When care is taken to give tube feedings safely and correctly, many problems can be avoided.
Here are some of the more common problems people have and what you can do to try to prevent them:
This is when the liquid food that was put in the stomach backs up and is breathed (inhaled) into the lungs.
To help prevent aspiration:
- Have your child sit up during each feeding and for at least 30 minutes after it's done.
- If feeding is ongoing all day (continuous), keep your child's head raised on 2 or 3 pillows while sleeping.
- Check for food that's still in their stomach (residual food) before giving a feeding. (Your nurse will teach you how to do this.)
- Check placement of the tube before starting each feeding. (Your nurse will teach you how to do this.) Don't start a feeding if your child feels full or bloated.
To help prevent diarrhea:
- Don't use a feeding solution that has been open and at room temperature for more than 6 hours.
- Don't use feeding solution left open in the refrigerator longer than 24 hours.
- Wash your hands before handling the tube or the feeding solution.
- Keep the bag and tubing or syringes clean.Infection from supplies can cause diarrhea and other problems.
- Make sure you store, clean and use the tube feeding equipment carefully. Wash your hands before using the tube.
To help prevent constipation:
- Ask about adding fiber to your feeding solution.
- Talk with your child's pediatrician about using a stool softener or laxative.
- Increase physical activity as allowed.
To help prevent skin irritation:
- Keep the skin around the feeding tube clean and dry.
- Watch for leakage around the tube. If it's leaking, tell your child's pediatrician right away.
- Tape the tube securely to keep from pulling on it.
- Change the dressing every day and any time it gets wet.
- Use skin protectant as needed.
- Contact your child's pediatrician if their nostril with the tube in it or the skin around the tube looks infected (red, painful, or oozing fluid).
Loss of body fluids (dehydration)
To help prevent dehydration:
- Ask your nurse about increasing the amount of water given through the tube between feedings.
- Watch for decreased amount of urine, less frequent urination, or dark-colored urine.
- Watch for signs of thirst or fever.
To help keep your tube from clogging:
- Make sure there are no kinks in the tube.
- Flush the tube after feedings.
- Flush the tube before and after putting medicine in it.
- Only use liquid medicines that are not thick syrups.
The tube feedings will be given on a schedule that best fits your child's needs and the amount of calories required. Your child's pediatrician, dietitian or nurse will talk with you about the schedule that's best. The choices are:
- Intermittent or bolus. The amount of tube feeding for the day is divided up into smaller portions to be given at set times during the day over short periods. This may be done by gravity (letting the liquid run into the tube on its own) or syringe (using a syringe to gently push in the liquid into the tube).
- Continuous tube feeding. The amount of tube feeding for the day is given slowly over a 24-hour period. A pump is used to keep the rate slow and steady.
It's important to make sure the tube is in the right place before starting each feeding. You will be taught how to do this. Make sure you do it every time you use the tube.