- A nasogastric tube is inserted to provide enteral nutrition if prescribed by your child’s doctor. Some medications can also be given through the nasogastric tube.
- The nasogastric tube can be removed after each feeding session or at a time agreed upon with your healthcare team.
- We suggest a procedure that you can use as a guide; discuss with your healthcare team the specific equipment recommended for your child.
- Ideally, the nasogastric tube should be inserted when your child’s stomach is empty (two hours after the last feeding session) to minimize the risk of vomiting or aspiration (accidental entry of formula into the lungs).
- In general, it is recommended to alternate between the right and left nostrils each time that the tube is inserted to optimize your child’s comfort. Also, by alternating nostrils, the skin on the cheek has a chance to heal if it has been irritated by the adhesive bandage. You can continue to use the same nostril if the other one is blocked or if it is impossible to insert the tube.
- It is important to measure the length of the tube to be inserted; it may vary depending on your child’s growth.
- It is normal for your child to feel nauseated or cough while the tube is being inserted. This should stop after the procedure.
- Always check the correct placement of the tube: during insertion, before each feeding , before medication is given via the tube, if your child is vomiting or coughing a lot, and if there are any signs that the tube has changed position (eg, protective dressing or adhesive bandage is loose, external length changed, permanent marker pen mark on the tube not visible, etc.).
- 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).
- Refer to your healthcare team to adjust the method if your child is able to do the care on his or her own.
- 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.
- The frequency of insertion and removal of the nasogastric tube is determined by your healthcare team. It varies, among other things, according to your child’s age, his or her specific needs and the type of tube used. For example, tubes may be:
- inserted before each feeding session and removed at the end OR
- left in place continuously, even at night.
- Nasogastric tube
- Adhesive bandage (eg, Hypafix™, Tegaderm™): to secure the tube to the cheek
- Oral/enteral syringe
- Depending on what is used to lubricate the tube: Tap water at room temperature in a glass or container or Water-soluble lubricant (never petroleum jelly like Vaseline®)
- Tissue paper
- pH indicator paper
- Permanent marker pen (to identify the tube insertion length)
- Thin protective dressing (eg, Duoderm™ extra-thin): to protect the skin of the cheek before attaching the tube if kept in place after use
- Pacifier for infants and young children
- Bowl (in case of vomiting)
Refer to your healthcare team if the material used at home or the sequence of steps taught is different from what is described in the method of care.
Depending on your child’s age and condition, always encourage your child’s autonomy in carrying out the method of care.