the tube seems to be okay, insert the tip of the tube from the food container into your feeding tube.

  4. While sitting up or with your head propped up at least 30 degrees to 45 degrees, start the feeding. If you develop coughing or have trouble breathing, stop the feeding immediately.

  5. Administer the feeding for the length of time instructed by your caregiver.

  6. To keep the tube open, following the feeding, flush the tube with 30 mLs of water using a syringe, and replace the plug at the end of the feeding tube.

  7. Do not leave unused food out between feedings. Refrigerate or store it as directed.

GIVING YOUR MEDICATIONS THROUGH THE TUBE

  • Use liquid forms of your medications, if available.

  • Some pills or tablets may be crushed and put into warm water. Do not use hot water, which could affect the contents.

  • Ask the pharmacist if you can crush your pills. Do not crush capsules that have SR (sustained release), XR (extended release), or CD (controlled release) printed on them unless your caregiver or pharmacist says it is okay.

  • After you have crushed your pills or capsules into small pieces or a powder, let the pieces dissolve in warm (not hot) water so that no pieces will clog your tube. Draw medication up into your syringe by pulling back on the plunger.

  • Attach the syringe to the end of the feeding tube and push on the plunger to give your medication.

  • Flush the tube with 30 mLs of water after giving your medication. This makes sure you have received all of your medications.

CARE OF THE SKIN AROUND THE ENTRANCE OF THE TUBE

  • Check the skin daily where the tube enters the abdomen for redness, irritation, drainage, or tenderness.

  • Clean around the tube daily with water or soap and water using cotton-tipped applicators or gauze squares. Dry completely after cleaning.

  • Change the dressing around the tube insertion site daily or as instructed.

  • Apply antibiotic ointment around the site, if directed by your caregiver.

  • If the dressing becomes wet or soiled, change it as soon as convenient.

  • You may use tape to fasten your feeding tube to your skin for comfort or do as directed.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You develop coughing or have trouble breathing during a feeding. Stop the feeding and call your caregiver immediately.

  • You notice swelling, redness, drainage, or tenderness at the tube insertion site.

  • You develop pain,nausea, vomiting, diarrhea, constipation, or bleeding around the tube insertion site.

  • The tube seems plugged and you are unable to get water through the tube.

  • There is food leaking from around the tube.

  • The tube falls out.