Nasogastric Tube (NG Tube): Tips for Care and Use

What is a nasogastric (NG) tube?

A nasogastric tube (NG tube) is a soft, flexible tube that goes in through your child’s nose, down the throat, through the esophagus, and into the stomach. It helps your child get the nutrition they need when they cannot eat or drink enough by mouth. You can also use it to give some medicines. 

Nasoduodenal (ND) and nasojejunal (NJ) tubes are like NG tubes but they end in the small intestine. 

The end of the NG tube that stays outside the body has an opening (called a port or feeding connection). This connects to a feeding syringe or bag. The tube is held in place with tape on the skin. 

Follow the care instructions given by your care team. Always wash your hands or use hand sanitizer before and after doing any NG tube care. 

Benefits of an NG tube

An NG tube helps patients get the calories and nutrients they need. It can also be used to give some medicines. Your care team will tell you what nutrition and medicines your child needs. Many children can still eat and drink by mouth with an NG tube. 

How to check for NG 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 stop the pump to change the feeding bag or to give medicine through the tube.  

To see if the tube is in the right place: 

• Look at the centimeter marking at the base of your child’s nostril. Make sure that the marking is in the same place as before. 
• Use a syringe to pull back gently on the plunger. If stomach contents come into the tube, the placement is correct. 

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

Signs of incorrect NG tube placement 

Watch for signs of choking or problems when giving medicines or formula. This may be caused by incorrect tube placement, how fast you do the feeding, or other problems. These warning signs include: 

• Coughing 
• Throat clearing 
• Gagging or burping 
• Trouble speaking 
• Trouble breathing 
• Soft or high-pitched sounds while inhaling 
• Nausea or vomiting   
• 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 care team right away. 

Giving feedings through a NG tube

Always follow the instructions for feedings given by your care team.

• Put your child in an upright position. If they are in bed, use pillows to raise their head and shoulders a minimum of 30 degrees.
• If your child cries during the feeding, stop the feeding until your child is quiet and calm.
• Do not change the type or amount of formula without talking to your child’s care team first.
• If the tube seems clogged so that nothing can be pushed in or is very hard to push in, contact your care team right away.

Learn more about feeding tubes.

Flushing the NG tube

• Always flush the tube with the recommended amount of water: 
  • At the beginning and end of giving medicines 
  • Before and after changing the feeding bag 
• If your child gets feedings slowly over a long time (continuous feeding), or is not getting anything through the NG tube, flush the tube 1 time each day. Choose a time that is easiest for you.  
• Your care team may tell you to flush the tube more often.  
• Do not use well water to flush the tube or mix medicines. Use sterile water or filtered bottled water unless your care team tells you to do something else. 
• Change the bag, tubing, and extension set every 24 hours. 

Giving medicine through the NG tube

• Use liquid medicine whenever you can.
• Ask your pharmacist about whether your child’s medicine comes in liquid form or if pills can be crushed.
• If you need to crush a tablet, make sure it is crushed into very fine pieces. Mix it well with a small amount of warm water to make a thin liquid.
• Do not crush coated or time-released tablets or capsules.
• Use a syringe to gently push the medicine and water mixture into the NG tube.
• Give each medicine separately. Do not mix medicines together. Flush the tube with the recommended amount of water after each medicine.
• Do not add any medicines to the formula.
• Dilute thick medicines as instructed by your pharmacist.

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

Safety reminders for NG tube care and use

• Always wash your hands with soap and water or use hand sanitizer before giving feedings or touching the tube.
• Do not use force to give feedings or medicines. If nothing can be pushed into the tube, or it is very hard to push in, do not keep trying. Contact your care team right away.
• Take care of the skin around the tube. Watch for irritation. Keep the area clean and dry.

When to call your care team

Contact your care team if you notice:

• The feeding tube has moved
• Your child shows signs such as choking, coughing, or gagging or has problems digesting the medicines or formula
• It is hard to push anything through the tube
• Your child has skin irritation around the feeding tube site

Questions to ask your care team

• How often should I check NG tube placement?
• What formula can I give through the NG tube?
• What medicines can be given through the NG tube?
• How often should I give feedings through the NG tube?
• What problems should I watch out for when giving feedings or medicines?
• When should I call my care team?

Related content