Nasogastric tube feeding at home

Who is this information for?

This leaflet is meant for parents who may be taking their baby home from hospital, who still needs some feeds by a nasogastric tube.

What is a nasogastric tube?

A nasogastric tube is a thin soft plastic tube that is passed through your baby’s nostril, down the back of the throat, through the oesophagus (food pipe) and into the stomach. A nasogastric tube is sometimes called an ‘NGT’. The NGT is then held in place by being taped to the side of your baby’s face, near the nostril. The tube is used to give your baby feeds and sometimes medicines.

Benefits

The benefits of taking your baby home while tube feeding are that you will get home earlier, your baby will thrive better in the home environment and bonding and family building can begin earlier.

Risks

The risk with NGT feeds is that the tube may become dislodged and that is why the tube is tested before each feed, to make sure it is in the right place. You will have been feeding your baby this way while they were in hospital and the staff will make sure that you are confident before taking your baby home. If the tube becomes dislodged, but your baby is able to take some of their feed by sucking then please orally feed your baby and then a member of the team will come and replace the tube, if it is within their working hours.

If, however, your baby cannot take any feed by mouth because they are too sleepy, then it will be important for the tube to be replaced promptly. Parents should take their babies to accident and emergency to get this done.

Contacts

Neonatal outreach team: 01223 216079 (24-hour answer phone service)
We work seven days a week – Saturday 08:00 - 16:00.

Outside of these hours please contact the neonatal unit,
Telephone number: 01223 245151 bleep 156 2279 MOTD

References / sources of evidence

NPSA. (2005) Carers briefing for those looking after babies under the care of neonatal units in the community.

Neonatal outreach team support at home

Establishing breast or bottle feeding of a premature baby can be a slow but rewarding process.

It is important that your baby has enough calories to ensure good weight gain. Your baby may be discharged home receiving some of their feeds by a nasogastric tube as well as breast or bottle feeding.

Your baby must be able to complete two full breast or bottle feeds in a day in order to be discharged home under the care of the outreach team. As your baby is able to breast / bottle feed well and achieve a satisfactory gain of weight, the amount and number of full nasogastric feeds will decrease. The pace of this decrease will be adjusted to suit you and your baby.

A feeding plan will be discussed with you before discharge and clear guidelines for feeding will be given for you to follow at home. You will also be given feeding charts to complete at home, for the outreach team to review during their visits.

Careful monitoring of progress with feeding and weight gain will be done by your outreach nurse at each home visit. Changes will be made to the care plan after discussion with you. Your outreach nurses will usually visit twice a week while the nasogastric tube is in place, followed by weekly visits until your baby is fully breast / bottle feeding, gaining weight and you and your family are confident and happy with caring for your baby.

Why does my baby need a tube?

Your baby may have had a tube inserted for various reasons:

• They may have been born early and because of this, not have developed the ability to suck fully.
• Your baby may have a problem with sucking and swallowing because of an illness or syndrome.
• Your baby may not be able to complete all of each feed that is needed to ensure proper growth and development.
• Your baby may be jaundiced and needs help with feeding because of sleepiness.

Equipment needed for home NGT feeding

• 20 ml syringes
• 5ml syringes
• PH indicator strips
• Extra tape
• Spare nasogastric tube
• Cold water sterilising solution or tablets
• Cold water tank
• Expressed breast milk or formula feeds

Testing the tube

The tube must not be used for feeding unless it has been tested with PH paper to ensure that it is still in the correct place.

Tube feeding procedure

1. Wash your hands and prepare the feed.
2. Ensure that your baby is comfortable before starting to feed
3. Test the tube (see section of the leaflet ‘Testing the tube’).
4. Draw up the milk into the 20ml syringe. Then pull back the plunger carefully until it meets resistance at the end of the barrel.
5. Attach the syringe to the nasogastric tube and withdraw the plunger from the barrel. The milk may now flow easily or it might need a gentle push on the plunger to get it going. Allow the milk to descend by gravity and continue until all the feed is gone.
6. Disconnect the syringe and close the end of the tube.