There are three ways to feed your child, and each child will have their own feeding schedule.

Types of feedings:

• Continuous drip feeding: Small amounts of formula are constantly fed throughout the day and/or night. A feeding pump provided the feeding.
• Bolus feeding: Certain amounts of formula are fed at various times during the day and/or night. You can use a large feeding syringe, a gravity drip bag, or a feeding pump to give this feeding. This method is most like the meal and snack routine used by kids who eat food by mouth.
• Combination drip and bolus feeding: Feedings given during the daytime are usually bolus feedings. The other or extra feedings are given by drip during the night.

You and your child’s care team will decide the best way to feed your child. They will also plan a feeding schedule that works best for your family. Try to give your child time to suck and be with others during feedings.

Supplies:

• Formula or liquid food warmed up or at room temperature. Store open cans of formula in the fridge and use within 24 hours.
• Feeding bag and feeding pump or a gravity feeding system.
• Syringe and water for flushing at the end of the feeding. This will likely be 5-10 milliliters but may vary based on your child’s age.
• Feeding extension set if your child has a button-type tube.

Steps:

1. Gather your supplies. Put them within reach.
2. Wash your hands with soap and water.
3. Prime the feeding bag and tubing.
4. Tell your child what you will be doing.
5. Position your child with their head elevated. Hold upright at a 45-degree angle. You can have your child sit in a chair, infant seat, high chair or wheelchair, or with the head of the bed up.
6. Attach the end of the primed feeding bag and tubing to the tube.
7. Unclamp the tube.
8. Turn on the pump.
9. Give the feeding as advised by your child’s doctor or dietitian. If your child cries during the feeding, the feeding will not flow smoothly into the stomach. It is best to stop the feeding, calm your child, and then finish the feeding.
10. After the feeding is done, flush the tube with water. Your child’s doctor may advise extra water at this point.
11. Clamp the tube.
12. Disconnect the tube and secure it.
13. Wash supplies with warm, soapy water.

Supplies:

• Formula or liquid food warmed up or at room temperature. Store open cans of formula in the fridge and use within 24 hours.
• Feeding bag and feeding pump, a gravity feeding system, or a 60-milliliter syringe.
• Syringe and water for flushing at the end of the feeding. This will likely be 5-10 milliliters but may vary based on your child’s age.
• Feeding extension set if your child has a button-type tube.

Steps:

1. Gather your supplies. Put them within reach.
2. Wash your hands with soap and water.
3. If you are using a feeding pump, prime the feeding bag and tubing. If you are using a gravity feeding bag, prime the tubing for the feeding bag.
4. Tell your child what you will be doing.
5. Position your child with their head elevated. Hold upright at a 45-degree angle. You can have your child sit in a chair, infant seat, high chair, wheelchair, or with the head of the bed up.
6. Attach the end of the primed tubing or a 60-milliliter syringe without the plunger to the tube.
7. Unclamp the tube.
8. Start by using the method that works easiest to give the bolus feeding. Either pour the formula into the syringe or turn on the pump.
9. Give the feeding as advised by your child’s doctor or dietitian. If your child cries during the feeding, the feeding will not flow smoothly into the stomach. It is best to stop the feeding, calm your child, and then finish the feeding.
10. After the feeding is done, flush the tube with water. Your child’s doctor may advise extra water at this point.
11. Clamp the tube.
12. Remove the syringe or extension set and secure the tube.
13. Wash supplies with warm, soapy water.

Do not plunge or push the whole feeding. See our troubleshooting tips to learn how to handle tube and skin problems and what to do for a blocked tube. Call the clinic nurse if feedings do not flow easily.

If you feed your baby through a G-tube, offer a pacifier while feeding. This will help your baby connect sucking with feeling full. It also provides comfort and supports early feeding skills.

If your child has a GJ-tube:

• The G-port is for the belly.
• The J-port is for the intestines. Always give feedings by drip into the J-port. Never give feedings by bolus in the J-tube.

To help keep the tube from moving around at the site:

• Make sure you secure the tube during long feedings.
• If your child has a low-profile button-type tube, remove the extension set when it's not in use.

Whether a child with a tube can also eat food by mouth depends on the child. Some kids have a tube because they can’t eat enough by mouth to grow. These kids can also often eat some food by mouth.

Other kids have trouble eating safely. Aspiration occurs when food or drink enters the lungs instead of the stomach. Some kids who aspirate can’t eat anything by mouth, while others can eat and drink small amounts of certain foods.

If your child sees a speech therapist, they will help decide what is safe. Your child’s doctor and therapist will tell you if your child can eat by mouth while also using a feeding tube.

Your child needs enough fluids each day to stay healthy and hydrated. Tube feeding formulas give fluids, but your child may still need extra water. The doctor or dietitian will tell you how much water to give.

Extra water is often given after medicine or between feedings. If your child does not need this, you should still provide a flush with 5-10 milliliters of tap water after each feeding. This helps keep the tube clean and prevents clogs.

Most special formulas for G-tube feedings have the vitamins and minerals your child needs. If your child gets home-blended tube feedings, they may need extra vitamins or minerals. The doctor or dietitian will help you decide what your child needs.