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Gastrostomy Feedings (Pump Feeding or Bolus Method)

(757) 668-7000


Your child needs gastrostomy tube (G-tube) feedings. A G-tube or skin level device has been placed into the stomach. Gastrostomy feedings will provide nourishment and fluids that your child needs. Your child's nurse will teach you about the amount and type of feeding your child needs and any equipment you will need before discharge.

To feed your child, you will need these supplies:

PUMP:

  • Feeding set
  • Continuous feeding extension set (for Mic-Key® only)
  • Measuring cup with pouring spout
  • Formula or blenderized feeding as ordered by your child's doctor
  • Glass of water (optional)

BOLUS:

  • Catheter tip syringe for G-tube
  • Feeding extension tube and slip tip syringe for Mic-Key®
  • Measuring cup
  • Formula or blenderized feeding as ordered by your child's doctor
  • Glass of water (optional)
  • Rubber band
  • Clamp for G-tube
  • Safety pin

Feeding your child:

  1. Wash your hands.
  2. Use formula that is at room temperature. Never microwave formula to bring it to room temperature. Keep opened containers of formula in the refrigerator.
    • It takes about 30 minutes for cold formula to reach room temperature. Measure the amount of formula needed for the feeding 30 minutes before the feeding is due and refrigerate any leftovers promptly.
    • Discard any formula after it has been out of the refrigerator for 4 hours.
    • Any opened blenderized feeding or commercially prepared formula should be thrown out after it has been in the refrigerator for 24 hours.
  3. Put two or three drops of formula on your wrist before feeding. The formula should feel warm, not hot or cold.

PUMP FEEDINGS:

  1. Close the clamp on the feeding bag. Pour the formula into the bag. Hang the bag high on a hook. Open the clamp and let the formula flow through the tubing until all of the tubing contains formula. Clamp the system. Your nurse will show you how to put the tubing through the feeding pump.
  2. For the G-tube, insert the catheter tip of the feeding tube into the G-tube.
  3. If your child has a skin level device, you will need to attach a feeding extension tube to the feeding system and fill it with formula. After all of the tubing contains formula, clamp the system.
  4. G-tube diagram
  5. Next, open the flap of the Mic-Key® and attach the open end of the feeding extension tube to the device. Open the clamp when you are ready to begin the feeding.
  6. Set the pump as instructed by your child’s nurse and begin the feeding.

BOLUS METHOD:

Pin Syringe to Your Shirt
  1. If your child has a skin level device, you will need to attach the extension set to the device and then connect the catheter tip syringe to the extension set. If your child has a long G-Tube, connect the catheter tip syringe to the end of the tube.
  2. Pour the formula into the syringe until it is half full. Filling the syringe full can cause spillage if your child coughs or moves. Next, unclamp the tube or extension tube. Hold the tip of the syringe no higher than your child's shoulders. If the feeding does not start to flow, milk the tube by squeezing it in a downward stroke.
  3. Make sure you and your child are sitting comfortably. To free your hands, you can pin the syringe to your shirt at shoulder height. This can be done by wrapping a rubber band around the top of the syringe and pinning the band to your shirt.

General feeding guidelines:

(Both Pump and Bolus Method)

Feeding Position
  1. For a gastrostomy feeding, your child's head must be raised. For an infant, you can hold him in the curve of your arm while feeding (cuddling position). If your child is older, you can feed him in a high chair or any seat as long as his head is raised. If your child is fed in these positions, hang the feeding set on a hook in the room.
  2. The feeding should take the same amount of time as a regular feeding or meal, at least 20-30 minutes. If your child cries during the feeding, stop the feeding until your child is quiet. This can be done by clamping or pinching the tube with your finger and thumb.
  3. Eating is a social time so make the feeding a happy time for your child. If your child needs oral stimulation, follow the instructions given to you by your child's occupational therapist or nurse, and the Way to Grow handout for Simulated Feedings.
  4. After the feeding, add water or air to clear the feeding from the tube. Your child's nurse will tell you which to use and how much. If your child has a G-tube, close the clamp on the tube and the feeding system and remove the feeding system.

Giving medications through the gastrostomy tube

Any medicine given through the tube should be finely ground and dissolved or given as a liquid to prevent a blockage in the tube. Giving it at the beginning of the feeding helps the medicine to be absorbed.

Some medicines may need to be given on an empty stomach. The tube needs to be flushed after the medication to ensure that the medicine gets into the stomach. Flushing with water after the medication also keeps the tube from becoming clogged. Your nurse will tell you how much water you should use to flush the tube.

Remember to tell your child's doctor or pharmacist that your child has a gastrostomy and that pills may clog the tube.

Cleaning the equipment

  1. Wash the syringe, feeding extension tube, feeding set and measuring cup in hot, soapy water. Rinse with hot water and dry. If formula is caked on the syringe or tubing, rinsing with a carbonated beverage before cleaning will help remove the dried formula.
  2. Change the extension set for the Mic-Key once a week.
  3. Change the feeding bag as recommended by your home health care equipment company.

Important:

  1. Always prepare your child's formula by the instructions given by your child's doctor or dietitian. Never give more or less of the formula volume than your child's doctor ordered.
  2. If your child seems hungry after the feeding ask your child's doctor or dietitian about increasing the feeding.
  3. Formula feedings are complete meals and will meet all your child's growing needs. Solid foods should only be added when advised by your child's doctor or dietitian.
  4. In some cases, children who are fed by gastrostomy may be able to take some solid foods by mouth. Your child's doctor, dietitian, occupational therapist, or speech therapist will suggest which solid foods to provide and the best way to feed your child. If your child's doctor or dietitian suggests that you can give your child solid foods through the gastrostomy tube the instructions must be followed carefully.
  5. Solid foods (baby, junior, or table foods), when used through a G-tube, must be blended with formula or water until they are thin enough to flow through the tube. Feedings are too thick if they stick to the tube or cause a blockage.
  6. If diarrhea occurs, lengthen the feeding time by 15 minutes. If the problem continues, call your child's doctor or dietitian. Inform them of any changes in your child's feedings including any new medicine being given.
  7. If your child's stomach becomes hard and swollen after a feeding, burping the tube or skin level device may help. For the G-tube, attach an empty syringe to the tube and unclamp it. This will allow air to escape. With the Mic-Key® Button, attach the decompression extension tube and open the end of the tube to air for 10 -30 minutes. Your child's nurse will show you how to do this. If the stomach is still swollen and your child acts as if he is in pain, call your child's doctor or the Emergency Room for advice.
  8. Constipation (hard, dry bowel movements) may become a problem with long-term tube feedings. Check with your child's doctor if this becomes a problem. Ask about using a formula with fiber or adding fiber to your child's feedings. Also, ask about adding fruit juice (apple or prune) to the feeding.
  9. The G-tube often has a device to secure it at the base where it meets the skin. The device keeps the tube in the proper place and prevents it from going in further. Before each feeding, pull back gently on the tube until it feels snug.
  10. The skin around the G-tube should be cleaned at least once a day with a mild soap and water.
  11. If the tube comes out and you have been taught to replace it, do so. If you have not been taught how to change the tube, place a towel over the opening and take your child to the Emergency Room to have the tube replaced as soon as possible. The tube needs to be replaced within two hours.
  12. If you have problems with leakage around the G-tube or skin level device contact the Pediatric Surgery G-Tube clinic at 668-7703.

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.

Reviewed: 08/2011

(757) 668-7000