Inserting a feeding tube for an infant

30 day Ng tube
30 day Ng tube

Why does my baby need a feeding tube?

Your baby needs a tube directed into her stomach to help her with feedings when she is having coordination issues with sucking, swallowing, and breathing. The tube is made of a soft material that is placed in your infant's nose or mouth, goes down the esophagus, and into her stomach. The tube feedings will help your baby receive necessary nutrition to help her grow and develop until she is able to feed by mouth.

Even though the baby has a feeding tube, she should be held, offered a pacifier, or allowed to suckle at her mother's emptied breast because feeding time is still a very important, special time for bonding.

Why do I need to know how to insert the tube?

You should know how to re-insert the tube just in case your baby pulls her own tube out or if it is time to change an old tube. Our daughter is in the NICU, and we are learning how to manage her care in order to bring her home sooner, so the feeding tube is a part of the process. It may be a little intimidating at first, but you can manage this task. The baby is not in pain and it is a quick, easy procedure that is necessary for her growth and development.

Feeding tube supplies

Feeeding tube, sterile water, and two types of tape
Feeeding tube, sterile water, and two types of tape

Supplies you will need to insert the tube:

Your baby's doctor or heathcare provider should be able to give you these necessary supplies for changing and inserting your baby's feeding tube:
  • New or clean feeding tube
  • Water to moisten the end of the tube
  • Permanent marker to mark the measure length of the tube
  • Tape for securing the tube to your infant's face
  • Skin barrier to use under facial tape
  • Stethoscope for checking tube placement

Getting ready:

  • Gather all of your supplies
  • Position the baby on her back. You may want to have another person hold the baby or swaddle her for comfort.
  • Decide where to place the tube: left nostril, right nostril, or the mouth.
  • Cut a 2" piece of facial tape to secure the tube once placement is confirmed.
  • Cut a 2" piece of skin barrier tape to apply to the skin where the tube and tape will go.
  • Thoroughly wash and dry your hands
  • Measure the length of tube needed to reach the baby's stomach.

Measuring for nose insertion

How to measure the length of tubing needed

  1. Hold the end of the tube next to the tip of your baby's nose or to the corner of her mouth.
  2. Measure out the tube across the face to the ear and down to the bottom of the baby's sternum.
  3. Mark this measurement on the tube with the permanent marker.

Inserting the tube:

  1. Ensure that the infant is awake and comfortable.
  2. Dip the end of the tube in water.
  3. Gently insert the tube through the nostril or mouth using a back then downward motion. Thread the tube down until you reach the measured point.
  4. The baby may gag during this procedure. Offering a pacifier may help alleviate some of this and the gagging should stop once the tube is in place.
  5. Lightly tape the feeding tube in place. The cheek or chin works best.

Checking the tube placement:

  1. Attach a syringe filled with air to the end of the tube.
  2. Place the stethoscope over the baby's stomach.
  3. Push air into the tube and you should hear a whoosh or gurgle of air in the stomach.
  4. Pull back gently on the syringe to check for stomach contents. They should be clear, mucus, or residual milk. Contents should NOT be brown, green, or bloody.
  5. If you hear the air and pull stomach contents, you have the tube in the correct place.

Problems to look out for:

  1. If the baby continues to gag, has labored breathing, or turns blue--remove the tube and try again later.
  2. Watch for an increase in stomach size, firmness, or inability to pass gas.
  3. If your baby vomits, stop the feeding immediately. A bulb syringe helps remove contents from the baby's mouth to prevent them from swallowing the vomit. Check the tube's position when the vomiting stops. Call the baby's doctor before continuing any feeding.
  4. If your baby has diarrhea, stop the feeding and call her doctor for further instructions.

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