Health Library

Gastrostromy or Gastro-jejunum Tube: Care

Your child is going home with a gastrostomy tube (G-tube) or gastro-jejunum tube (G-J tube) in place. The G-tube is placed through the abdominal wall into your child’s stomach. The G-J tube is placed through the abdominal wall into your child’s stomach and extends into the jejunum (part of the small intestine). These tubes are used to deliver liquid food directly to your child’s stomach or small intestine. You were given home care instructions for your child’s G-tube or G-J tube before he or she was discharged from the hospital. This sheet can help you remember those steps when you and your child are at home. Arrangements may also be made for a home health nurse to help you.

NOTE: There are many types of G- and G-J tubes, syringes, and feeding pumps. Your child’s tube and supplies may look or work differently from what are described and shown here. Always follow the instructions given by your child’s health care provider or home health nurse. Ask them for phone numbers to call if you need help. Also, make sure you have the phone number for your child’s medical supply company. You’ll need to order more supplies for your child in the future. Write all of these phone numbers below.

Health care provider phone number: ________________________________

Home health nurse phone number: ________________________________

Medical supply company phone number: ____________________________

Home Care: Feeding Instructions

There are two types of feeding that can be done with a G- or G-J tube:

• Bolus feeding. A meal-sized amount of liquid food is given through the tube several times a day. Bolus feeding is given using a syringe or a pump.

• Continuous feeding. Liquid food is dripped slowly through the tube. Continuous feeding is given using a pump.

Your child may be prescribed one or both types of feeding. Detailed instructions for each type of feeding are given below.

Bolus Feeding Using a Syringe

Your child’s health care provider or home health nurse will tell you how much liquid food to use for each bolus feeding. You’ll also be told how often to feed your child every day. Write these numbers below:

How much to give at each feeding:  _________________________

How often to feed: ­­ __________________________

Supplies

• G- or G-J tube

• Liquid food

• Feeding syringe

• Extension tubing

Steps

• Wash your hands with soap and water.

• Check the label and expiration date of the liquid food. Don’t use any can (or bag) if the expiration date has passed. Instead, get a new can (or bag).

• Open the feeding port cap on the G- or G-J tube.

• Connect the extension tubing to the feeding port of the G- or G-J tube.

• Make sure the clamp on the extension tubing is closed.

• Pull the plunger out of the feeding syringe.

• Connect the feeding syringe to the other end of the extension tubing.

• Pour the liquid food into the feeding syringe. Fill only to the amount that was prescribed by your child’s health care provider. 

• Open the clamp on the extension tubing.

• Hold the feeding syringe straight up. This allows the food to run through the G- or G-J tube by gravity. Adjust the angle of the feeding syringe to control the flow rate of the food.

• If the food flows too slowly or doesn’t flow at all, place the plunger in the syringe. Gently, push the plunger a bit. This can help remove anything that is blocking or clogging the tube. Do not push the plunger all the way into the syringe or with force.

• Refill the feeding syringe with food, if needed. Repeat steps until your child has received the prescribed amount of food.

• After the feeding, flush the extension tubing with water (as you were shown in the hospital).

• Disconnect the syringe from the extension tubing.

• Disconnect the extension tubing from the G- or G-J tube.

• Close the feeding port cap on the G- or G-J tube.

Additional instructions: ________________________________________________________________________________________

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Bolus or Continuous Feeding Using a Pump

• For bolus feeding, your child’s health care provider or home health nurse will tell you how much liquid food to use for each feeding. You’ll also be told how often to feed your child every day. Write these numbers below:

How much to give at each feeding:  _____________

How often to feed: ­­ __________________________

• For continuous feeding, the amount of food to be given and time frame are often set on the pump for you. Don’t change these settings unless you’re instructed to do so.

Supplies

• G- or G-J tube

• Extension tubing

• Liquid food

• Clean feeding bag

• Feeding pump

• 5–10 cc/ml syringe (for flushing)

• Water (for flushing)

 Steps

• Wash your hands with soap and water.

• Make sure the pump is in the STOP/OFF mode.

