Nasojejunal NJ tube (3013)

What is a NJ tube?

An NJ tube is a feeding tube. It is put in the nose and goes down the food tube (esophagus), past the stomach. It ends in a part of the small intestine called the jejunum. The tube is used to give feedings, liquids and medicine to your child. Feedings go right into the intestines instead of the stomach.

Why does my child have a NJ tube?

Your child has had a hard time getting feedings into the stomach. It may be from:

• slow stomach emptying.
• severe tummy pain, choking, coughing, gagging or vomiting during feedings. 
• Some children can’t gain weight when this happens.  Children who have breathing problems may need this type of tube.

What supplies do I need?

For site care:

• Tape
• Tegaderm™

For feeding and medicine:

• Different sizes of Enfit syringes (5mL, 10mL)
• Feeding pump and bags

How do I care for a NJ Tube?

Securing:

• Clean your child’s face with soap and water, rinse and completely dry with soft towel. Tape the NJ tube in place on the nose and cheek. 
• If the tape holding the NJ tube in place starts to get loose, carefully re-tape or reinforce. This is important to keep the tube from coming out. 
• Secure the tube in place by hanging it over the ear, taping behind the ear or taping or pinning it to clothing.
• If the NJ tube is secured with a Bridle clip, keep the face and tube clean.  If your child has a nasal bridle, clean the bridle with baby shampoo and water every day. Gently loop NJ tube behind ear and secure behind the ear with a piece of tape.  Loop the remaining tube and pin or tape to clothing.

Flush daily to prevent blocking:

• Gently flush the tube four times a day. Use 10 mL of water to flush.
• Flush the tube with water slowly after medicine is given.
• During continuous NJ feeds you will need to stop the feeds to do the flushes.
• Flush the tube by pulsing the syringe of water into the tube after feedings are given.
• If your child is less than 10 pounds or is on a fluid restriction, follow the flushing guidelines given by your doctor.

How do I feed my child?

• Feedings are given by a slow drip method. This helps prevent vomiting, diarrhea or discomfort.
• Set the feeding pump to give the feeding as you were told by the doctor or dietitian. 
• When the feeding is done, disconnect NJ tube from feeding pump. 
• Gently flush the NJ tube with 10ml water flush. 
• Close the feeding port cover.

How do I vent or drain the stomach?

NJ tubes cannot vent or drain the stomach. If you need to vent or drain your child’s stomach, talk to your child’s provider. 

How long will my child have a NJ tube? 

An NJ tube is short-term. Most children need the tube for short periods of time. 

• Once the first NJ tube is in and feedings are going well, attempts will be made to go back to feedings into the stomach. 
• If your child accepts being fed into the stomach, the NJ tube may be changed for a gastric tube (NG or G-tube). 
• If your child gets most calories by mouth (oral), the NJ tube may be removed. 
• If your child needs an NJ tube longer than 4 months, the doctor may talk to you about the need for a permanent jejunostomy (J-tube.) 

Troubleshooting problems

If the NJ tube is blocked:

• Use a 5mL syringe filled with sugar-free carbonated water or club soda and try to flush. You may also use a 10mL, 3mL or 1mL syringe. Smaller syringes have higher pressure and may help to unclog the tube.
• Push and pull on the plunger of the syringe to unclog the tube. Push and pull on the plunger until the tube is easy to flush. You may have to push more firmly than you are used to.
• If you are not successful right away, leave the carbonated water in the tube for 20 minutes.  Then try to flush the tube again.
• If you are not able to clear the tube, contact Imaging (Radiology) to replace the tube.