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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Nutrition

Enteral Nutrition: Gastrostomy Tube Feeding (295)

Enteral Nutrition: Gastrostomy Tube Feeding (295) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition

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Gastrostomy Tube Feeding

A gastrostomy tube (g-tube) is a tube that enters through your abdomen and rests in your stomach. This tube is
used for tube feeding formula, water, and medicine (instead of taking them by mouth). Tube feeding formula is
a liquid source of nutrition that provides calories, protein, water, vitamins and minerals. Tube feedings that are
started in the hospital will require follow-up with a registered dietitian after discharge.

My Tube Feed and Hydration Plan





































Tube Feed Formula
____________________________________________________________________________

Amount of Tube Feed Formula Needed Daily
You need a total of _____ cans or _____ ounces per day
This will provide ________ calories, _______ grams (g) of protein and _________ milliliters (mL) of water

Tube Feed Schedule
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Additional Water Flushes Needed
You need a total of ________ mL of water per day to stay hydrated (equal to ____ fluid ounces and ____ cups)

Your goal tube feeds provide ________ mL of water per day

In addition to goal tube feeds, you need ______ mL of water per day (equal to ____ fluid ounces and ____
cups)

Water Flush Schedule
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

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Continuous, Intermittent, or Cyclic Tube Feeds by Pump
Continuous, intermittent or cyclic tube feeds are given using a pump over a specified time frame.

1. Wash your hands with soap and water. Dry them with a clean towel.
2. Use room temperature formula. Very cold formula may cause stomach discomfort.
3. Preparing the feeding: You will either use a ready-made formula or one that requires at home preparation
from powder.
A. Ready-made:
ξ If using a ready-made formula, wash the lid of the can and dry the lid with a clean towel
ξ Only open containers of formula that you will need for the feeding
ξ Shake the can(s) before opening
ξ Only place 8 hours’ worth of formula into the bag or as otherwise directed
ξ Leftover formula that is open can be stored in the refrigerator with a cover
ξ Discard formula that has been open for more than 24 hours
B. Prepared formulas from powder:
ξ Follow the mixing instructions for preparation given by your healthcare provider
ξ Only place 4 hours’ worth of formula into the bag
ξ Leftover formula that is open can be stored in the refrigerator with a cover
ξ Discard formula that has been prepared more than 24 hours ago.
4. Pour the formula into the feeding bag.
5. Open the cap on the feeding tube and using a syringe, insert at least 30 mL of warm water into your tube
or as instructed by your healthcare provider..
6. Remove the syringe and put the tubing from the pump into your feeding tube. Start the pump at the
recommended rate.
7. Keep your head elevated at least 30 degrees while you receive a feeding.
8. To prevent clogging, flush the tube with 30 mL water every 4 hours while the tube feeding is running, or
as recommended by your healthcare provider.
9. When the feeding is complete, disconnect the feeding bag. Flush the tube with at least 30 mL of warm
water (or as instructed by your healthcare provider) and cap the tube to prevent leaking.
10. Rinse the feeding bag and tubing with water and then swish with warm water and a small amount of liquid
dishwashing detergent. Rinse and allow to air dry. Change the tube feeding bag every 3 days.
11. Clean the syringe with warm, soapy water and allow to air dry completely between feedings. Change the
syringe each week.
12. To allow you more freedom, there are special backpacks you can get for feeding pumps. Check with your
medical supplier about this option.

Gravity Tube Feeds
Gravity tube feeds are given multiple times per day, several hours apart and are given using a feeding bag over
30 minutes or less. The feeding bag hangs above the head allowing the formula to drip in.

1. Complete steps 1-3 listed under the topic of tube feedings by pump.
2. Check the roller clamp to ensure that the tubing is pinched closed.
3. Pour the formula into the feeding bag. No more than 2 cans or 480 mL of formula will be put into the
feeding bag at a time. Close the lid on the feeding bag and hang the bag on a pole/hook at least 12 inches
higher than your stomach.

