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.

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

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.

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

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

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.