Caring for the G-tube Site

You will clean your child’s skin around the G-tube 1 - 3 times a day with mild soap and water. Try to remove any drainage or crusting on the skin and tube. Be gentle. Dry the skin well with a clean towel.

The skin should heal in 2 - 3 weeks.

Your provider may also want you to put a special absorbent pad or gauze around the G-tube site. This should be changed at least daily or if it becomes wet or soiled.

Do not use any ointments, powders or sprays around the G-tube unless told to do so by your provider.

Tips for Feeding Time with Your Child

Make sure your child is sitting up either in your arms or in a high chair.

If your child fusses or cries while feeding, pinch the tube with your fingers to stop the feeding until your child is more calm and quiet.

Feeding time is a social, happy time. Make it pleasant and fun. Your child will enjoy gentle talk and play.

Try to keep your child from pulling on the tube.

Since your child isn’t using their mouth yet, your doctor will discuss with you other ways to allow your child to suck and develop mouth and jaw muscles.

Feeding Your Child Using a Feeding Pump

Gather supplies:

• Feeding pump (electronic or battery powered)
• Feeding set that matches the feeding pump (includes a feeding bag, drip chamber, roller clamp, and long tube)
• Extension set, for a Bard Button or MIC-KEY (this connects the button to the long tube on the feeding set)

Your nurse will show you the best way to use your system without getting air into the tubes. Follow these steps to feed your child:

• Wash your hands.
• Check that the formula or food is warm or room temperature by putting a few droplets on your wrist.

Follow these steps, and any steps your child's nurse gave you, to feed your child:

• Start with the feeding set, close the roller clamp and fill the feeding bag with food. If your child has a button, connect the extension set to the end of the feeding set.
• Hang the feeding bag high on a hook and squeeze the drip chamber below the bag to fill it at least half way with food.
• Open the roller clamp so that the food fills the long tube, leaving no air in the tube.
• Close the roller clamp.
• Thread the long tube through the feeding pump. Follow the directions on the pump.
• Insert the tip of the long tube into the G-tube and open the clamp. If your child has a button, open the flap and insert the tip of the extension set into the button.
• Open the roller clamp and turn the feeding pump on. Make sure the pump is set to the rate ordered by your provider.

When the feeding is done, your nurse may recommend that you add water to the bag and let the water flow through the feeding set to rinse it out.

If your child has a G-tube, clamp the G-tube and close the roller clamp before disconnecting the feeding set from the G-tube. If your child has a button, close the clamp on the feeding set, disconnect the extension set from the button, and closet the flap on the button.

The feeding bag should be changed every 24 hours. Food (formula) should not be left in the bag for more than 4 hours. So, only put 4 hours (or less) worth of food in the feeding bag at a time.

All of the equipment can be cleaned with hot, soapy water and hung to dry.

Bloating after Feeding

If your child's belly becomes hard or swollen after a feeding, try venting or "burping" the tube or button:

• Attach an empty syringe to the G-tube and unclamp it to allow air to flow out.
• Attach the extension set to the MIC-KEY button and open the tube to the air to release.
• Ask your doctor for a special decompression tube for "burping" the Bard Button.

Giving Medicines to Your Child

Sometimes you may need to give medicines to your child through the tube. Follow these guidelines:

• Try to give your child medicine before a feeding so that they work better. You may also be asked to give your child medicines on an empty stomach outside of mealtime.
• The medicine should be liquid, or finely crushed and dissolved in water, so that the tube does not get blocked. Check with your doctor or pharmacist on how to do this.
• Always flush the tube with a little water between medicines. This will make sure that all the medicine goes in the stomach and are not left in the feeding tube.

When to Call the Doctor

Call your child’s nurse or doctor if your child:

• Seems hungry after the feeding
• Has diarrhea after feedings
• Has a hard and swollen belly 1 hour after feedings
• Seems to be in pain
• Has changes in their condition
• Is on new medication
• Is constipated and passing hard, dry stools

Also call the doctor if:

• The feeding tube has come out and you do not know how to replace it.
• There is leakage around the tube or system.
• There is redness or irritation on the skin area around the tube.

Alternate Names

Feeding - gastrostomy tube - pump; G-tube - pump; Gastrostomy button - pump; Bard Button - pump; MIC-KEY - pump

References

Altman GB, ed. Feeding and medicating via a gastrostomy tube. Delmar’s Fundamental and Advanced Nursing Skills. 2nd Ed. Albany, NY: Delmar Thomson Learning; 2003: 742-749.

Update Date: 11/11/2012

Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.