FOR PATIENTS

With good feeding tube care at home, you should be able to avoid most problems in the long term, including tube blockages and leaks or fluid around the tube.

It’s important to follow the instructions carefully, avoid administrating anything other than tube feed through the tube and change your feeding sets regularly.

Also, good hygiene is important and you must flush the tube before and after all feeds and medications. Generally you should use 10 ml of sterile or boiled and cooled water to flush your tube unless the dietitian has told you otherwise. Refer to your tube feeding plan for guidance.

Caring for your PEG or JEJ tube

The area around the PEG tube on the outside of the stomach is called the ‘stoma site’. How to care for a PEG tube is detailed here:

  1. Wash your hands with soap and water.
  2. Check the stoma site for any signs of:
    1. leakage
    2. swelling
    3. irritation
    4. redness
    5. skin breakdown
    6. soreness
    7. movement of the tube in and out of the stomach

If you notice any of the above, inform someone on your healthcare team.

  1. Clean the skin around the stoma site with saline solution or other disinfectant as the nurse at the hospital instructed you. Begin at the centre of the stoma site and work outwards.
  2. When you have finished washing the stoma site, gently dry the area thoroughly.
  3. You should advance in and rotate the tube in a full circle each day as part of the cleaning routine. This helps to keep the stoma healthy.
  4. If you are concerned about the stoma site or tube, contact your healthcare team.

Caring for your nasogastric (NG) tube

  1. Keep the tube clean and dry.
  2. Clean the skin around your nostril with a damp cotton wool pad and warm soapy water.
  3. Rinse and dry carefully.
  4. Pay particular attention to the nostril in which the tube is placed and if it looks irritated or if it’s sore tell a member of your healthcare team.

To protect your skin, place a hydrocolloid dressing under the NG tube and secure the tube with an occlusive dressing. Putting the end of the tube behind the ear will keep it further out of the way.

You should check the position of the tube before every use to make sure that it is still in the stomach. Your dietitian or nurse will show you how to do this before you are discharged home. If at any point you’re unsure whether or not the tube is in the correct position, it’s important that you do not feed. Immediately contact your doctor, nurse, dietitian or hospital for further advice.

It’s also important to flush the tube before and after you give any feeds and medications using the feeding tube.

Ongoing oral care

Even though your mouth won’t be used as often for eating and drinking anymore, it’s still important to care for your mouth in order to prevent infections. You should continue to brush your teeth twice a day and rinse your mouth out several times throughout the day. You can apply cream or lip balm to your lips to avoid them drying out.

If you or your loved one has dentures, they should be cleaned with a brush and stored in a denture pot filled with fresh water overnight. Your mouth will still need to be cleaned and you should use mouth gel to keep your mouth moist.

If you have any problems with a dry mouth, sore tongue, bleeding gums or blistered mouth, you should seek advice from your doctor, dentist or speech therapist.

FOR PARENTS

With good care of your child’s tube, you should be able to avoid most problems in the long term, including tube blockages and leaks or fluid around the tube.

It’s important to follow the instructions carefully, avoid administrating anything other than tube feed through the tube and change your child’s giving sets regularly.

Also, good hygiene is important and you must flush the tube before and after all feeds and medications. Generally you should use 10 ml of sterile or boiled and cooled water to flush your tube unless the dietitian has told you otherwise. Refer to your tube feeding plan for guidance.

Caring for your child’s PEG, button or JEJ tube

The area around the PEG tube on the outside of the stomach is called the ‘stoma site’. It’s very

important that you clean the stoma site every day after your child is discharged from hospital. After two to three weeks when the site has healed, you can care for the PEG tube by following the simple

instructions below:

  1. Wash your hands with soap and water.
  2. Check the stoma site for any signs of:
    1. leakage
    2. swelling
    3. irritation
    4. redness
    5. skin breakdown
    6. soreness
    7. movement of the tube in and out of the stomac

If you notice any of the above, inform someone on your healthcare team.

  1. Clean the skin around the stoma site with saline solution or other disinfectant as the nurse at the hospital instructed you. Begin at the centre of the stoma site and work outwards.
  2. When you have finished washing the stoma site, gently dry the area thoroughly.
  3. You should advance in and rotate the tube in a full circle each day as part of the cleaning routine. This helps to keep the stoma healthy.

If you are concerned about the stoma site or tube, contact the PEG clinical nurse specialist in the hospital from which you were discharged.

Caring for your child’s nasogastric (NG) tube

  1. Keep the tube clean and dry.
  2. Clean the skin around your child’s nostril with a damp cotton wool pad and warm soapy water.
  3. Rinse and dry carefully.
  4. Pay particular attention to the nostril in which the tube is placed and if it looks irritated or if your child complains of soreness, tell a member of your healthcare team.
  5. aware that children have a tendency to pull out the NG tube, so try to teach them why it’s important not to do this.

To protect your skin, place a hydrocolloid dressing under the NG tube and secure the tube with an occlusive dressing. You should check the position of the tube before every use to make sure that it is still in the stomach. Your dietitian or nurse will show you how to do this before your child is discharged home. If at any point you’re unsure whether or not the tube is in the correct position, it’s important that you do not feed your child. Immediately contact your doctor, nurse, dietitian or hospital for further advice.

It’s also important to flush the tube before and after you give any feeds and medications using the feeding tube.

Ongoing oral care

Even though your child’s mouth won’t be used as often for eating and drinking anymore, it’s still important to care for his or her mouth in order to prevent infections.

You should continue to brush your child’s teeth twice a day and encourage them to rinse their mouth out several times throughout the day. You can apply cream or lip balm to their lips to avoid them drying out.

If your child has any problems with a dry mouth, sore tongue, bleeding gums or blistered mouth, you should seek advice from your doctor, dentist or speech therapist.

Promoting oral stimulation

Children who are tube fed and cannot eat might become anxious about eating and other things associated with their mouth, such as teeth cleaning. It’s important to promote pleasurable experiences or sensations around your child’s mouth. This can also help prepare your child for the possibility of eating again one day.

A speech therapist will give you advice and recommend activities to do with your child, but some ideas include:

  • Encourage your child to put objects such as teething rings or soothers in their mouth
  • Touch your child around his or her mouth
  • Play mouth games such as blowing kisses and raspberry sounds
  • Encourage messy play with non-food or food items
  • Introduce food smells
  • Offer food tastes if your child’s healthcare team says this is acceptable. If so, allow your child to taste at the same time your child is being fed by the tube. This will help your child to associate the smell, taste and sight of food with the feeling of hunger being satisfied.
  • Include your child in the social occasion of family mealtimes