Tube feeding your child at home Trust Abbott Nutrition for

Trust Abbott Nutrition for
Your Home Tube-Feeding Needs
Tube feeding your
child at home
USE UNDER MEDICAL SUPERVISION.
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© 2011 Abbott Laboratories Inc.
LITHO IN USA 76450.002/MAY 2011
Abbott Nutrition | Abbott Laboratories
Columbus, OH 43219-3034 USA
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Table of Contents
Your Child’s Feeding Plan .................................... 2
Introduction to Tube Feeding
Adjusting to Tube Feeding......................................... 4
What Is Tube Feeding? ............................................. 4
How Tube Feeding Works ........................................ 6
Feeding Tubes for the Stomach ............................ 6
Feeding Tubes for the Small Intestine ................... 6
The Process of Tube Feeding
Hand Washing .......................................................... 9
Checking Tube Placement ........................................ 9
NG-, G-, or J-Tubes .................................................. 9
Checking Residual .................................................. 10
Decompression....................................................... 10
Tube Flushing .......................................................... 10
Positioning Your Child ............................................. 11
Feeding Your Child
Feeding Schedule ................................................... 13
Types of Formula..................................................... 13
Feeding Equipment ................................................. 14
Preparing the Feeding ............................................. 14
Giving Medications ................................................. 15
Attention health care
professional:
Abbott Nutrition provides
the general information and
guidelines found in this booklet
to health care professionals as
an aid in counseling parents.
To maximize the benefits of
this booklet for your patient’s
caregivers, please complete
the Feeding Plan on page 2.
Tube Feeding Methods
Gravity Feeding ....................................................... 17
Syringe (Bolus) Feeding .......................................... 18
Pump Feeding......................................................... 20
Infection Prevention and Problem Management
Preventing Infection ................................................ 23
Oral Hygiene ........................................................... 25
Preventing and Managing Constipation .................. 26
Preventing and Managing Diarrhea ......................... 26
Signs and Prevention of Dehydration ...................... 27
Clogged Tube ......................................................... 27
Out-of-Place Tube ................................................... 27
When to Call a Health Care Professional................. 28
Glossary.................................................................. 29
Your Child’s Feeding Plan
Child’s name ____________________________________________________________________
In case of an emergency, dial 911 or call____________________________________________
If you have a question or problem, call your health care professional:
Doctor ___________________________________ Phone ________________________________
Doctor ___________________________________ Phone ________________________________
Feeding Bag
Nurse____________________________________ Phone ________________________________
Supply Source ____________________________ Phone ________________________________
Tube Type
NG (nasogastric)
NJ (nasojejunal)
G (gastrostomy) or PEG
J (jejunostomy) or PEJ
Tube Information
French Size______________________________________________________________________
Length (if a low profile G-tube) ______________________________________________________
Balloon Volume (if a balloon G-tube) _________________________________________________
Reorder Number _________________________________________________________________
Feeding Method
_____ Gravity Drip
_____ Pump
_____ Syringe (bolus)
Feeding Schedule
Formula Name ___________________________________________________________________
Drip Chamber
Amount of Formula/Day ___________________________________________________________
Feeding Schedule ________________________________________________________________
________________________________________________________________________________
Amount of Each Feeding __________________________________________________________
Enteral
Feeding Pump
Additional Water _________________________________________________________________
Hourly Feeding Rate ______ mL/hour or Gravity Drip Rate _____ Drops/Minute
Rotor
Flush Amounts Use a 30 mL or larger syringe.
Adapter
Before a Feeding ________ mL
Before Medications ________ mL
After a Feeding ________ mL
After Medications __________ mL
During Continuous Feeding _______ mL
Between Medications ______ mL
Every ________ Hours
2
3
Introduction To Tube Feeding
Introduction to Tube Feeding
Adjusting to tube feeding
It will take time for you to get used to
tube feeding your child at home, but
be patient. With the help of your health
care professionals, this booklet, and
some practice, you will soon learn
to set up feedings and care for your
child’s feeding tube. Encourage other
family members to help, and even your
child if he or she is able.
