MyTubeFeeding.ca | Instructions & Education

Instructions & Education

Managing your child’s tube feeding: syringe feeding, gravity feeding
   and using a pump
Administering water & medication
Personal care
Oral stimulation
Keeping a record

Managing your child’s tube feeding

In this section, we will cover the different feeding delivery methods and the supplies needed.

Checking the placement of your child’s feeding tube
(If instructed by your healthcare professional)

You may be asked to check the placement of your child’s feeding tube at home before you start a feeding - or less often (once a day or a few times a week). If you have been asked to check the position of your child’s tube, follow these steps:

  1. Wash your hands
  2. For a nasogastric or nasojejunal tube: check the proper tube position as instructed by your child’s healthcare professional. There may be a special mark drawn on the tube or a certain length it should be from the end of your child’s nose. For a gastrostomy or jejunostomy tube: use a ruler or non-stretchy tape measure to measure the number of inches/centimetres from the spot where the tube exits your child’s body to the end of the tube.
  3. Compare the number with previous measurements. If there is a change, call your child’s healthcare professional. Do not begin the next feeding.
Using Syringe Feeding

Gather your supplies

  • Formula
  • Clean cup or container, if needed
  • 60 mL syringe
  • Water at room temperature

Get set up

  1. Wash your hands
  2. Wipe the top of the formula container with a clean, wet cloth
  3. Shake the formula container gently
  4. Check your child’s ‘feeding schedule’ for how much formula to use

Starting the feeding

  1. Get your child into a comfortable position – have him or her sit upright or lie with the head of the bed raised to 45 degrees (about the height of 2 pillows)
  2. Open your child’s feeding tube
    • Fold over and pinch or clamp the end of the feeding tube to stop the flow. Then uncap the tube.
  3. Flush the feeding tube with water – your child’s healthcare professional will tell you how much water to use
  4. Close or recap your child’s feeding tube

Use either Method A or Method B

METHOD A
BY GRAVITY - POURING FORMULA INTO THE SYRINGE

  1. Open your child’s feeding tube
    • Fold over and pinch or clamp the end of the feeding tube to stop the flow. Then uncap the tube.
  2. Attach the syringe to the end of your child’s feeding tube. Unfold the tube to start the flow.
  3. Pour formula into the syringe
  4. Let the formula flow into the tube by gravity. Holding the syringe higher or lower will control the feeding rate.
  5. Continue refilling the syringe until your child’s entire feeding is given
    • This entire process may take a few minutes or you may space out the syringe feeding over a longer period of time
    • Talk to your child’s healthcare professional about how long your child’s tube feeding should take
  6. Take the syringe off your child’s tube – fold over and pinch the end of the feeding tube to stop the flow and recap the tube
  7. After feeding, flush your child’s feeding tube with water – your child’s healthcare professional will tell you how much to use
  8. Close or recap the feeding tube
  9. Clean, rinse and dry your supplies as directed by your healthcare professional

METHOD B
PUSHING FORMULA WITH THE SYRINGE

  1. Pour your child’s formula into a clean cup or container
  2. Draw the formula up into the syringe
  3. Open your child’s feeding tube
    • Fold over and pinch or clamp the end of the feeding tube to stop the flow, then uncap the tube
  4. Attach the syringe to the end of your child’s feeding tube
  5. Gently push the formula into the tube with the syringe plunger
  6. Take the syringe off your child’s tube – fold over and pinch or clamp the end of your feeding tube to stop the flow and recap the tube
  7. Repeat steps 6 to 10 until your child’s entire feeding is given
    • This entire process may take a few minutes or you may space out the syringe feeding over a longer period of time
    • Talk to your child’s healthcare professional about how long your child’s tube feeding should take
  8. After feeding, flush the feeding tube with water – your child’s healthcare professional will tell you how much to use.
  9. Close or recap the feeding tube
  10. Clean, rinse and dry your supplies as directed by your healthcare professional
Using Gravity Feeding

Gather your supplies

  • Formula
  • Feeding bag and tubing
  • Pole
  • 60 mL syringe
  • Water at room temperature

Get set up

  1. Wash your hands
  2. Wipe the top of the formula container with a clean, wet cloth
  3. Shake the formula container gently.
  4. Close the tubing on the feeding bag by closing the slide/roller clamp
  5. Pour the formula into the feeding bag and close the top of the bag
    • Check your child’s ‘feeding schedule’ for how much formula to use
  6. Hang the feeding bag on the pole so it is at least 18 inches / 45 centimetres above the level of your child’s stomach
  7. Start the flow of formula through the feeding bag tubing by opening the side/roller clamp
  8. Let the formula flow to the tip of the tubing
  9. Close the side/roller clamp

Starting the feeding

  1. Open your child’s feeding tube
    • Fold over and pinch or clamp the end of the feeding tube to stop the flow. Then uncap the tube.
  2. Flush your child’s feeding tube with water – your child’s healthcare professional will tell you how much to use
  3. Attach the tip on the end of the feeding bag tubing to the feeding tube
  4. Get your child into a comfortable position – have him or her sit upright or lie with the head of the bed raised to 45 degrees (about the height of 2 pillows)
  5. Open the slide/roller clamp to adjust the flow rate as directed by your child’s healthcare professional.
  6. After the feeding, close and remove the feeding bag tubing
    • You may be asked to pour water into your child’s feeding bag and run this into his or her body before taking off the feeding bag.
  7. Flush the feeding tube with water – your child’s healthcare professional will tell you how much to use.
  8. Close the feeding tube
  9. Clean, rinse and dry your supplies as directed. Your child’s healthcare professional will tell you how often to replace the feeding bag and tubing.
Using a Feeding Pump

