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Your First Day Home

Starting a Feeding Tube at Home
Tube Feeding Basics
When to Call Your Healthcare Professional

Starting a Feeding Tube at Home

This section includes guidelines on how to administer a tube feeding, as well as information on feeding schedules, providing additional water, and administering medications. Please be sure to check with your healthcare team for specific step-by-step instructions.

Tube Feeding with an Enteral Feeding Syringe (Bolus Feeding)
Before starting, follow your healthcare professional’s instructions to check the position of your tube before you begin a feeding.

Supplies
  1. Clean measuring cup with pour spout
  2. Formula (room temperature)
  3. Syringe (60 mL)
  4. Water (room temperature)
Preparation
  1. Wash hands thoroughly.
  2. Rinse the top of the formula container with hot water or wipe with clean wet paper towel.
  3. Shake formula container well before opening.
  4. Use syringe to flush feeding tube with water, as directed, by your healthcare professional.
  5. Pour formula into clean measuring cup or directly into the syringe.
Administration
  1. Sit or lie with your head elevated at least 30 degrees (about the height of two pillows) and remain in this position for 30 to 60 minutes after each feeding to help prevent nausea or reflux.
  2. Open (unclamp or uncap) feeding tube.
  3. Fill syringe with formula and attach to feeding tube. Release feeding tube to allow formula to flow.
  4. Raise or lower height of syringe to increase or decrease flow (feeding) rate.
  5. If indicated, add more formula to syringe as formula flows into feeding tube.
  6. After feeding, use syringe to flush feeding tube with water, as directed by your healthcare professional.
  7. Detach syringe from feeding tube and close (reclamp or recap) feeding tube.
Tube Feeding by Gravity
Supplies
  1. Feeding container and tubing (gravity set)
  2. Formula (room temperature)
  3. Pole
  4. Syringe (60 mL)
  5. Water (room temperature)
Preparation
  1. Wash hands thoroughly.
  2. Rinse the top of the formula container with hot water or wipe with clean wet paper towel.
  3. Shake formula container well before opening.
  4. Use syringe to flush feeding tube with water, as directed by your healthcare professional.
  5. Pour formula into feeding container and close cap.
  6. Hang feeding container on pole so it is at least 18 inches above stomach.
  7. If using a pre-filled feeding container, shake and connect as directed.
  8. Open clamp on flow regulator until the formula fills the tubing.
  9. Close clamp on the flow regulator.
  10. Make sure drip chamber on the tubing is about half full.
Administration
  1. Sit or lie with head elevated at least 30 degrees (about the height of two pillows) and remain in this position for 30 to 60 minutes after each feeding to help prevent nausea or reflux.
  2. Open (unclamp or uncap) feeding tube.
  3. Connect tip on the end of gravity set into feeding tube.
  4. Open flow regulator clamp to adjust flow rate, as directed by your healthcare professional.
  5. After feeding, close and disconnect gravity set from feeding tube.
  6. Use syringe to flush feeding tube with water, as directed.
  7. Close (reclamp or recap) feeding tube.
Tube Feeding with a Pump
Supplies
  1. Enteral feeding pump
  2. Feeding container and tubing (pump set)
  3. Formula (room temperature)
  4. Pole
  5. Syringe (60 mL)
  6. Water (room temperature)
Preparation
  1. Wash hands thoroughly.
  2. Rinse the top of the formula container with hot water or wipe with clean wet paper towel.
  3. Shake formula container well before opening.
  4. Use syringe to flush feeding tube with water, as directed by your healthcare professional.
  5. Pour formula into feeding container and close cap.
  6. Hang feeding container on pole so it is at least 18 inches above stomach.
  7. If using a pre-filled feeding container, shake and connect as directed.
  8. Follow instructions provided to set up and operate pump.
Administration
  1. Sit or lie with head elevated at least 30 degrees (about the height of two pillows) and remain in this position for 30 to 60 minutes after each feeding to help prevent nausea or reflux.
  2. Open (unclamp or uncap) feeding tube.
  3. Connect tip on the end of pump set into feeding tube.
  4. Set flow rate on pump to recommended mL per hour.
  5. If applicable, open roller clamp on pump set.
  6. Start the pump.
  7. After feeding, disconnect pump set from feeding tube and recap end of pump set.
  8. Use syringe to flush feeding tube with water, as directed by your healthcare professional.
  9. Close (reclamp or recap) feeding tube.
Tube Feeding Schedules
Intermittent or bolus feeding
In order to provide the nutrition you need, your healthcare professional will provide guidelines to help develop schedules for intermittent or bolus tube-feeding and water flushes, including information such as:
  • The name of your tube-feeding formula
  • The number of feedings you will need to get each day
  • The amount of formula each feeding should be (or how many containers should be used at each feeding)
  • The amount of room temperature water needed to flush the tube after each feeding

Continuous feeding
In order to provide the nutrition you need, your healthcare professional will give you a schedule for continuous tube-feeding and water flushes, including information such as:
  • The name of your tube-feeding formula
  • The amount of formula you should get each day, or the number of containers of formula you will need each day
  • Your feeding schedule: As you become more familiar with your feedings, you may want to vary the feeding times. Check with your healthcare professional before making any changes to the feeding schedule.
  • The pump flow rate setting
  • To assure adequate fluid intake, the total amount of room temperature water that should be given each day in addition to the formula
  • The amount of water to use to flush the tube
Administering Medications
Medications may be needed to keep your body healthy. The following provides directions for administering medication through your feeding tube. Follow your healthcare professional’s instructions for taking your medication. Use liquid medications whenever possible. If using pills, crush medications into a very fine powder and dissolve in water.