Some families feed the child at family
mealtimes, while others give tube
feedings in private. Talk about what
works best for you, your child, and
your family. To feed your child away
from home, ask your supplier about the
various feeding equipment available.
To help you and your child adjust to
tube feeding, contact an organization
that offers educational materials and
the chance to meet other families
facing the same situation. The Oley
Foundation is a nonprofit organization
for those who depend on home enteral
(tube-fed) or parenteral (IV) nutrition. All
services are offered free of charge for
patients and their families.
Call 1-800-776-OLEY or visit
www.oley.org for more information.
Important words you should
know are shown in bold the
first time you see them in this
booklet. Look in the Glossary
on page 29 to find out what
these words mean.
4
What is tube feeding?
Tube feeding helps your child get a
complete and healthy diet at home.
Because your child cannot eat or
drink enough or at all by mouth, he or
she has to be fed through a feeding
tube. The feeding tube delivers a liquid
food called formula directly into the
stomach or the small intestine.
Complete, balanced nutritional formulas
contain the protein, carbohydrate, fat,
vitamins, minerals, and water found in
a healthy diet of regular food. These
are nutrients your child needs to grow
and develop.
Your health care professional will set up a
feeding plan for your child (see page 2).
This plan will include which formula
to use, and when and how much
to feed your child. Your health care
professional should evaluate your child
regularly and track your child’s weight
and height to make sure he or she
is getting the right kind and the right
amount of formula. You should also
track the medications and extra water
you give your child each day. Keep this
information in a notebook to share with
your health care professional.
Follow your health care professional’s
instructions. Ask him or her if you have
any questions about tube feeding your
child at home.
5
Introduction To Tube Feeding
How tube feeding works.
During normal eating, food goes into the
mouth, down the esophagus, and into
the stomach. During tube feeding, formula
goes directly into the stomach or the
small intestine through a feeding tube.
Feeding tubes for
the stomach
• Nasogastric (NG) tubes go into
the nose and down to the stomach.
• Gastrostomy (G) tubes go
directly into the stomach through a
hole in the abdominal wall called
a stoma. A type of gastrostomy
tube placed nonsurgically is known
as a PEG tube.
Feeding tubes for the
small intestine
• Nasojejunal (NJ) tubes go
into the nose and down to the
jejunum, the second part of the
small intestine.
esophagus
• Jejunostomy (J) tubes go directly
into the jejunum through a stoma
or through a gastrostomy tube
and into the jejunum. They are
sometimes called PEJ tubes.
stomach
jejunum
6
7
The Process of Tube Feeding
The Process of Tube Feeding
Hand washing
Checking tube placement
Always wash your hands before
preparing the formula and before
touching the feeding tube, tube site, or
feeding equipment. If your hands aren’t
clean, you could spread germs that
might cause an infection.
Before you begin feeding, be sure your
child’s feeding tube is in the right place.
Ask your health care professional how
often you should check your child’s
feeding tube placement. If the feeding
tube is not in the right place, do not
start the feeding and call your health
care professional right away.
• Wash with soap and water.
• Rinse thoroughly.
• Dry with a clean towel.
NG-, G-, or J-Tubes
Measurement—Use a ruler to
measure the tube from the skin to the
end of the tube. The new measurement
should be about the same as the
day before. If the measurement is
different from the day before, do not
give the feeding. Call your health care
professional.
8
9
The Process of Tube Feeding
Checking residual
Decompression
Positioning your child
If your child has a G- or NG-tube, your
health care professional may tell you
to check the residual before feedings
and show you how to do it. Checking
residual is a way to make sure that the
stomach is emptying formula. Residual
is the formula that remains in the
stomach from the last feeding.
Sometimes tube feedings cause a
buildup of air in the stomach. Your
health care professional may teach
you how to release air or fluid from the
stomach before or after feedings. This
is called decompression or venting.
When giving your child a feeding, follow
the guidelines below on how to position
your child. These guidelines will help
reduce your child’s risk of breathing
(aspirating) formula into the lungs,
which can cause serious problems.
