NOTE: For ease of reading the rest of the text, the word (nutritional) “formula” also includes “breast milk”, “fortified breast milk” or “infant formula”.

• Your healthcare team has agreed that certain medications can and should be given through your child’s feeding tube or button.
• We suggest a procedure that you can use as a guide; discuss with your healthcare team the specific equipment used for your child.

Considerations:

• Always check with your healthcare team which medications can be given through the tube or button.
• Refer to your healthcare team for specifics regarding the preparation and expiration date of medications.
• Medications should always be given in liquid form to avoid blocking the tube or button:
  • Use the liquid form of the medication if available, being careful to verify both the dose (mg) and volume (ml) of the medication.
  • If the medication is in tablet form, check with your healthcare team to see if it can be crushed into a fine powder and mixed with a little water.

• • If the medication is in a capsule, check with your healthcare team to see if you can open it and mix the contents with a little water.
  • Coated or extended-release medications cannot be crushed as this may interfere with their effectiveness.
• Never mix medications with the formula to prevent them from reacting with each other and clogging the button or tube.
• Administer each medication separately. Never mix different medications in the same syringe; give them one at a time in different syringes. Mixing medications can clog the button or tube or interfere with the effectiveness of the medication.
• Stop the administration of the formula, if given continuously, to administer the medication.
• Check with your healthcare team to see if there is a time delay between giving the formula and giving the medication.
• Several medications can be administered in the same session, but it is important to irrigate the tube/button well between each medication.
• Follow the recommendations for the expiration date of the medications. Return medications that are past their expiration date to the pharmacy.
• If you are not sure that the button or tube is in the right place after you have done the usual checks, do not administer the medication. Replace the nasogastric tube, gastrostomy balloon button or tube, or contact your healthcare team if your child has another enteral feeding device.
• The amount and type of water used to irrigate (eg, tap water or boiled cooled water) depends on the type of tube or button (including its extension set) and the child (eg, age, health condition, etc.). Always follow the instructions of your healthcare team.
• Assess the need to be have a second person available during the procedure to keep your child in a safe position (e.g., if your child is young and/or moving).
• Ensure your child’s comfort during care by using different positioning and distraction techniques that suit your child best.
• Good hand washing is essential before and after performing this care.
• See Medication safety for general tips and tools.

According to the medical prescription.