Gastrostomy or Gastro-jejunum Tube: Pump Feeding
Your child is going home with either a gastrostomy tube (G tube) or gastro-jejunum tube (G-J tube) in place. A G-tube is placed through the abdominal wall into the stomach. This tube sends liquid food directly into the stomach. A G-J tube is placed through the abdominal wall into the stomach and leads into part of the small intestine called the jejunum. It sends liquid food directly into the jejunum. You’ll need to feed your child through this tube. You were shown how to do this before your child was discharged from the hospital. This sheet will help you remember those steps at home. If you need more help, talk with the hospital about how to arrange a home health nurse to help you.
Keep in mind that there are many types of G and G-J tubes, syringes, and feeding pumps. Your child’s tube and supplies may look or work differently from what are described and shown here. Make sure to follow the instructions given by your child’s healthcare provider or home health nurse.
Contact information to keep handy
Ask for phone numbers to call if you need help. Also, make sure you have the phone number for your child’s medical supply company. You’ll need to order more supplies for your child in the future. Write all of these phone numbers below.
Healthcare provider phone number: ____________________________________
Home health nurse phone number: _____________________________________
Medical supply company phone number: __________________________________
Types of feeding
There are 2 types of feeding with G and G-J tubes. Your child may be have one or both types of feeding. They are:
Continuous feeding. Liquid food is dripped slowly through the tube for part or all of a day. Continuous feeding can be done into either the stomach or the jejunum. This type of feeding is only done using a pump. The amount of food to be given and time frame are often set on the pump for you. Do not change pump settings unless you’re instructed to do so.
Bolus feeding. This is a meal-sized amount of liquid food given through the tube several times a day. Bolus feeding is given using a syringe or a pump. Bolus feeding is done into the stomach but not into the jejunum. Your child’s healthcare provider or home health nurse will tell you how much liquid food to use for each feeding. You’ll also be told how often to feed your child.
For bolus feeding, fill in the numbers below:
Feed your child on this schedule: ____________________________________________
Give this much at each feeding: ______________________________________________
Feeding your child
The supplies you’ll need are:
Clean feeding bag
5 to 10 ml syringe (for flushing)
Water (for flushing)
Follow these steps:
Wash your hands with soap and water.
Make sure the pump is in the STOP/OFF mode.
Check the label and expiration date of the liquid food. Don’t use any can or bag of food if the expiration date has passed. Instead, get a new can or bag of food.
Make sure that the clamp on the feeding bag tubing is closed.
Pour a little more than the prescribed amount of liquid food into the feeding bag.
Hang the feeding bag on the pole above the pump. Make sure the feeding bag tubing hangs straight.
Open the clamp slowly. Let a small amount of food run through the end of the feeding bag tubing. This clears air out of the feeding bag tubing. It also helps keep your child from having gas later.
Close the clamp on the feeding bag tubing.
Load the feeding bag tubing into the pump.
Open the feeding port cap of the G or G-J tube.
Connect the extension tubing to the feeding port of the G or G-J tube.
Make sure the clamp on the extension tubing is closed.
Connect the feeding bag tubing to the other end of the extension tubing.
Open the clamps on both the feeding bag tubing and extension tubing.
Check that the settings on the pump are correct.
Turn the pump to START/ON.
After the feeding, disconnect the feeding bag tubing from the extension tubing. Then, flush the extension tubing with water as you were shown in the hospital.
Disconnect the syringe from the extension tubing.
Disconnect the extension tubing from the G or G-J tube.
Close the feeding port cap of the G or G-J tube.
Never place medicine down the feeding tube that you were not instructed to do so. This can cause the tube to clog and not work.
When to call the healthcare provider
Contact the healthcare provider right away if any of the following occurs:
Your child has trouble breathing.
The tube feels loose or comes out.
The opening where the tube enters the skin becomes larger.
Red, rough tissue forms around the tube site.
The tube becomes clogged or blocked and you can’t clear it.
The skin around the tube site has redness, swelling, leaking fluid, or sores.
You see blood around the tube, in your child’s stool, or in the contents of the stomach.
Your child coughs, chokes, or vomits while feeding.
Your child’s belly looks bloated or feels hard when gently pressed.
Your child has diarrhea or constipation.
Your child has a fever 100.4°F (38°C) or higher.
October 06, 2017
Bankhead, R. Enteral Nutrition Practice Recommendations. Journal of Parenteral and Enteral Nutrition (2009); 33(2); pp. s122-s167
Bass, Pat F. III, MD, MPH,Lehrer, Jenifer, MD