It is never easy to see a family member with a feeding tube. A feeding tube (or nasogastric tube) is often required for patients who have difficulty swallowing. This allows them to receive the necessary nutrients in a safe way. First time caregivers in particular, may find feeding tube management challenging.
At Jaga-Me, we believe in empowering caregivers to care for their loved ones. In this article, we will be sharing tips from Jaga-Me nurses on tube feeding.
*Do check the manufacturer’s note for exact recommendations.
Syringes should be washed with water (do not boil) and thoroughly dried after each use. They should be changed every 2-3 days, and more frequently if there are visible marks in the syringe.
Tube Feeding Checklist
Check that the micropore securing the tube is intact and has not shifted.
Measure the exposed length of the tube. It should be the same as the exposed length when the feeding tube was first inserted. Some tubes have numeric markings for reference.
Check the pH of the gastric content (aspirate).
Using an alcohol swab, clean the exterior of the spigot (cover of the exposed end of the feeding tube).
While kinking the tube, remove the spigot and clean the opening of the tube with an alcohol swab.
Insert the syringe (with plunger) into the opening of the tube. Release the kink.
Pull the plunger back gently till some gastric content is seen (usually colorless or green-yellow color).
If no gastric content can be seen, lean the patient to the left. Wait for 5 minutes and reattempt to collect gastric content. If there is no gastric content again, pump 10ml of air and try again. If there is still no gastric content, put 10ml of cool boiled water into the syringe and through the feeding tube. Wait for 5 minutes and attempt again. If this last attempt is unsucessful, contact your home nurse.
Observe the gastric content. The color should be colorless or yellow-green with some mucus strands. Semi-digested milk curds can be seen as well.
Pour the gastric content over a pH paper and compare the result to a pH chart. It should be between pH 1-6. *check the recommended pH range with your doctor, as your loved one may be taking some medication that could affect the pH of his gastric content*
You may feed your loved one if the pH is between 1-6 and the appearance of the gastric content is normal.
Frequently Asked Questions
How do I check if that the tube is still in place?
You can measure the exposed length of the feeding tube, and check that the micropore tape has not shifted.
What should I do if the tube has been displaced?
We recommend for a trained nurse to assess the situation in person. Do not attempt to re-insert the feeding tube on your own.
How do I maintain the oral and nasal hygiene of the patient?
If your loved one is able to brush their teeth, allow them to do so twice a day
If they are unable to brush their teeth, use a toothette to clean the gums, teeth and tongue. Dip the toothette with sodium bicarbonate or oral gargle solution.
Using a damp cotton bud, gently clean the exterior of the nose with the feeding tube.
How often should I replace the micropore tape?
The micropore tape should be replaced once a day, when cleaning your loved one’s face. Using a warm cloth, gently loosen the micropore tape. Remove the tape from the face and from the tube. Reattach a new micropore tape.
Why is the milk not flowing down during the feeding?
It is most likely that the tube is stuck with milk or medicine. You may reposition your loved one to the left and observe if the milk flows. If it does not, contact your home nurse for replacement of the feeding tube. Do not use the syringe and plunger to attempt to force through the obstruction as you could cause significant discomfort to your loved one.
Expert tips from a Jaga-Me Nurse
To prevent the exposed length of the feeding tube from flopping around, you may use a claw-shaped hair clip to clip the end of the tube to your loved one’s shirt.
Excess milk can be stored in the fridge for up to 24 hours (it helps to label the can/packet of milk with the opening date & time). Sit the can of milk in a bowl of warm water for 10 minutes to warm the milk. Check the temperature of the milk against your inner wrist before feeding your loved one.
Encourage your loved one to practise swallowing while feeding through the feeding tube. This helps them to maintain their swallowing muscles.
Always mix the milk powder with water and sieve it to prevent clumping.
We recommend families to have at least one extra NG Tube in the event of an emergency.
During feeding and 1 hour after feeding, position your loved one at, minimum, a 45-degree angle. This prevents milk from potentially flowing into their lungs.
The maximum amount that can be fed each time is 400ml. Allow adequate time between each feed for the body to digest the milk.
To ensure that the tube is free from milk/medicine clogs, flush the feeding tube with 20 – 30ml of water after each feed.
Check with your pharmacist if the medication your loved one requires can be pounded into powder. Do not mix medicine with the milk. Instead, mix it with water.
How can I get more expert support?
You can speak to a Jaga-Me nurse at 8498 4598 for medical assistance. Alternatively, you can seek advice from your JagaPro in person when you engage Jaga-Me’s Home Care Services.