If your child has an upset stomach or
feels full, wait 30 to 60 minutes before
starting the feeding.
Ask your health care professional how
often to flush your child’s feeding tube
and how much water to use (see the
Feeding Plan). Flushing your child’s
feeding tube regularly with water helps
to prevent it from clogging. Use a
30 mL or larger syringe to flush your
child’s feeding tube.
10
Tube flushing
• Do not give a feeding while your
child is lying flat. If possible, hold
your young child during feedings as
you would if you were giving him or
her a bottle.
• An older child can sit in a chair
or high chair, or he or she can
be propped up on a couch at
a half-sitting position (at least a
30-degree angle).
• If you feed your child in bed, place
rolled blankets under the mattress
to raise the head of the bed 6 to 8
inches (30 to 45 degrees). Lay your
child on his or her right side.
• If your child cries during the
feeding, stop the feeding. Continue
the feeding when your child is quiet
and calm.
• Keep your child in a raised position
for at least 1 hour after the feeding.
Lying flat can cause vomiting or
coughing.
If your child has had a Nissen
fundoplication and he or she gags
during feeding and seems to need to
vomit but can’t, call your doctor.
11
Feeding Your Child
Feeding Your Child
Feeding schedule
Your health care professional will set up
a feeding schedule for your child.
• Intermittent feeding or bolus
feeding—Formula is fed at a higher
feeding rate for a short amount of
time, typically 3 or more times a day.
• Continuous feeding—Formula is fed
at a slower feeding rate for a longer
amount of time, such as all day or
all night.
Milliliters (mL)
Cups (c)
Fluid ounces (fl oz)
30 mL
1/8 c
1 fl oz
60 mL
1/4 c
2 fl oz
120 mL
1/2 c
4 fl oz
240 mL
1c
8 fl oz
To help with formula preparation, the
table above converts milliliters (mL) to
cups and ounces.
Types of formula
Formulas come in three types:
• Ready-to-use formula does not
have to be mixed with water before
use. It comes “ready to use”
in cans or Ready to Hang
(closed system).
• Powder formula has to be mixed
with water to make a liquid feeding.
• Concentrate is a liquid that must be
mixed with water before use so that
the formula is the right strength.
Formula made by adding water to powder
or concentrate is called reconstituted
formula. To make reconstituted
formula, follow the directions on the
label for the amounts of powder or
concentrate and water to mix, or follow
the mixing instructions given to you by
your health care professional.
12
13
Feeding Your Child
Feeding equipment
Preparing the feeding
The feeding container has to be
connected to special tubing called the
feeding set. Some containers come
with the feeding set already attached.
Formula flows from the container to
the pump (if you are using a pump)
and then into your child’s feeding tube
through the feeding set.
1. Wash your hands.
Ask your health care professional how
often you should replace your child’s
feeding set and container, and how
you should care for them in between
feedings.
2. a. Feed ready-to-use formula at
room temperature. Shake the
can well and wipe the top of the
container with a clean cloth before
opening. Or,
b. Mix powder or concentrate
formula with water following
label directions.
3. Measure the amount of formula for
your child’s feeding in a measuring
cup (see the Feeding Plan). If you feed
your child by syringe, go to step 8.
4. Write the date and time on the
feeding container.
5. Attach the feeding set to the
container (if it is not preattached)
and close the clamp.
6. Pour the formula into the feeding
container.
7. Hang the container on an IV pole or
wall hook.
8. Cover any unused formula, and write
the date and time on it. Store it in
the refrigerator.
9. Follow the instructions for gravity
feeding, syringe feeding, or
pump feeding. Your health care
professional will tell you which
method to use.
14
Throw away unused formula that has
been stored in the refrigerator within
48 hours of opening it. Throw away
mixed, unused powder formula within
24 hours of mixing. For formula that
has been hung for a feeding, follow the
guidelines below:
• Hang reconstituted formula up to
4 hours.
• Hang ready-to-use formula 4 to 8
hours or as recommended by your
health care professional.
• Hang Ready to Hang (closed
system) for up to 48 hours after
being spiked, providing a clean
technique is used and only one
new feeding set is used.
