Nasogastric Tube (NG Tube) Care and Use  

What is a nasogastric tube?

A nasogastric tube (NG tube) can be used for feedings when your child is not able to eat or drink enough by mouth. A nasogastric tube passes through the nose, down the throat and into the stomach. Nasoduodenal (ND) and nasojejunal (NJ) tubes are like NG tubes but end in the intestine.

An NG tube is long and flexible. The end that stays outside the body has an opening (port or feeding connection) that attaches to a feeding syringe or bag. The tube is secured to the skin with tape. It is important to take care of the skin around the feeding tube. Watch for skin irritation and keep the area clean and dry.

Many children can still eat and drink by mouth with an NG tube. Your care team will recommend feedings based on your child’s needs. Follow instructions for care and use of the NG tube. Your care team will let you know when the NG tube needs to be replaced. Long-term NG tubes are usually replaced every 30 days or as needed.

Always wash your hands with soap and water before giving feedings or caring for the tube.

How to check for tube placement

You must check to make sure the tube is in the correct place at least 1 time each day. A good time to do this is when you have stopped the pump to change the feeding bag or to if you are using the NG tube to give medicines.

These steps will help you check the correct placement of the tube:

• Wash your hands well with soap and water or use a hand sanitizer.
• Look at the centimeter marking at the base of your child’s nostril. Make sure that the marking is in the same place before using the tube.
• You can also check for NG tube placement by pulling back on the plunger of the syringe. If stomach contents come back into the NG tube, the placement is correct.

If you are not sure that the tube is in the correct place, do not use the tube. Contact your health care provider so the tube can be checked.

Watch for signs of choking or problems digesting the medicines or formula. This may be caused by incorrect tube placement, the rate of the feeding, or other issues. These warning signs include:

• Coughing
• Throat clearing
• Gagging or burping
• Trouble speaking
• Trouble breathing
• Soft or high-pitched sounds while inhaling
• Nausea, vomiting, or diarrhea
• Stomach pain or swelling
• Acting more irritable or showing signs of discomfort or distress

If any of these symptoms occur, stop the feeding, and call your child’s doctor right away.

How to give feedings through an NG tube

• Position your child in an upright position. If the feeding will happen in bed, put your child’s head and shoulders up on pillows.
• Follow instructions for feedings given by your health care provider.
• If your child cries during the feeding, stop the feeding until your child is quiet and comforted.
• Do not change the type or amount of formula without talking to your child’s doctor first.
• Flush the NG tube at least 1 time each day with tap water to prevent the tube from becoming clogged. Usually, this is done at the end of a cycled feeding or after giving medicine through the tube. If your child is receiving continuous feedings or is not receiving anything through the NG tube, flush the tube one 1 time a day. Choose a time that is easiest for you. You may be asked to give more flushes by your medical team.
• If you are at home and have well water, use sterile water to flush the tube or if directed by your medical team to dilute medicines.
• If the tube seems clogged so that nothing can be pushed in or is very hard to push in, contact your health care provider right away.

Find more information on tube feedings.

How to change the feeding container, pump tubing, and extension set

• Start with a new bag or bottle and tubing at the beginning of each feeding cycle. If the cycle is longer than 12 hours, the container and tubing can be changed anytime during the cycle. The tube and container should not be used for more than 12 hours.
• Change the pump tubing and feeding container every 4 hours when using powder formula or breast milk.
• Change the extension set every 24 hours.

How to give medicine through the NG tube

• Use the liquid form of each medicine whenever possible.
• Check with your pharmacist about whether your child’s medicine is offered in liquid form or if pills can be crushed.
• If you crush a tablet, make sure you crush it into very fine pieces. Mix it well with a small amount of warm water to make a thin liquid.
• The crushed medicine and water mixture can be pushed into the NG tube using a syringe.
• Always rinse the NG tube with the recommended amount of water at the beginning and end of giving medicines, and before and after feeding bag changes.
• Give each medicine separately. Do not mix medicines together. Rinse the tube with the recommended amount of water after each medicine.
• Do not add any medicines to the formula in the feeding container.
• Do not crush coated or time-released tablets or capsules.
• Dilute thick medicines as instructed by your pharmacist.

Find more information on how to give medicines through a feeding tube.