• Check the label and expiration date of the liquid food. Don’t use any can (or bag) if the expiration date has passed. Instead, get a new can (or bag).

• Make sure the clamp on the feeding bag tubing is closed.

• Pour a little more than the prescribed amount of liquid food into the feeding bag.

• Hang the feeding bag on the pole above the pump. Make sure the feeding bag tubing hangs straight.

• Open the clamp slowly. Let a small amount of food run through the end of the feeding bag tubing. This clears air out of the feeding bag tubing. It also helps keep your child from having gas later.

• Close the clamp on the feeding bag tubing.

• Load the feeding bag tubing into the pump.

• Open the feeding port cap of the G- or G-J tube.

• Connect the extension tubing to the feeding port of the G- or G-J tube.

• Make sure the clamp on the extension tubing is closed.

• Connect the feeding bag tubing to the other end of the extension tubing.

• Open the clamps on both the feeding bag tubing and extension tubing.

• Check that the settings on the pump are correct.

• Turn the pump to START/ON.

• After the feeding, disconnect the feeding bag tubing from the extension tubing. Then, flush the extension tubing with water (as you were shown in the hospital).

• Disconnect the syringe from the extension tubing.

• Disconnect the extension tubing from the G- or G-J tube.

• Close the feeding port cap of the G- or G-J tube.

Additional instructions: ________________________________________________________________________________________________

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Home Care: Flushing the Tube

One of the things you must do is flush your child’s tube to keep it from getting clogged. Detailed instructions are given below.

Flushing the Tube for Bolus Feeding Using a Syringe

Flush your child’s G- or G-J tube after each feeding or as instructed by your child’s health care provider or home health nurse.

Supplies

• Feeding syringe

• Water

Steps

• Wash your hands with soap and water.

• The feeding syringe should already be connected to the extension tubing.

• Pour water into the syringe. Let it run through the extension tubing by gravity.

• If the water flows too slowly or doesn’t flow at all, place the plunger in the syringe. Gently, push the plunger a bit. This can help remove anything that is blocking or clogging the G- or G-J tube. Do not push the plunger all the way into the syringe or with force. Changing the child’s position so that he or she is lying down or sitting upright may also improve the flow. Disconnect the syringe from the extension tubing.

• Disconnect the extension tubing from the G- or G-J tube.

• Close the feeding port on the G- or G-J tube.

Additional instructions: ________________________________________________________________________________________

___________________________________________________________________________________________________

___________________________________________________________________________________________________

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Flushing the Tube for Bolus Feeding or Continuous Feeding Using a Pump

Flush your child’s G- or G-J tube after each feeding or as instructed by your child’s health care provider or home health nurse.

Supplies

• 5–10 cc/ml syringe

• Water

Steps

• Wash your hands with soap and water.

• Make sure the pump is in the STOP/OFF mode.

• Close the clamp on the feeding bag tubing.

• Disconnect the feeding bag tubing from the extension tubing.

• Put the tip of the empty syringe in water.

• Draw up 5–10 cc/ml of water.

• Connect the syringe to the extension tubing.

• Gently push the plunger all the way into the syringe.

• Disconnect the syringe from the extension tubing.

• Disconnect the extension tubing from the G- or G-J tube.

• Close the feeding port cap of the G- or G-J tube.

Additional instructions: ______________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

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Call the doctor right away if any of the following occurs:

• The tube feels loose, comes out, or the size of the opening where the tube enters the skin increases.

• Redness, swelling, leakage, sores, or pus develops around the tube.

• Red, rough tissue develops around the tube site.

• You see blood around the tube, in child’s stool, or in contents of the stomach.

• The tube becomes clogged or blocked and you can’t clear it.

• Your child coughs, chokes, or vomits while feeding.

• Your child has a bloated or rigid abdomen (belly feels hard when gently pressed).

• Your child has diarrhea.

• In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

• In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

• In a child of any age who has a temperature of 103°F (39.4°C) or higher

• A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years or older

• Your child has had a seizure caused by the fever