Nasogastric tube (NG tube)
What is a nasogastric tube?
A nasogastric tube can be used to feed your child when he or she is unable to eat or drink by mouth. It
is called a nasogastric tube because it passes through your child’s nose, down the throat and into the
stomach. You may hear it called an NG tube.
Checking for tube placement
You must check the tube placement each time you insert the NG tube. Once it is in place, you must
check to make sure the tube is in the stomach at least one (1) time each day. A good time to do this is
when you have stopped the pump to change the feeding bag or to give medicines using the NG tube.
These steps will help you check the correct placement of the tube.
•
Wash your hands well with an antibacterial soap (any soap that says deodorant or antimicrobial).
See “GREAT information…Clean hands” for guidelines.
•
Pull back the plunger of a syringe to the 10ml or 15ml mark. You should have nothing but air in
the syringe at this point.
•
Connect the syringe to the NG tube. Place the flat side of a stethoscope over your child’s stomach.
While you listen through the stethoscope, slowly push the air into the NG tube. If the tube is in the
right place, you will hear the air as it passes into the stomach (it sounds like a “burp”).
Another way for you to check for tube placement is to pull back on the plunger of the syringe. If
stomach contents come back into the NG tube, the placement is correct.
If you are not sure that the tube is in the stomach, do not put the formula or any other liquid in
the tube. Call or come to the clinic so the tube can be checked.
Giving continuous or cycled feedings
Follow these steps for giving continuous or cycled feedings to your child.
•
Gather supplies in a clean work area:
~ _____ ml of liquid formula (_______________)
~ Feeding container (bag or bottle)
~ Pump tubing (if needed)
~ Feeding pump
~ Syringe (at least 35ml size)
~ Water
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•
Wash your hands with an antibacterial soap (any soap that says deodorant or antimicrobial).
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Remove the clamp or cap from the NG tube or disconnect the old pump tubing. Using the syringe,
slowly push _____ ml of water into the NG tube. This is known as flushing the NG tube.
•
If the tubing is attached to the feeding container, close the clamp on the tubing.
•
Pour the formula into the feeding container (Formula should not be at room temperature for more
than 4 hours.)
•
If the tubing is not attached to the feeding container, close the clamp on the tubing and attach it to
the bag or bottle.
•
Prime the tubing with formula.
•
Connect the tubing to the pump according to the pump instructions.
•
Connect the pump tubing to the NG tube.
•
Check the rate on your feeding pump. Make sure it is set for the correct rate-per-hour. Follow this
schedule:
~ Give _____ ml every hour for 24 hours.
~ Give _____ ml every hour between the hours of _____ and _____ or for _____ hour
•
Start the feeding.
•
Wash your hands again.
Things to remember
•
To operate the pump, read the instructions for that specific pump. Follow the instructions you have
been given.
•
If your child is in bed during the feeding, be sure that you put his or her head and shoulders
up on pillows.
•
Watch your child for any signs of nausea, vomiting, diarrhea, stomach swelling, or increased
irritability. Any one of these signs may mean that your child is not able to digest the formula at the
rate it is running. If these symptoms occur, stop the feeding and call your child’s doctor right away.
•
At the end of a cycled feeding, you will push _____ ml of water through the NG tube, using at
least a 35ml size syringe.
•
You must flush the NG tube at least one (1) time each day with tap water to prevent the tube from
becoming clogged. Usually, this is done at the end of a cycled feeding or after giving medicine
through the tube. If your child is receiving continuous feedings or is not receiving anything
through the NG tube, you may flush the tube one (1) time a day when it is easiest for you.
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Changing the pump tubing and feeding container
Change the pump tubing and feeding container at least every 12 hours. Start with a new bag or bottle
and tubing at the beginning of a feeding cycle. If the cycle is longer than 12 hours, the container and
tubing can be changed anytime during the cycle, as long as it is not used for more than 12 hours.
Giving medicine through the NG tube
•
Use the liquid form of each medicine whenever possible.
•
Check with your doctor or pharmacist about whether your child’s medicine is offered in liquid
form or if pills can be crushed.
•
If you crush a tablet, make sure you crush it into very fine pieces. Mix it well with a small amount
of warm water to make a thin liquid.
•
The crushed medicine and water mixture can be pushed into the NG tube using a syringe (at least
35ml in size).
•
Always rinse the NG tube with _____ ml of water before and after giving any medicine through it.
•
Give each medicine separately. Do not mix medicines together. Rinse the tube with______ml of
water after each medicine.
•
Do not add any medicines to the formula in the feeding container.
•
Do not crush coated or time-released tablets or capsules.
Helpful hints
The following will help you care for your child with special feeding needs.
•
If the tube seems clogged (nothing can be pushed in or it is very hard to push in) please call your
doctor or come to the hospital as soon as possible.
•
Replace the NG tube one (1) time each month or as needed.
•
If your child cries during the feeding, stop the feeding until he or she is quiet and comforted.
•
Do not change the type or amount of formula without talking to you child’s doctor first.
If you have questions about the nasogastric tube (NG tube) or tube feeding, talk with your child’s doctor,
nurse or dietitian.
Adapted with permission from St. Jude Children’s Research Hospital. Revised 5/06
UC Davis Cancer Center 12/06
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