The Best Practices for Feeding Tubes

A feeding tube is responsible for delivering liquid nutrition through a flexible tube that goes through the nose or directly into the stomach or small intestine, for medically fragile children who can’t eat or swallow properly. Whether you’re a Pediatric Home Care Nurse or a caregiver who is supporting a child with a feeding tube, here’s a quick and helpful refresher on best practices. 

Proper Tube Placement

Feeding tubes can be placed in two different ways: through the nose (non-surgical and known as NJ tubes) or a small opening made in the wall of the abdomen (ostomy surgery, known as G-tubes). The best feeding tube depends on the needs of the patient, including:

• Health of the digestive system.
• Duration of nutrition support.
• Frequency of use.
• Child’s age, size, and health status.
• Child’s activity level.
• The amount of care needed to maintain the tube.
• Risk of infection and other problems.

While feeding tubes are typically inserted in a hospital setting, Pediatric Home Care Nurses may be responsible for replacing them when they are clogged or damaged.     

Keep Tube and Stoma Clean

Keeping a feeding tube and the area around it clean will help prevent infections and ensure that the tube is functioning properly. After disconnecting a feeding tube for cleaning, use a large syringe filled with warm water, connect the syringe to the feeding port, and gently push the plunger to flush water through the tube. This will need to be repeated before and after feedings and after administering medications. For the skin around the stoma (surgical opening in the abdominal wall), use mild soap and water to gently clean the area.

Follow the Correct Feeding Schedule 

Medically fragile patients with feeding tubes have various feeding schedules based on their specific needs. There are three different schedules nurses and caregivers can follow for the child: 

• Continuous (delivered at a steady rate over 24 hours).
• Bolus (administered in large doses, typically three to six times a day over a short period).
• Cyclic (also known as intermittent feeding, typically over 20-60 minutes every few hours).

Make sure to always follow the exact formula type, amount, and schedule that has been ordered by the patient’s healthcare provider. 

Be Aware of Potential Complications 

When a feeding tube is not properly monitored, it can lead to a series of medical complications, and some may be life-threatening. Here are potential complications to look out for:

• Constipation.
• Dehydration.
• Diarrhea.
• Skin Issues (around the site of the tube).
• Unintentional tears in the intestines (perforation).
• Infection in the abdomen (peritonitis).
• Feeding tube blockages (obstruction) and involuntary movement (displacement).

Offer Emotional Support

A feeding tube can be scary or intimidating for a child. When a caregiver or nurse offers emotional support during the feeding tube insertion, routine feeding, or cleaning, it can help the child feel calm and safe. There are many ways to provide emotional support, from explaining the feeding tube process in a way the child will understand to incorporating medical play.

Nurses at Thrive SPC are skilled in providing care for patients with a wide range of pediatric medical complexities, including nutrition issues. To explore more about how Thrive SPC offers high-quality home health care, head to https://www.thrivespc.com/.