Patient education: How to give a tube feeding (The Basics)

What is tube feeding? — Tube feeding, also called "enteral feeding," is a way of getting food and nutrients when a person cannot eat by mouth. With tube feeding, the person gets liquid food or formula through a flexible, plastic tube. This liquid food has all of the nutrients the body needs. The tube can also be used to give medicines.

There are a few different types of feeding tubes, including:

●"NG tube" – This goes through the nose and into the stomach (figure 1). Sometimes, the tube goes beyond the stomach and into the intestine. If so, it is called an "NJ" tube.

●"G tube" – This goes through the wall of the belly and into the stomach (figure 2). Sometimes, the tube goes beyond the stomach and into the intestine. If so, it is called a "GJ" tube.

●"G button" – This goes through the wall of the belly and into the stomach like a G tube. But instead of having tubing outside of the body, it has a "button" opening that sits mostly flat against the skin.

●"J tube" – This goes through the wall of the belly and into the small intestine.

The type of feeding tube you get depends on why you need it and how long you will need it.

How is tube feeding done? — It depends on the type of tube you have and what your needs are. Your doctor will give you instructions about how to feed yourself based on your situation.

There are different ways to give feeds, including:

●Bolus feedings – These are tube feedings that you give yourself several times each day, like meals. They can be given with a syringe or through a hanging bag that uses gravity to drip liquid food or formula into the tube.

●Continuous feeding – This involves using a machine called a feeding pump. The pump can be set to slowly give liquid food or formula over many hours. It can also be set to give "intermittent" feeds, similar to boluses, at specific times.

How do I give myself a tube feeding? — Your doctor or nurse will show you exactly how to feed yourself through the tube when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand. 

Before you give yourself a tube feeding, you need to know:

●The type and amount of formula or liquid food to give

●If you need to measure "residual" or leftover stomach contents before you give a feeding. Your doctor or nurse will teach you how to check for residual contents if this is part of your care.

●About how long each feeding should take

●If you should flush the tube with water before and after your feeding, and how much water to use

General steps to give yourself a tube feeding:

●Wash your hands.

●Gather the supplies. This usually includes formula, what you will put it in (syringe or bag), water, a cup, and a clean cloth. If you have a G button, you also need an "extension set" of tubing.

●If you are connecting extension tubing, remove the air before you give a feed. This is called "priming." Your doctor or nurse will show you how to do this.

●Give your feeding based on your doctor's or nurse's instructions:

•To use a syringe – Remove the plunger from the syringe. Pour the liquid food or formula into the syringe, and insert it into the tube. The liquid will flow in by gravity. If the liquid isn't flowing, you can insert the plunger back into the syringe and push down slightly to get the flow started. You can then remove the plunger again. It should take about 20 to 30 minutes to finish flowing.

•To use a feeding bag – With the roller clamp on the bottom of the feeding bag tube closed, pour the liquid food or formula into the top of the feeding bag. Hang the bag on a hook or an IV pole. With the end of the bag's tube in a cup, open the roller clamp until the liquid starts to flow into the cup, and then close the roller clamp. This will clear the air from the tube. Next, attach the bag's tube to the feeding tube and open the roller clamp. The liquid food or formula will flow in by gravity. It should take about 30 to 60 minutes.

•To use a feeding pump – With the roller clamp on the bottom of the feeding bag tube closed, pour the liquid food or formula into the top of the feeding bag. Hang the bag on a hook or an IV pole. With the end of the bag's tube in a cup, open the roller clamp until the liquid starts to flow into the cup, and then close the roller clamp. This will clear the air from the tube. Next, attach the bag's tube to the feeding pump and turn the pump on. Your doctor will tell you what rate the machine should be set to.

●When the feeding is over, use a syringe to gently flush the feeding tube with water. Your doctor or nurse can tell you how much to use.

●Remove the syringe, and close the tube cap after you are finished.

●Wash all of the supplies in warm soapy water. Let air dry.

Sit up while you feed yourself, and do not lie down for an hour after you are finished. This will keep food from getting into your lungs.

What else should I know? — Some medicines can be given through a feeding tube, but only do this if your doctor or nurse tells you to. If they do, make sure that you understand and follow all of their instructions. Always flush the feeding tube with water before and after.

Take care of your mouth and teeth, even if you are not eating and drinking by mouth. Brush your teeth 2 to 3 times each day, and floss regularly.

When should I call the doctor? — Call for advice if:

●Your stomach looks or feels swollen.

●You have diarrhea.

●You have stomach cramps.

●You feel nauseous or vomit.

●You have trouble breathing.

●The feeding tube is blocked or comes out.

●You have too much "residual" at beginning of your feeding.

●The skin around the feeding tube becomes red or swollen.

More on this topic

Patient education: Enteral (tube) feeding (The Basics)
Patient education: How to care for a nasogastric tube (The Basics)
Patient education: How to put in a child's nasogastric tube (The Basics)
Patient education: How to care for a G tube or G button (The Basics)
Patient education: Surgical gastrostomy (The Basics)
Patient education: Percutaneous endoscopic gastrostomy (PEG) in adults (The Basics)