Nasogastric tube placement for children and teens (1405)

Key points below

For children and teens

What is a Nasogastric (NG) tube?

It is a thin, soft tube that goes in your child’s nose and down the throat (esophagus) into the stomach. NG tubes are used to give nutrition or medicine to your child.

Your doctor or nurse will tell you if you need to learn how to put the tube in. They will also tell you how often you should change the NG tube.

When is the best time to change the tube?

Choose a time before feeding or giving medicine to put in the NG tube.

Your child’s stomach should be nearly empty. This will help keep your child from throwing up when the tube is put in.

What supplies are needed?

If the NG tube is not broken when you change it, you can use it again, if needed.

You must wash the NG tube well with warm water and soap before re-using it.

NG tube.
½ inch tape, cut 2 pieces.
Water soluble lubricant. This will be given to you by the home care agency.
Small syringe (5 to 10 mL).
Measuring tape.
pH strips.
Tape to hold NG in place (if desired).

How is the NG tube put in?

Before you begin, tell your child what you are going to do.

1. Get your supplies.

2. Attach the syringe to the end of the NG tube.

3. Wash your hands for at least 20 seconds with warm water and soap.

4. Use a different nostril each time you put in the NG tube.

5. Have your child lay in a crib or bed. If it is safe, your child can recline in a chair. If your child is active, someone will need to hold your child while you put the tube in.

6. Measure the tube.

Place the tip of the tube on the stomach between the belly button and the lower rib cage. Hold it there.
Bring the tube up to your child’s ear lobe then out to the nose.
Mark the end of the NG tube with a piece of tape at the tip of the nose.

7. Put the tube in.

Dip the tip of the NG tube in water soluble lubricant to wet the tube.
Put the tip of the tube in one nostril and gently push it to the back of the throat. Sometimes it is helpful to have your child lower their chin to their chest.
Have your child take a sip of water through a straw while you are putting in the NG tube. This may help it go in.
Quickly push the NG tube in until the piece of tape is at the tip of the nose (nare). Do not force.
Tape the NG to your child’s cheek. To help keep the NG from being pulled out by accident, you may loop the NG tube and tape it behind the ear or to clothing.
Measure how long the tube is from the nose to the end of the tube. Write this measurement down.

Note, If child turns has any of these problems:

breathing
coughs a lot
gasps
cries without sound while putting in the NG tube
pull it out! Stop and give your child a rest. Then try again.

How will I know the NG tube is in the stomach?

Be sure to check that the tube is in the right place in the stomach each time you put it in, before each feeding, or before giving medicine.

You must check the pH to make sure the NG tube is in the stomach every time you place the NG tube.

To check pH:

Do this on an empty stomach. Right before the feeding, attach a syringe to the end of the NG tube. Pull back on the syringe and check for stomach contents. If you get stomach contents, place a drop on the pH strips and compare with the guide on the box. If the pH is below 5, the NG tube is in the stomach. However, you will not always get stomach contents even though the NG tube is in. If nothing comes out, wait 5 minutes, push a small amount of air through the NG tube, and try a second time to pull back and check for stomach contents.

To measure the NG tube:
Measure the outer portion of the NG tube (from tip of nose to end of tube). Compare this measurement with previous measurements. There should be less than 5 centimeters difference between the old (when the NG tube was placed) and new measurements.

Are there any complications with the NG tube?

The NG tube may go into the lungs when it is put in.

Your child may:

Vomit.
Have nasal congestion.
Cough a lot.
Have an increase in bowel movements.
Choke.
Be very crabby.
Make a gurgling sound when they breathe.

If any of these happen, remove the NG tube and call your doctor.

ALERT

Call your child’s doctor, nurse, or clinic if you have any questions or concerns or if:

You are not able to put the NG tube in either nostril.
Your child has special health care needs that were not covered by this information

If you have concerns, call your provider or nurse. During normal business hours, call the office. After hours, call the CHW Operator 414-266-2000 and ask them to page the GI fellow on call.