Gather your supplies

  • Formula
  • Feeding bag and tubing
  • Feeding pump
  • Pole
  • 60 mL syringe
  • Water at room temperature

Get set up

  1. Wash your hands
  2. Wipe the top of the formula container with a clean, wet cloth
  3. Shake the formula container gently
  4. Pour the formula into the feeding bag and close the top of the bag – make sure the slide/roller clamp is closed
    • Check your child’s ‘feeding schedule’ for how much formula to use
  5. If using an IV pole, hang the feeding bag on the pole above the feeding pump
  6. Since every pump is different, follow the instructions given by your child’s healthcare professional to use your child’s feeding pump and ‘prime’ the tubing (‘priming’ means to fill the tubing with formula before it is attached to the feeding tube)

Starting the feeding

  1. Get your child into a comfortable position – have him or her sit upright or lie with the head of his or her bed raised to 45 degrees (about the height of 2 pillows)
  2. Open your child’s feeding tube
    • Fold over and pinch or clamp the end of the feeding tube to stop the flow. Then uncap the tube.
  3. Flush your child’s feeding tube with water – your child’s healthcare professional will tell you how much to use.
  4. Attach the tip on the end of the feeding bag tubing to your feeding tube
  5. Set the flow rate on the pump. Your child’s healthcare professional will tell you what flow rate to use.
  6. If needed, open the side/roller clamp on the feeding bag tube
  7. Start your child’s feeding pump
  8. After the feeding, take the feeding bag tube off of the feeding tube
  9. Flush your child’s feeding tube with water – your child’s healthcare professional will tell you how much to use.
  10. Close the feeding tube
  11. Clean, rinse and dry your supplies as directed
    • If you are pouring formula into a feeding bag container for your child’s tube feeding, check with your child’s healthcare professional about how long your child’s feeding formula should “hang” or stay in the feeding bag and tubing at room temperature
  12. Replace the feeding container and tubing as advised by your child’s healthcare professional

"When we first found out that our son needed to be tube fed, we were mostly just scared and wondering if he would still be able to eat by mouth. If he would ever be [able to] transition off the tube. Would we ever be able to leave the house? At first, we were not at all comfortable with administering our son's tube feedings. We only had two days of watching at the hospital, and we didn't have anything to practice with. We had no idea what we were doing. But now, I am able to train my extended circle of care.”
—Jacquelyn F., mom of Rafael, age 6


Administering water or medications

Water is part of your child’s formula, but extra water and sometimes medications are needed to keep their body healthy and the feeding tube working well.

  • Your child’s healthcare professional will tell you how much water or medication to take.
  • Your child’s healthcare professional will tell you which medications you can crush, or if there are liquid medications that can be used.
Read this first: Checklist

Check with your child's nurse, doctor or pharmacist to find out about:

  • Which medications should not be crushed
  • How to crush medications – if you are asked to do this
  • How much water to mix with your medication
  • Which medications should not be given together
  • If there are any other special instructions about giving your medications through your child's feeding tube
Step-by-Step Instruction

When giving water and medications, follow the steps below. When giving water only, start at step 2.

  1. Using a 60 mL syringe, flush your child’s feeding tube with 15-30 mL of warm water before giving medication (unless you are told something different by your child’s healthcare professional). See Figure 1.
  2. Using a 60 mL syringe, draw up the right dose of medication or water into the syringe. Open your child’s feeding tube and attach the syringe to the feeding tube. See Figure 2 and Figure 3.
  3. Gently push the water or medication into the tube. See Figure 3.
  4. Take the syringe off your child’s feeding tube and refill the syringe with warm water until the all of the water you need is given, or to flush all the medication out of the syringe.
  5. Close the feeding tube when finished and place the cap back on the tip of the syringe.

Personal care

Oral stimulation

Eating and drinking food and fluids by mouth is an important part of a young child and toddler’s learning and development. Oral stimulation may help a young child to learn or maintain how to chew, drink or suck. Ask your child’s healthcare professional for ideas about providing your child with safe ways to chew or suck.

Keeping a record

The following tools can help you and your child’s healthcare professional keep track and assess your child’s progress with tube feedings, and also help you keep a current list of your child’s care providers.

Nestlé Health Science has made every effort to include on this website only information that it believes to be accurate and reliable. This site is applicable to children ages 1-16 years and contains information from a variety of sources including practice-based resources, guidelines from professional organizations, and experiences of healthcare professionals who have managed patients on home tube feeding. Information provided on this site is for education purposes. It is not intended to replace the advice or instruction of your child’s healthcare professionals, or to substitute medical care. Contact a qualified healthcare professional if you have any questions regarding your child’s tube feeding product, prescription and supplies, or if you have specific question or issues about what is best for your child as you manage your child’s tube feeding at home.