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Enteral Feeding: Questions about Feeding Tube Use and Care
For some patients, transitioning from the hospital to the home requires adjusting to enteral feeding. Learning how to properly use and clean feeding tubes is an important task that may be completed by parents, nurses and caregivers. It is essential that anyone involved in feeding understand the possible risks and complications of not correctly caring for equipment. The better you maintain the enteral equipment and the more you learn about how formula works, the more equipped you will be to provide care.
Here is an introductory guide to caring for feeding tubes:
Feeding tubes can become clogged with formula and/or medications if not flushed properly. You can help prevent this from happening by flushing the tube with water before and after each use, administering medications separately from one another, and using liquid forms of medications when possible.
If your tube does become clogged, the following instructions may help unclog the tube.
First, make sure that your feeding tube is not kinked or clamped closed.
- Warm water
- Baking soda
- If the clog is visible, massage the tube between your fingers to dislodge the clog. Next, flush your feeding tube with 30 mL of warm water.
- If the clog remains, fill your syringe with 30 mL of warm water and attach the syringe to the feeding tube and gently pull back on the plunger and then push the plunger. Repeat this back-and-forth motion several times to see if you are able to break up the clog.
- If the warm water does not help the clog, try the same technique with warm water and a small amount of baking soda. Mix 1/4 tsp. baking soda with every 2 oz. or ¼ cup water.
- Push the baking soda solution through the feeding tube and clamp or crimp the feeding tube and wait for 30 minutes. Then attempt to flush with water. Repeat until the clog is released.
*Safety Note: If these remedies do not work, call your physician or go to the ER. Do not use any other liquid or solution such as carbonated beverages, cranberry juice, or meat tenderizer to unclog your tube. Never put a wire or anything else into the feeding tube to unclog it. This could puncture the feeding tube, hurt your stomach or intestines, or cause other problems.
Caring for a Gastrostomy Tube is easy to do if you follow a few simple steps. It is important to keep the skin around the tube clean and dry, this will help prevent infections from developing and maintain the life of the tube.
- Begin by washing your hands with warm, soapy water. Rinse and towel dry.
- Remove any old dressings that are in place.
- Inspect the area where the tube enters the skin. Check for swelling, redness, or unusual drainage. A small amount of clear, tan drainage is normal.
- Clean the skin around the tube with warm, soapy water. Use a soft washcloth or a small piece of gauze. Clean in a circular motion starting next to the tube and working your way outward. Rinse the site with warm water. Remember to not only clean around the tube site, but also under the external device that keeps the tube in place.
- This is called a bolster and is usually a round disk. You can dip a cotton swab in warm water and gently clean under the bolster.
- After cleaning, allow the site to air dry or dry with a clean cloth to prevent irritation from moisture.
- Heavily taped dressings may promote skin problems, so put a clean, dry dressing on the site only if needed.
- Never use creams or ointments on the site unless directed to do so by your doctor.
- If you notice that the stoma is draining more than normal, contact your doctor. This could be a sign that the tube size needs to be changed.
- Contact your doctor if the tube is clogged, the stoma is draining more than usual, there is green or bloody drainage, there is a bad smell coming from the stoma, or the skin around the stoma is red or hot to the touch.
Everyone responds differently to tube feeding. Your doctor or dietitian has chosen what they think is the best formula for you. It may take a while for your body to adjust but eventually you will function just as you did prior to the tube placement. If you experience persistent or chronic vomiting, diarrhea, constipation or gas, call your doctor.
Your bowel movements will be soft but not watery like diarrhea. If you are on any pain medications, you could experience constipation. If this, or watery stools occurs, contact your doctor.
Formulas should be stored, unopened, at room temperature. Be careful not to expose the formula to extreme temperatures for extended periods of time. Once the formula has been opened, store the remainder in the refrigerator for up to 24 hours then discard.
Pump: To clean the pump, use a damp cloth or sponge to wipe down the outside of the pump. Do not submerge the pump or power adapter in water or any other cleaning solution. Make sure the pump is completely dry before plugging into an electrical outlet.
Syringe: After each use, remove the plunger from the barrel and rinse both under warm water. Next, set both parts on a dry towel to air dry. If the syringe becomes difficult to push down or the plunger gets stuck in the barrel, you may apply a small amount of food grade oil, such as vegetable oil on the black rubber part of the plunger so it will slide easier through the barrel.
Bag Set: If you are on gravity feedings or are using a pump for your feeds and are doing intermittent feeds, rinse out your bag set after each use. Never allow formula to dry inside of the feeding bag and tubing; this may cause it to clog. To clean the bag set, fill the bag halfway with warm water, gently swish the water around the bag to clean the inside of the bag and discard the water. Next, fill the bag again with clean, warm water and allow the water to run through the tubing until the water is no longer cloudy and runs clear from the tip of the bag set.
Joey Pumps: There is no need to disconnect the bag set from the pump. Leave it connected and use the manual prime button to run the water through the tubing. Once you are finished, cover the tip of the bag set with the tip protector and let the bag set air dry. Make sure you change the bag set out with a new one once every 24 hours.
Even if you are currently getting most of your nutrition from food sources, you can still use the formula to supplement your diet. There may be times when you aren’t feeling well or don’t feel like eating a full meal. So, to avoid losing weight, you can give yourself a portion of your ordered formula to keep your weight and energy up until you require the formula for 100% of your needs.
The formula is a complete balanced liquid that contains all the calories, protein, fat, vitamins, and minerals that your body needs, just like regular food. However, just like you would by mouth, you will be required to give yourself additional water through the tube to make sure you stay hydrated. Your doctor or dietitian will set up a feeding plan for you, which includes how much formula and water you require and when. If you have any questions about enteral nutrition, an Epic Medical Solutions Registered Dietitian can provide you with assistance.
If you are experiencing bloating, upset stomach, liquid stool, unusual weakness, feelings of fullness, or anything that stops you from feeding for more than several hours, you should call your healthcare provider.
You should be flushing your tube with at least 60 mL of water 1-2 times every day to keep it clean, even if you aren’t using your tube for formula yet. This will help to protect your tube.
Parents are often concerned about their child moving from an NG-Tube to a G-Tube. Learn more about the benefits, what to expect, and what other parents say from the Feeding Tube Awareness Foundation.