Giving medications
You may have to give your child
medications through the feeding tube.
Ask your pharmacist or health care
professional if medications should be
given on a full or an empty stomach. If
your child has a J-tube, ask if the
medications will work properly, because
they will not go into the stomach.
Follow the guidelines below to help
prevent tube clogging when giving your
child medications.
• Use liquid medications when possible.
• If your child’s medication comes
only as a tablet, crush the tablet
into a fine powder using a pill
crusher. Mix well with warm water.
DO NOT crush enteric-coated
tablets, timed-release tablets,
or capsules.
• Use a 30 mL or larger syringe
to flush the feeding tube as
recommended by your health care
professional.
• Use a 30 mL or larger syringe
to give medications through the
feeding tube.
• Give one medication at a time.
• DO NOT mix medications.
• DO NOT add medications to the
formula or container.
15
Tube Feeding Methods
Tube Feeding Methods
Gravity feeding
In gravity feeding, formula flows down
the tubing into the stomach or the small
intestine. A clamp on the gravity feeding
set helps control the feeding rate.
6. Use the clamp to control the flow.
Set the flow to the gravity drip rate
written on your child’s care plan.
• Make the flow faster by opening
the clamp.
• Make the flow slower by
tightening the clamp.
Before each gravity feeding:
1.
Refer to “Preparing the Feeding”
section on page 14.
7.
2.
Check tube placement if
recommended by your health care
professional.
8. If your health care professional has
told you to give your child extra water
after feedings, pour the prescribed
amount into the container.
3. Check the residual if recommended
by your health care professional.
4. Flush the feeding tube as
recommended by your health care
professional.
9. Open the clamp and let the water
drip in until gone.
After each gravity feeding:
1.
Flush the feeding tube as
recommended by your health care
professional.
2.
Close the cap on the feeding tube
until the next feeding.
Follow these steps:
1.
Hang the filled feeding container
about 2 feet above and to the side
of your child’s feeding tube.
2.
Remove the cover from the end of
the feeding set.
3. Prime the feeding set.
When the feeding is complete,
close the clamp.
Ask your health care professional about
caring for the container and feeding set
between feedings, and how often they
should be replaced.
4. Insert the tip of the feeding set into
the feeding tube.
5. Slowly open the clamp on
the tubing.
16
17
Tube Feeding Methods
Syringe (bolus) feeding
Gravity syringe method:
Push syringe method:
In syringe feeding, formula flows
slowly into the feeding tube, or it can
be gently pushed into the tube by
putting pressure on the plunger in the
syringe. Follow the syringe feeding
method recommended by your health
care professional. You can also use a
syringe to give your child extra water
or fluids.
1. Remove the plunger from the barrel
of a syringe.
1. Use the plunger of the syringe
to draw the formula from the
measuring cup into the syringe.
Before each syringe feeding:
1. Refer to “Preparing the Feeding”
section on page 14.
2. Check tube placement if
recommended by your health care
professional.
3. Check the residual if recommended
by your health care professional.
4. Flush the feeding tube as
recommended by your health care
professional.
2. Place the syringe tip into the
feeding tube.
3. Hold the syringe above your child’s
stomach.
4. Pour measured formula into
the syringe.
5. Slow the flow by lowering the
syringe, or speed the flow by raising
the syringe.
6. Allow the formula to flow slowly into
the feeding tube until gone. Ask
your health care professional how
long you should infuse the formula.
7. If your health care professional has
told you to give your child extra
water after feedings, pour the
prescribed amount into the syringe.
8. Allow the water to flow into the
feeding tube until gone.
2. Place the syringe tip into the
feeding tube.
3. Push the formula into the feeding
tube slowly and gently until gone
(about 10 to 15 minutes).
4. If your health care professional
has told you to give your child
extra water after feedings, use the
plunger of the syringe to draw the
prescribed amount into the syringe.
5. Push the water into the feeding tube
slowly and gently.
After each syringe feeding:
• Flush the feeding tube as
recommended by your health care
professional.
