Caring for Your New Feeding Tube

 

Activity

Allow yourself to rest today.

Your abdomen will feel sore for a few days.  Use pain medicines as prescribed.

Use caution with seat belts or activities that could pull on your tube.

 

Skin Care

Clean the skin around your tube site every day.

• Always wash your hands well before touching the skin and tube.

• Use warm water and mild soap such as Dove or Oil of Olay.

• Clean in a circular motion, starting at the tube site and working outward.

• If you have a plastic disc (bolster) next to your skin holding your tube, you may use a Q-tip or gauze to clean under the plastic.

If you have T-fasteners:

• T-fasteners are small clear buttons on your skin around the tube.

• Keep the T-fasteners clean and dry. Use mild soap and water and a Q-tip or gauze to clean around them daily.

• T-fasteners should dissolve in 3 weeks. This will allow the buttons to fall off. T-fasteners can also be removed by your primary clinic in 3 weeks.  If this does not happen, call the clinic that placed your tube for help.

You may have some drainage with a small amount of blood around the tube site for the first week.

• You can use a clean dressing over the bolster to soak up drainage during this time.

• Change the dressing every day to prevent infection.

• Once the drainage has stopped, you no longer need a dressing.  (Dressings can trap moisture and increase the risk of infection.)

Do not use:

• Special cleansers or skin preparations such as hydrogen peroxide on your skin.  They can cause irritation.

• Antibiotic ointments on your skin.  They trap moisture and could cause infection.

• Do not use large dressings and tape.

Check your skin daily for redness, leakage, swelling, bleeding, pain, or soreness.

Call for help if you have concerns.

 

Bathing and Swimming

Showering:

• Wait 24 hours after your tube has been placed before you take a shower.

• You do not have to cover it. Let the water run over it. Do not scrub.

Tub bath:

• Wait 14 days for a tub bath.

• If you have T-fasteners, wait until they have dissolved or been removed before you have a tub bath.

Swimming:  If the skin around your tube is well healed and you don’t have any leakage, you may swim at your own risk with the tube uncovered.  A well maintained chlorinated pool with few babies and children is probably fine.  Swimming in lake water is not a good idea due to the risk of infection.

 

Tube Placement

Check the tube placement daily to be sure that:

• The marker on the tube is always the same number: _____________________________

• If your tube has no marker numbers, measure the tube length from the skin to the end of the tube: _____________inches.

If the tube falls out, call to have the tube replaced right away.

• If you do not get the tube put back in soon, the hole could close.

• Call the doctor’s office where your tube was placed right away.

• If it is after hours, go to the emergency room.

• If it is after hours AND your tube was placed by Interventional Radiology at St. Mary’s, call 218.786.8364 and ask the operator to page the radiology nurse on call.

• Never try to put the tube back in. Cover the hole with a clean dressing and use tape to secure it.

• Do not use the tube for feeding or medicine until it has been replaced by your healthcare provider.

• Always secure your tube to your skin.  This will help prevent making a bigger hole around your tube, which could cause leakage.

 

Tube Flushes

Flush the tube often with warm tap water to prevent the tube from clogging.

Flush the tube with at least 30 mL (1oz) of water:

• Once a day if you are eating well and do not need to use your tube.

• Every 4-6 hours while awake if you are using continuous pump feedings.

• Before and after checking residuals.

• Before and after intermittent feedings.

• Before and after receiving medicines.  (If you receive more than one medicine at a time, use 5mL of water between each medicine.)

 

Clogged Tube

Watch for kinks.  Make sure the tube is never pinched off.

If you have a clogged tube:

• Place a 60mL (2 oz) syringe into the tube and pull back the plunger to remove extra fluid.  Remove the syringe from the tube and throw away the fluid.

• Draw up 10mL of warm water into the syringe.  Place the syringe into the tube and gently move the plunger back and forth to clear the tube.

• If the clog doesn’t clear, try the steps above again.  If this still does not help, call your healthcare provider for help.

 

Medicines

Ask your pharmacist before using a new medicine through your tube.

• Use the liquid form of a medicine when it is available.

• If the medicine only comes in a tablet, crush the tablet into a fine powder and mix well with water.

• Do not crush time-released or enteric-coated tablets or capsules.  Some capsules contain beads that do not dissolve in water. Ask your pharmacist for advice.

Flush the tube with 30 mL (1oz) of water before and after giving medicines.

• Do not add medicines to the tube feeding formula.

Flush the tube with 5 mL of water between medicines.

• Do not mix medicines together. Give them one at a time.

• If you have a lot of medicine you take every day, talk to your dietitian about how much water to use.

 

Positioning During Feeding

• Do not feed yourself while lying flat.

• Sit in a chair or prop yourself up to at least a 30 degree angle.

• Stay in a raised position for at least 1 hour after your feeding is done.

 

Call for Help If:

• You have redness, unusual drainage or leakage, swelling, bleeding, pain or soreness around the tube or around your T-fasteners.

• The marker on your tube has changed more than 2 numbers or the length of your tube has changed more than 1 inch.

• The tube falls out. Call right away. Do not delay.

• You still have T-fastener buttons in place 3 weeks after the tube has been put in.

• The tube stabilizer is loose and you can’t tighten it, or you can’t get it off to change it.

• You cannot clear a clogged tube.

• You have nausea, diarrhea, extreme gas or bloating that lasts for more than 24 hours.

• You have constipation that lasts for more than 3 days (depending on your normal frequency).

• You have hard stools for more than 5 days.

• You have a fever.

 

Call for help if you have any concerns!

 

Tube Information:

Type of tube: _____________________________________________

French size of tube: ________________________________________

Brand of tube: ____________________________________________

Tube secured or stabilized with:________________________________________

(important if you need your tube replaced)

For More Information

See the booklet called Tube Feeding, A Step-by-Step Guide from Krames, 2006.