Read More

Patient Instructions

Your child’s gastrostomy tube or “G-tube” is a special tube in your child’s stomach that will help deliver food and medicines until your child can chew and swallow. Sometimes, it is replaced by a button, called a Bard Button orMIC-KEY, 3 to 8 weeks after surgery.

These feedings will help your child grow strong and healthy. Many parents have done this with good results.

You will quickly get used to feeding your child through the tube, or button. It will take about the same time as a regular feeding, around 20 to 30 minutes. There are two ways to feed through the system: the syringe method and the gravity method. Each method is described below. Make sure you follow all of the nurse’s instructions as well.

Your doctor will tell you the right mix of formula or blended feedings to use, and how often to feed your child. Have this food ready at room temperature before you start, by taking it out of the refrigerator for about 30 to 40 minutes. Do not add more formula or solid foods before you talk to your child’s nurse.

All of the equipment can be cleaned with hot, soapy water and hung to dry. You can try using seltzer to clean the tube if there is dried up formula inside it. You will also clean your child’s skin around the tube 1 to 3 times a day with mild soap and water, and dry. The skin should heal in 2 to 3 weeks.

Remember to wash your hands regularly to prevent the spread of germs. Take good care of yourself as well, so that you can stay calm and positive, and cope with stress.

Make sure your child is sitting up either in your arms or in a high chair.

If your child fusses or cries while feeding, pinch the tube with your fingers to stop the feeding until your child is more calm and quiet.

Feeding time is a social, happy time. Make it pleasant and fun. Your child will enjoy gentle talk and play.

Try to keep your child from pulling on the tube.

Since your child isn’t using their mouth yet, your doctor will discuss with you other ways to allow your child to suck and develop mouth and jaw muscles.

Your nurse will show you the best way to use your system without getting air into the tubes. Follow these steps to feed your child:

• Wash your hands
• Gather your supplies (feeding set, extension set if needed for a G-button or MIC-KEY, measuring cup with spout, room temperature food, and a glass of water).
• Check that your formula or food is warm or room temperature by putting a few droplets on your wrist.
• Close the clamp on the feeding tube.
• Hang the bag high on a hook, and squeeze the bag to fill it half way with the feeding.
• Next, open the clamp so that the food fills the tube with no air.
• Close the clamp.
• Insert the catheter tip into the G-tube.
• When you are finished feeding, your nurse may recommend that you add water to the tube to flush it out. G-tubes will then need to be clamped at the tube and the feeding system, and removed. For a G-button or MIC-KEY, you’ll close the clamp and then remove the tube.

If you are using a G-button system, you will attach the feeding tube to the feeding system first, then fill it with formula/food. Clamp the tube, then open the flap of the G-button or MIC-KEY and attach the feeding tube to the button. Release the clamp when you are ready to feed.

Your nurse will teach you the best way to use your system without getting air into the tubes. Follow these steps to feed your child:

• Wash your hands.
• Gather your supplies (a syringe, feeding tube, measuring cup with spout, room temperature food, water, rubber band, clamp, and safety pin).
• Check that your formula or food is warm or room temperature by putting a few droplets on your wrist.
• For G-tubes, insert the syringe into the open end of the feeding tube.
• For a G-button or Mic-Key, open the flap and insert the bolus feeding tube. Then attach the Leur-Lock syringe to the open end of the feeding tube.
• Pour the formula into the syringe until it is half full and unclamp the tube. Hold the tip to the syringe no higher than your child’s shoulders. If the food is not flowing, squeeze the tube in downward strokes to bring the food down.
• You can wrap a rubber band around the syringe and safety pin it to the top of your shirt so that your hands are free to play.
• When you are finished feeding, your nurse may recommend that you add water to the tube to flush it out. G-tubes will then need to be clamped at the tube and the feeding system, and removed. For a G-button or Mic-Keys, you’ll close the clamp and then remove the tube.

If your child’s belly becomes hard or swollen after a feeding, try venting, or “burping,” the tube or button:

• Attach an empty syringe to the G-tube and unclamp it to allow air to flow out.
• Attach the feeding adapter to the Mic-Key button and open the tube to the air to release.
• Ask your doctor for a special decompression tube for “burping” the Bard Button.

Sometimes you may need to give medicines to your child through the tube. Follow these guidelines:

• Try to give your child medicine before a feeding so that they work better. You may also be asked to give your child medicines on an empty stomach outside of mealtime.
• The medicine should be liquid, or finely crushed and dissolved in water, so that the tube does not get blocked. Check with your doctor or pharmacist on how to do this.
• Always flush the tube with a little water between medicines.
• Never mix medicines.

Call your child’s nurse or doctor if your child:

• Seems hungry after the feeding
• Has diarrhea after feedings
• Has a hard and swollen belly 1 hour after feedings
• Seems to be in pain
• Has changes in their condition
• Is on new medication
• Is constipated and passing hard, dry stools

Also call the doctor if:

• The feeding tube has come out and you do not know how to replace it.
• There is leakage around the tube or system.
• There is redness or irritation on the skin area around the tube.

Feeding - gastrostomy tube; G-tube; Gastrostomy button; Bard Button; MIC-KEY

Altman GB, ed. Feeding and medicating via a gastrostomy tube. Delmar’s Fundamental and Advanced Nursing Skills. 2nd Ed. Albany, NY: Delmar Thomson Learning; 2003: 742-749.

Updated by: George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.