Tube feedings are some times used for patients who have trouble swallowing or cannot take food or medication by mouth.  A feeding tube can go into the nose and down to the stomach or through the skin in the abdomen and into the stomach.

A liquid food (formula) is given to patients through the tube.  There are several ways to give the formula, and there are several kinds of prescribed formulas.  Your doctor will have prescribed a liquid food and the amount to be given at each feeding that provides the necessary nutrition.

Preparing to Give the Feeding

Before you begin the feeding, you will need to:

• Wash your hands before preparing the formula and before giving the feeding.
• Prepare only enough formula that can be used in 24 hours. Refrigerate any open cans or unused formula.
• Allow the formula to warm to room temperature.
• Gather and place in a clean space near the patient:
  • 60 cc syringe
  • Prescribed formula at room temperature
  • 50-60 cc (1/4 to 1/2 cup) warm water
• Assist the patient to a sitting position, or position with head and shoulders raised to at least 30 degrees.
• Unclamp the feeding tube

Uncap the end of the feeding tube or remove the covering.  Check the tube for proper placement to be sure it is safe to give the feeding.  There should be a mark of indelible ink on the tube where it exits the body.

• Attach the syringe to the end of the feeding tube and pull back on the plunger. You will probably feel some resistance.  Within a few seconds you should be able to see stomach fluid (it will be yellow-green) enter the tubing.  If you can’t remove any fluid, help the patient move and turn a little.  Try again to draw up some fluid.  If you draw back more than  of the previous feeding, then wait about an hour before administering the feeding and try again.  Always put back in anything you draw out of the stomach by pushing in the plunger.
• Remove the syringe from the feeding tube to break the suction. Reclamp the tube.

Giving the Feeding

• Remove the plunger from the syringe. Put the end of the syringe into the opening of the tube. Unclamp the tube.
• Slowly pour in 50-60 cc (1/4 cup) warm water, letting it drain in by gravity. If the water flows in easily, then continue with the feeding formula.  If the water does not flow easily, raise or lower the height of the syringe.  It should be no more than about 12 inches above the stomach.
• Take about 15 minutes to administer 200-300cc (about 1 cup) of feeding formula. If you give the feeding faster than this, it can cause stomach upset.
• Try to keep the syringe from emptying. Clamp the tube off to refill it if you need to.  When the end is open with no formula in the syringe, air can enter the tube and cause gas.

Pour in 50-60 cc (1/4 cup) of warm water to clear the tube when you have finished giving the formula.  Use more water if needed to flush the tube because formula can build up on the inside of the tube and cause it to clog.

• Clamp off the tube and remove the syringe or funnel.
• Plug or cap the end of the tube.
• Wash the syringe and plunger in warm, soapy water and rinse thoroughly. Air dry and store in a clean covered container.
• Have the patient remain in a sitting or elevated position for 30-60 minutes after the feeding (if tolerated).
• Call your Hospice nurse if:
  • You do not see a mark of indelible ink where the tube enters the body.
  • The tube feeding does not go in easily.
  • The patient complains of pain or nausea, vomits, or has diarrhea or constipation.
  • The tube falls out.

Special Instructions:

Tube feeding formula:_________________________________________

Amount to be given at each feeding:  _______________________________

How often to give the feeding____________________________________

Other instructions: _________________________________________________________________________________________________________________________________________________________

Call Suburban Hospice, Inc., 833-888-7222 if you have any questions or concerns.  We want to be responsive to your needs.