• Close the cap on the feeding tube
until the next feeding.
Ask your health care professional about
caring for the syringe between feedings.
18
19
17
Tube Feeding Methods
Pump feeding
In pump feeding, a pump moves the
formula through the feeding tube and
into the stomach or the small intestine.
If your child has a feeding tube that
goes into the small intestine (NJ or J),
you must use a pump to deliver formula
at a slow, continuous feeding rate. This
is because the small intestine cannot
hold as much formula as the stomach.
Before each pump feeding:
Follow these steps:
1. Refer to “Preparing the Feeding”
section on page 14.
1. Hang the filled feeding container or
place it in an ambulatory carrier.
2. Check tube placement if
recommended by your health care
professional.
2. Connect the feeding set to the
pump.
3. Check the residual if recommended
by your health care professional.
4. Flush the feeding tube as
recommended by your health care
professional.
3. Remove the cap from the end of the
feeding set.
4. Prime the feeding set.
5. Insert the tip of the feeding set into the
feeding tube.
6. If your feeding set has a clamp,
open it completely.
7. Turn on the pump and set the
flow rate.
8. Start the pump.
20
9. After the feeding container is
empty or dose has been fed, stop
the pump.
10. If your health care professional
has told you to give your child
extra water after feedings, pour
the prescribed amount into the
container. Start the pump.
11. When the water is gone, stop
the pump.
After each pump feeding:
• Flush the feeding tube as
recommended by your health care
professional.
Ask your health care professional about
caring for the container and feeding set
between feedings, and how often you
should throw them away.
21
Infection Prevention And Problem Management
Infection Prevention And
Problem Management
Preventing infection
To help prevent infection and other
problems (such as hypergranulation
tissue around the stoma site), keep the
skin around your child’s feeding tube clean
and dry, and avoid placing pressure on it.
G- and J-Tubes: Care of the Stoma:
Follow these steps at least once
each day:
1.
Wash your hands.
2.
Gather the materials you need to
clean the tube site: soap, cottontipped swabs, warm water.
Call your health care professional if there
are signs of infection or skin problems:
• Redness or rash
• Swelling
• Pain or soreness
• Unusual drainage
3. Clean skin with a clean cloth and
soap and water. Start at the tube
and work outward in circles.
4. Clean under the skin disk or
external hub with a cotton swab
and soap and water.
5. Rinse the site with warm water and
allow it to dry completely.
6. If your health care professional
has told you to use a dressing,
change it every day or right away if
it becomes wet or soiled.
For G Tubes Only: The external hub or
skin disk should not be tight against
your child’s skin. Make sure the tube
turns all the way around freely and moves
up and down slightly (about ¼ inch).
22
23
Infection Prevention And Problem Management
If your child has a gastrostomy
tube with a balloon bumper, check
the balloon every 7 to 10 days (or
as instructed by your health care
professional) to make sure that it
has enough water in it. This will help
prevent leakage of stomach contents
and accidental tube removal.
To check balloon volume:
1. Wash your hands.
2. Place a syringe in the balloon
inflation valve.
NG- and NJ-Tubes: Care of the Nose:
Follow these steps at least once each day:
5. Cut or tear a long piece of tape
halfway down the center.
1.
Wash your hands.
2.
Moisten a cotton swab with warm
water and clean the edges of both
nostrils.
6. Place the wide part of the tape on
the bridge of the nose.
3. Hold the tube in place and remove
the water from the balloon.
4. Refill balloon with amount of water
recommended for your child’s tube
(see Feeding Plan). If stomach
contents leak around the tube,
contact your health care professional
for recommendations.
3. Apply a water-based lubricant,
such as K-Y® Jelly, to the nostril
around the tube if you wish.
Call your health care professional if the
nostril is red or bleeding or if your child
says it feels numb.
Change the tape on your child’s
tube as directed by your health care
professional. Use only tape marked
“hypoallergenic” and “easy to remove.”
To change tape:
1.
Wash your hands.
2.
Hold the tube in place and gently
remove the old tape.
3. Wash the skin with soap and
warm water.