Check with your nurse, doctor, or pharmacist to get specific instructions on:
  • How to crush medications
  • How much water to mix with your medication
  • Which medications should not be crushed
  • Medications that need special considerations when given through a feeding tube

Even though your tube feeding formula contains water, extra water may be required for proper hydration and to prevent clogging of your feeding tube. Follow your healthcare professional’s instructions for flushing your feeding tube before and after medications and feedings.

Instructions
  1. Using a 60 mL or larger syringe, rinse or flush feeding tube with 15-30 mL of warm water before administering medication (unless instructed otherwise by your healthcare professional). Do not force the water flush. If you have difficulty flushing your feeding tube, contact your healthcare professional.
  2. Using a 60 mL or larger syringe, draw up correct dose of medication. Open feeding tube and connect syringe into feeding tube.
  3. Gently push water and medication into tube. When administering water only, you may remove plunger from syringe and allow water to flow in by gravity.
  4. Remove syringe from feeding tube and refill syringe with warm water as needed until desired amount of water is given, or to flush all medication from the syringe.
  5. Close (reclamp or recap) feeding tube and recap syringe.
STORING TUBE FEEDING FORMULAS
It is important to store formula properly. Formula is like food and can cause illness if it is not handled or stored properly.
  • Store unopened formula in a clean, dry place at room temperature.
  • If only part of a container of formula is used, cover it with plastic wrap, label it with the date and time it was opened, and put it in the refrigerator.
  • Use it within 24 hours of opening it. If not used in 24 hours, throw it out.
  • To avoid an upset stomach, take formula out of the refrigerator 30 minutes before using and leave covered with plastic wrap.
  • Do not heat formula in a microwave or on a stovetop.

When to Call a Healthcare Professional

Home tube feeding presents a new set of procedures and responsibilities for you and your family. It is only natural to have questions, or to need some help, once you are home. Your healthcare professional can help you answer questions such as:

  • What to expect from the tube feeding experience and the different tube feeding options available.
  • What type of equipment is needed and how to set it up.
  • How to know if you are getting enough nutrition.

Contact your healthcare team if you have any questions about any part of your home tube feeding plan, including how you are tolerating your tube feeding, if you are having any problems, or if you have questions about your formula.
Your healthcare team is there for you, to make sure that your home tube feeding experience is as comfortable and problem-free as possible.


When to Contact your Healthcare Provider:
If you are having problems with how your feeding tube is working, or if there is a change in your health (like a fever or diarrhea) that has you worried, contact your health care provider. Some of these potential problems are: Problems with the Feeding Tube:

  • Tube is clogged: Formula will not flow smoothly through the tube and you have checked the tube for kinks or bends and flushed the tube with water
  • Tube moves in or out more than 1 inch
  • Tube falls out
  • Large amounts of fluid leaking around the tube (dressing is soaked more than once a day)

Changes that may signal an infection, feeding intolerance, or other health problem:

  • Skin area around tube has signs of infection
  • Reddened area
  • Warm to touch
  • Firm to touch
  • Tender
  • More drainage than usual
  • Drainage that smells bad
  • Bloody or coffee-ground-colored drainage from the tube
  • A sudden increase or decrease in the amount of drainage through the tube
  • Nausea and/or vomiting that does not go away
  • Fever of 101 degrees or higher
  • Unusual and/or sudden weight loss or gain (more than two pounds a day)
  • Constipation: No stools for two days or stools that are difficult to pass
  • Diarrhea: Four or more loose or watery stools a day
  • Stomach becomes bloated or distended and tight

OWN YOUR FEEDING TUBE: Learn how to use and live with your feeding tube in this five-part video series with Gunnar Esiason.

1. The First Day Home with Your Feeding Tube.
In this "How-To" video, you wil see how you can use your feeding tube in different... MORE>
2. What Can I Expect from My Feeding Tube?
The video will show you a few lifestyle changes you may experience after you have had... MORE>
3. Normalcy with the Feeding Tube.
In this video, you will see how those who require a feeding tube are still able to maintain a... MORE>
The content on this website is for educational purposes only and should not be considered to be medical advice.
It is not intended to replace the advice of your healthcare team.
Please consult your healthcare team with any questions about your home tube-feeding plan.