Nasogastric (NG) tube: Feeding your child

The following information provides instructions on feeding your child through their nasogastric (NG) tube. When at home, feeding through the NG tube should be done by gravity.

Feeding your child through the NG tube

1. Gather the following equipment:
• adapters
• 5 or 10 mL syringe
• prepared formula
• feeding bag
• infusion tubing
• IV pole
2. Wash your hands.

3. Check the correct tube placement.
• Attach the empty 10 mL syringe to the adapter and gently flush with air to clear the tube. Then pull back on the plunger to withdraw about 2 mL of stomach contents.
• Wet pH testing paper with the stomach fluid and compare the color with the label on the container. For the majority of children, the colour on the strip should be less than 4. For children who are on stomach acid suppressing medications or who have just fed, the colour on the strip should be less than 6. Ask your health-care provider what colour to expect.
4. If you believe the NG tube is not correctly placed, remove it and try again. If you have trouble pulling back some stomach fluid to do the pH test, try the following:
• Use a larger syringe and draw back more gently to prevent collapsing the tube.
• Push in 1 to 2 mL of air through the NG tube into the stomach and gently draw back on the syringe.
• Change your child’s position by having them lie on their right or left side for a few minutes to move the position of the tube in the stomach.

Closing the clamp on the infusion tubing

Handling the feeding bag

5. Close the clamp on the infusion tubing.
6. Pour the prepared formula into the feeding bag, close the seal tightly and hang the bag on the IV pole.
7. Open the clamp to allow the feeding solution to push all the air out of the infusion tubing. Close the clamp once you see the fluid drip out of the end of the tubing.
8. Connect the tubing to your child’s NG tube. The air in your child’s NG tube will not cause problems.
9. Open the clamp far enough to get the desired rate of flow. To do this watch how fast the formula drips - a faster drip means the feed will go in quicker.
10. When the feed is done, close the clamp and remove the infusion tubing from the NG tube. Set it aside.
11. Cap off the NG tube.

12. If your child keeps their feeding tube in, flush the tube with 5 mL of water to clear any formula residue between feeds. Use the attached plug to close the tube.

    If your child does not keep their feeding tube in all the time, about 30 minutes after the feed, hold up the end the tube so that it can drain into the child. Remove the tape and gently remove the tube.

When to flush the tube

Flush the NG tube:

• At the end of every feed
• After giving medication

Cleaning your equipment

• Flush the feeding bag and tubing with warm soapy water. To rinse well, let the water flow through the tubing and into the sink. Allow the tube and bag air dry. Throw away the bag and infusion tubing into your regular garbage bin every seven days and get a new one.
• Take apart the syringes and wash syringes with warm soapy water. Rinse well with warm, clear water and let air dry. Use a new syringe every seven days. Throw away used syringes into your regular garbage bin.
• Syringes and feeding bags can be discarded in regular garbage bins.
  

For more information, please see Nasogastric (NG) tube: How to insert your child's NG tube and Nasogastric (NG) tube feeding: Common problems.