Tube feeding with a nasogastric or nasojejunal tube — Canterbury Whāngai ā-ngongo ki te ngongo ā-ihu

The NG and NJ tubes let you have special liquid food (feed), medications and fluids if you cannot meet all your nutritional needs by eating normally.

Tube feeding

Flush your feeding tube with warm water:

• before and after you tube feed
• before and after you take medications down your tube
• every 3 to 4 hours during the daytime whether or not you are feeding — to stop it blocking.

If you have safe drinking water, you can use tap water to flush your tube. Otherwise, use boiled, cooled water.

Ways to feed

If you have an NG tube, there are 3 ways of tube feeding:

• gravity feeding
• bolus feeding
• pump feeding.

Your dietitian will decide which type of feeding is best for you.

If you have an NJ tube, you can only use pump feeding.

Gravity feeding

This is where the feed flows out of a syringe or feed bottle and into the feeding tube by gravity.

Bolus feeding through a syringe

This is when you have a set amount of feed at specified times during the day. This is like having meals at mealtimes.

Pump feeding

This is when a pump is used to continuously deliver a set amount of feed through your feeding tube over a set amount of time.

Your dietitian will discuss the options with you in more detail and provide you with a plan and instructions when needed.

• After feeding, wash the syringe with mild dishwashing detergent, rinse thoroughly and leave it to air dry.
• Put the syringe in a clean zip-lock bag or a clean container with a lid. Keep it in the fridge to prevent it being contaminated by germs (bacteria).
• You can use each syringe for about 2 weeks.
• Giving sets (only used for pump feeding) can only be used once. Throw them away after you have used them for 24 hours and do not reuse them.
• Cover open cans or bottles of feed and store them in your fridge. Throw away any open, unused feed after 24 hours.
• You can use open ready-to-hang bottles of feed for 24 hours. Throw away any open, unused feed after 24 hours.
• Your feed should be at room temperature when you use it. If it has been in the fridge, leave it for 30 minutes before using it.

Your feeding tube may block if you do not flush it regularly or do not take your medications correctly.

You can stop your tube from blocking by flushing it with warm water. You need to do this before and after each feed and before and after giving medications. You also need to do it every 3 to 4 hours during the daytime whether or not you are feeding.

If your tube gets blocked try the following, which may clear it:

• check for any kinks in the tubing
• massage the tube from the nose end, out towards the end of the tube
• insert a 60 ml syringe into the end of the tube
• pull back the plunger and withdraw as much fluid as possible from the tube
• take the syringe out of the tube and throw away the fluid you withdrew
• half-fill a 60 ml syringe with warm water and attach it to the end of the tube, move the plunger back and forth to try to clear the blockage
• massage the tube again and then use the back and forth action with the plunger to try to clear the tube
• if you have repeated this 3 or 4 times and you cannot unblock the tube, call the contact number given to you by your dietitian.

The hospital pharmacist will review your medications before you go home. They will make sure you can take them through your feeding tube. There are some important points to note.

• Use the main port of your feeding tube for medications.
• Use the bolus feeding method to put medications down your feeding tube, unless your dietitian or nurse tells you to do it another way.
• Flush your tube with 20 ml warm water before and after giving medications. This helps stop your feeding tube from getting blocked.
• If you have more than one medication, take each one separately. Flush your feeding tube with 10 ml to 15 ml of warm water between each medication.
• Finely crush each solid medication separately (a mortar and pestle is best for this). Mix it with 10 ml to 15 ml of water before putting it down the feeding tube.
• You can take liquid medications down your feeding tube without diluting them.

When you are discharged from hospital, the hospital dietitian will give you a small supply of nose plasters, syringes and giving sets.

When you need more nose plasters, you can order them from your local pharmacy. Nasofix is one of the brands you can use.

Your dietitian will organise your first supply of syringes and giving sets. For an ongoing supply, contact the Health New Zealand  Supply Department for Canterbury (see details below).

Give as much notice as possible. Let them know if you cannot collect the syringes and giving sets — they can courier them to you. There is no charge for giving sets, syringes or delivery.

If you are under the care of the Ashburton Hospital dietitians, phone the Ashburton Supply Department (see details below). You will need to collect your giving sets from the Supply Department.

Your hospital dietitian will organise your feed when you first go home. After this, your community dietitian or healthcare provider will organise it. If you need to contact your feed supplier because your feed has not arrived, use the contact details below.

Health New Zealand Supply Department

To contact the Health New Zealand Supply Department for Canterbury:

• phone: 03 364 0082 or 03 364 0080
• address: 4 Rapide Way, Yaldhurst, Christchurch (near the airport).

Our hours are Monday to Friday, 7:30am to 4:30pm.

Ashburton Hospital Supply Department

To contact the Ashburton Hospital Supply Department:

• phone: 03 307 8462
• address: Ashburton Hospital, Entrance D, 12 Elizabeth St, Ashburton.

Open for collection Monday to Friday, 10:30am to 2:30pm.

Feeding pump suppliers

For any issues with your pump, use the following contact details:

FreeGo pump (Abbott)external link

• phone 0800 738 090

Flocare Infinity pump (Nutricia)external link

• phone 0800 222 430

Kangaroo Joey pump (Cardinal Health)external link

• phone 0800 522 400

Feed suppliers

Abbott and Nestle feed (through Unichem Ilam Healthworks Pharmacy)

• phone: 03 351 8633

Nutricia feed

• phone: 0800 688 747