Placement of a feeding tube through the nose (nasal feeding tube) is a common procedure in children with a serious illness. A feeding tube helps your child get the nutrition they need when they cannot eat or drink enough by mouth. You can also use it to give fluids and some medicines. Types of nasal feeding tubes include:
Nasogastric (NG) tubes
Nasojejunal (NJ) tubes
Nasoduodenal (ND) tubes
The thin, flexible, hollow tube is passed through the nose, down through the esophagus, and into the stomach (NG tube) or intestine (NJ or ND tube). This allows nutrition support and medicines to be given through the feeding tube. Nasogastric tubes can also be used to remove air or other contents from the stomach.
What to expect before nasal feeding tube placement
NG tubes are usually placed when your child is awake. Patients who have NJ and ND tubes may get anesthesia or sedation medicines for the procedure.
If your child is having anesthesia, they should not eat or drink anything by mouth, including candy and gum, for several hours before the procedure. This is called fasting. Your care team will tell you when your child should start fasting. You might also hear it called NPO. It is short for a Latin phrase that means “nothing by mouth." It is important to follow all fasting instructions from your care team.
What to expect during nasal feeding tube placement
Nasogastric tube placement
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.
Your child may get a numbing spray or gel to make the nose and throat more comfortable. They may get sedation medicine to help them relax.
General steps for NG tube placement include:
Your child will sit up or have their head raised.
The nurse measures the tube to make sure it is the right length.
The tip of the tube is coated with a gel so it goes in more easily.
Your child tucks their chin down toward their chest.
The nurse puts the tube into one nostril and slowly moves it down the throat.
The nurse may ask your child to swallow or take a sip of water to help the tube move into place.
The nurse checks the tube position by testing stomach contents or using an x-ray.
The tube is taped to the face, so it stays in place.
It is important for your child to breathe normally and stay relaxed during the procedure. Swallowing air or water through a straw can help move the tube to its proper position.
NG tubes are usually changed every 30 days or as your care team advises.
Note: Procedures can vary depending on hospital policies, resources, expertise, and patient needs. Be sure to discuss your child’s procedure with your care team.
Nasojejunal and nasoduodenal tube placement
A nasojejunal (NJ) tube is placed in your child’s nostril and ends in the small intestine.
Your child may get anesthesia or sedation medicine to help them sleep or relax during the procedure. General steps for NJ or ND tube placement include:
Your child will have the procedure in an interventional radiology or treatment room.
Your child will get anesthesia to help them sleep through the procedure. The care team will watch your child’s heart rate and blood pressure during and after the procedure.
The tube is coated with a slippery gel.
Using imaging guidance, the tube is placed through the nose, down the throat, and into the stomach.
The tube is then guided into the small intestine. A thin wire may help guide it.
The tube is taped to the face so it stays in place.
Note: Procedures can vary depending on hospital policies, resources, expertise, and patient needs. Be sure to discuss your child’s procedure with your care team.
What to expect after feeding tube placement
Nasal feeding tubes can usually be used right away once the correct placement has been confirmed. A member of your care team will go over feeding tube care and instructions. Be sure to keep a list of questions and write down information to make it easier to remember.
Your child may be able to eat and drink by mouth with a feeding tube. Ask your care team about this.
Risks of nasal feeding tubes
Serious problems are rare during feeding tube placement. But problems can happen. Risks include:
Pain or discomfort during placement
Reactions to anesthesia
Injury to the nose, throat, or digestive tract
Tube moving out of place
Tube blockage
Skin irritation or infection
Care at home
Follow your care team’s instructions for tube care and use. General home care tips include:
Wash your hands before touching the tube.
Clean the skin around the nose and tape daily with mild soap and water.
Replace the tape if it becomes loose or dirty.
Flush the tube with the recommended amount of water before and after feedings or medicines.
Use only the type of formula or liquid medicine your care team approves.
Check that the tube is not pulling when your child moves.
Watch for redness or irritation where the tube or tape presses or rubs against the skin.
When to call your care team
Call your child’s care team right away if you notice any of these problems:
Your child has trouble breathing, severe coughing, or choking.
There is bleeding from the nose or throat.
Your child has severe pain or cannot swallow.
There are signs of infection, such as fever, redness, swelling, or pus around the nose or tape site.
The tube comes out or looks like it has moved out of position.
The tube is blocked, and you cannot flush it as instructed.
Your child vomits repeatedly or has stomach pain that does not go away.
Questions to ask your care team
Why does my child need this type of feeding tube?
How long will my child need the tube?
Will my child be awake or asleep during placement?
Can I stay with my child before and after the procedure?
What medicines will be used to help with pain or relaxation?
How do I care for the tube at home?
Can my child eat or drink by mouth while they have a feeding tube?
How often will the tube need to be changed?
Are there any activities my child should avoid?
Key points about placement of nasal feeding tubes
A feeding tube is used to help provide nutrition, fluids, and medicines.
Nasal feeding tubes are placed through the nose. Types include nasogastric (NG) tubes, nasojejunal (NJ) tubes, and nasoduodenal (ND) tubes.
An NG tube goes into the stomach; NJ and ND tubes go into the small intestine.
NG tubes are usually placed while your child is awake. NJ and ND tubes are placed under anesthesia.
Follow all fasting guidelines before the procedure.
Common problems include discomfort, skin problems, tube movement, or blockage. Serious problems are rare.
Always ask questions and make sure you understand how to use and care for the feeding tube at home.
Tube feeding, or enteral nutrition, provides liquid nutrition into the stomach or intestine through a feeding tube. Learn about enteral feeding in children.
If your child has a feeding tube, such as an NG or G tube, it is important to take care of the skin around the tube. Learn skin care tips for feeding tube sites.