4. Rinse and dry thoroughly.
7.
Wrap one end of the tape and then
the other around the tube until all
the tape is used.
8. Place another piece of tape on top
of the tape on the nose.
9. Place the tube on the side of the
face that the tube enters your
child’s nose. Be sure the tube
doesn’t rub against your child’s
nose or pull on the nostril.
10. Tape the tube to your child’s
cheek. Tape it to a different place
each time.
11. After taping, put the tube over your
child’s ear to keep it out of the way.
Oral hygiene
Your child might not be able to eat
or drink, but good mouth care is still
important.
• Brush your child’s teeth, gums,
and tongue with a toothbrush and
a small amount of toothpaste at
least twice a day.
• Rinse with water as needed to
freshen the mouth.
• If your child’s mouth or lips are dry,
ask your health care professional
to recommend a lip balm or
moistener.
Call your health care professional if you
notice bleeding or other mouth problems.
24
K-Y® is not a trademark of Abbott Laboratories.
25
Infection Prevention And Problem Management
Preventing and
managing constipation
Preventing and
managing diarrhea
Signs and prevention
of. dehydration
Tube feeding may result in fewer,
harder stools. If your child has hard
stools that are difficult to pass, he
or she may have constipation.
Constipation can make your child feel
full and uncomfortable, and it can
cause a loss of appetite.
Diarrhea may be more serious in
small children and infants than in adults
because it can cause dehydration
quickly. See page 28 to find out when
to call your health care professional.
If your child has stomach cramps or
feels full, wait 30 to 60 minutes before
starting a feeding.
Dehydration means that the body
needs more water. Diarrhea, vomiting,
fever, certain medications, or simply
not getting enough water can cause
dehydration.
To help prevent constipation:
• Encourage your child to use the
bathroom as soon as he or she
feels the need to go.
• Let your child exercise and be as
active as possible.
• Write down the time of your child’s
bowel movements so you will be able
to notice when something is wrong.
If your child has a problem with
constipation, talk to your health care
professional to see whether your
child is getting enough fluids, needs a
formula with fiber, or needs a change in
medications.
If your child’s feeding tube gets clogged
or blocked, attempt flushing with 30 mL
of warm water to unclog.
If you still cannot clear the clog, call your
health care professional. The feeding
tube will have to be replaced if it cannot
be unclogged.
• Increased thirst
• Dry lips
Out-of-place tube
• Medications.
• Dry and warm skin
• Nutrients that do not get absorbed
well in the intestines.
• Rapid weight loss
• Feeding formula too fast.
• Fever
• Formula that is not mixed correctly.
• Small amounts of dark, strongsmelling urine
If your child’s feeding tube comes out,
stop the feeding and go to the hospital
emergency room to get it replaced
right away. It is very important to get
G- or J-tubes replaced before the
stoma starts to close. Do not try to
replace the tube yourself unless you
have been taught how by your child’s
health care professional.
Diarrhea can be caused by:
• Spoiled or contaminated formula.
• Contaminated tube-feeding
equipment.
To stop diarrhea, your health care
professional might suggest:
• Changing medications.
• Feeding formula more slowly.
• Replacing the formula with water
or an electrolyte solution for a
short time.
• Changing to a formula with fiber or
to a different formula.
• Reviewing the formula preparation.
• Reviewing the care of tube-feeding
equipment.
26
24
20
Some signs of dehydration are:
Clogged tube
• Weakness
To prevent dehydration:
• Give your child extra water after or
between feedings as prescribed
by your health care professional.
• Ask your health care professional
whether your child’s medications
can cause dehydration.
• Call your health care professional if
your child has a fever or diarrhea.
Ask if you should give your child
more water, or change the feeding
schedule or formula. If fever or
diarrhea continues, call your health
care professional.
If the feeding tube comes out completely:
• Go to your hospital emergency room.
• Take the feeding tube with you.
If your child’s feeding tube is partially
out of place:
• Do not use the feeding tube.
• Check how much the tube is out
of place; compare its markings to
your records.
• Tape your child’s feeding tube to
his or her skin to prevent further
movement.