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4. Open the cap on the feeding tube and using a syringe insert at least 30 mL of warm water into your tube or
as instructed by your healthcare provider.
5. Remove the syringe and connect the tubing from the feeding bag to the g-tube.
6. During feedings, sit upright so that your shoulders are higher than your stomach. Sit in a chair or prop
yourself up in a bed or on the couch. Never lay flat on your back during feedings unless otherwise
instructed.
7. Unclamp the tubing coming from the feeding bag. Control the flow rate by using the roller clamp. A good
rate to start at is generally 1-2 drips per second. You may control the speed of flow per your comfort.
8. Once your feeding is finished, clamp the tube, remove the tubing from the feeding bag and unhook the
feeding from your g-tube.
9. Flush your g-tube with at least 30 mL of warm water or as instructed by your healthcare provider. Close the
cap on your feeding tube.
10. Rinse the feeding bag and tubing with water and then swish with warm water and a small amount of liquid
dishwashing detergent. Rinse and allow to air dry. Change the tube feeding bag every 3 days.
11. Clean the syringe with warm, soapy water and allow to air dry completely between feedings. Change the
syringe each week.

Bolus (Syringe) Feeds
Bolus (syringe) tube feeds may be given multiple times per day, several hours apart and are given through a
syringe over 15-30 minutes. If you have been able to handle tube feeds by the gravity drip method, you may try
the syringe method.

1. Complete steps 1-3 listed under the topic of tube feedings by pump.
2. Open the cap on the feeding tube and using a syringe, insert at least 30 mL of warm water into your tube or
as instructed by your healthcare provider.
3. Fill the syringe with formula and allow the formula to flow slowly. You may adjust the flow rate by gently
pinching the feeding tube or raising/lowering the height of the syringe. We do not suggest you use the
plunger of the syringe to force formula into the tube. This can cause bloating and discomfort. Repeat this
step as many times as needed to complete the feeding. It will take about 4 full syringes to complete 1 can of
formula or about 15 minutes.
4. After the feeding is complete, flush tube with 30 mL of warm water or as instructed by your healthcare
provider.
5. After all the water has gone through the tube, place cap on the feeding tube.
6. Clean the syringe with warm, soapy water and allow to air dry completely between feedings. Change the
syringe each week.

Water Flushes
Your body needs enough fluid each day to stay hydrated. Your tube feed formula will provide some fluids.
The rest of your fluid will be met by oral intake (if safe) and/or by doing water flushes through your feeding
tube. You may not be getting enough fluid if you have: dizziness, dry mouth, dry lips, lower urine output than
normal and darker urine.

Medicines
You can give medicine through the feeding tube if you are unable to swallow them. Follow these instructions:

1. Do not add medicine directly to the formula
2. Give each medicine one at a time; do not mix together.
3. Flush the tube with 30 mL water before giving a medicine or as instructed by your healthcare provider. If
giving more than one medicine at one time, flush in between each dose with 10 mL water.

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4. Crush and dissolve pills in at least 30 mL water prior to flushing them through the tube. Never crush
enteric-coated or time-release capsules. Flush the tube again with 30 mL water after administering the
medicine or as instructed by your healthcare provider.

Call Your Doctor If…
ξ Your tube may clog sometimes. Medicines may cause clogs or it may clog if you are not flushing your tube
with water often enough. This is not an emergency. First try to flush the tube with 30 mL of warm water.
Never force fluid into the tube. If this does not unclog the tube, call your doctor. If your tube clogs at night
you can wait until morning to call.
ξ If your tube falls out, it is important that you call your doctor right away. Although this is not harmful to
you, replacing the tube becomes more difficult or impossible the longer the tube is out.
ξ For adults: Weigh yourself 3 times a week at the same time of day on the same scale. Early morning is best,
after urinating. Keep a record of your weight. If you notice weight gain or loss of more than 2-3 pounds
per week contact your doctor, nurse or registered dietitian.
ξ Nausea or upset stomach that continues for more than 24 hours.
ξ Diarrhea (3 or more loose, watery bowel movements) for more than 2 days.
ξ Constipation (lack of bowel movement) that continues more than 5 days.
ξ Anything that causes you to stop giving tube feedings for more than one day.

Teach Back
What is the name of the formula being prescribed for your tube feeds?
How many cans of formula do you need each day if unable to eat anything by mouth?
When do you need to flush your tube with water?

If you are a UW Health patient and have more questions please contact UW Health at one of the phone numbers
listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can
be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.













Your health care team may have given you this information as part of your care. If so, please use it and call if you have any questions. If
this information was not given to you as part of your care, please check with your doctor. This is not medical advice. This is not to be
used for diagnosis or treatment of any medical condition. Because each person’s health needs are different, you should talk with your
doctor or others on your health care team when using this information. If you have an emergency, please call 911. Copyright © 9/2017
University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and
the Department of Nursing. HF#295