• Call your health care professional
and get help as soon as possible.
27
25
21
When To Call A Health Care Professional
When to Call A
Health Care Professional
Glossary
When to call a health care
professional
The following information will come
from your health care professional:
abdominal wall: skin and body tissue that protects
the organs of the digestive system
nasojejunal (NJ) tube: a feeding tube that goes
from the nose to the jejunum
Call your health care professional if
your child has:
• Diarrhea that lasts
aspiration: a method to check tube placement
by using a syringe to withdraw stomach contents
through the feeding tube
Nissen fundoplication: a surgical procedure to
help keep food or formula from coming back into the
esophagus from the stomach
constipation: bowel movements that don’t happen
very often or hard stools that are painful or difficult
to pass
nutrients: parts of food that nourish the body (protein,
carbohydrate, fat, vitamins, minerals, and water)
• Feeding tube out of place, either
completely or partially
• Constipation that lasts
• Residual more than
days
days
mL
• Choking or difficulty breathing
• Anything that makes you stop
feeding for more than
hours
• Upset stomach that lasts 24 hours
• Other _________________________
• Vomiting
• Signs of dehydration
• Unusual weakness
• Fever
• Blood in or around the feeding tube
• Creamy, bad-smelling drainage
from the stoma
• Formula or stomach contents
leaking around the tube site
Always feel free to call your
health care professional if
you are worried about your
child’s condition. You may also
want to write down questions
to ask your child’s health
care professional at the next
checkup or visit.
continuous feeding: tube feeding where the
formula drips slowly, all day or all night (or both)
decompression: removing air or fluid from
the stomach
dehydration: a condition in which the body does
not have enough water
diarrhea: frequent and loose, watery bowel
movements
electrolyte: a nutrient (such as sodium, potassium,
or chloride) that helps regulate cell and organ function
esophagus: the muscular tube leading from the
mouth to the stomach
feeding tube: a tube into the stomach or small intestine
through which formula is given
• Red, sore, or swollen tube site
formula: a liquid nutritional product that has the
same nutrients as regular food
• Tube clog that you can’t flush out
with warm water
gastrostomy (G) tube: a feeding tube that goes into
the stomach through a stoma
• Diarrhea that lasts
• Constipation that lasts
• Residual more than
days
days
mL
• Weight loss or gain of more than
pounds in a week, or
ounces in a day
• Anything that makes you stop
feeding for more than
hours
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gravity feeding: a feeding method in which
formula drips down through the feeding tube from a
container placed above the patient
hypergranulation tissue: extra tissue that grows
around the stoma
intermittent (bolus) feeding: a feeding method in
which formula is given 3 or more times a day
jejunostomy (J) tube: a feeding tube that goes into
the small intestine
jejunum: the second part of the small intestine
nasogastric (NG) tube: a feeding tube that goes
from the nose to the stomach
PEG (percutaneous endoscopic gastrostomy):
a nonsurgical way to place a feeding tube into the
stomach through the abdominal wall
PEJ (percutaneous endoscopic jejunostomy):
a nonsurgical way to place a feeding tube into the
jejunum through a gastrostomy tube
prime the feeding set: this means pour the
feeding into the feeding bag and let flow through
to the end of the delivery tube to remove the air
from the feeding bag tube. This prevents air from
being pumped into the stomach. Your health care
professional should show you how to do this based
on what type of feeding set or pump you are using.
pump feeding: a feeding method in which a
mechanical pump moves formula through the
feeding tube
residual: formula from the last feeding that is still in
the stomach at the next feeding
small intestine: the part of the digestive tract
between the stomach and large intestine that
digests and absorbs nutrients
stoma: an opening in the abdominal wall through
which a gastrostomy tube or jejunostomy tube
enters the body
stomach: the organ between the esophagus and
small intestine that holds food during the early part
of digestion
syringe: a hollow, plastic tube with a plunger used
to draw fluid out of or inject fluid into a feeding tube
syringe feeding: a feeding method in which
formula flows from a syringe into the feeding tube or
is pushed gently into the feeding tube with a syringe
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