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      Feeding through the G-tube

       

      There are three methods to feeding through the G-tube (click on each to view a video).

      1. Gravity feeding through an open "racked" syringe or bag
      2. Syringe or bolus feeding
      3. Pump feeding

      What formula will you be using?

      • This will be discussed with your nutritionist before the G-tube is inserted.

      How do you advance tube feed?

      You will start the tube feed at a low rate after surgery and gradually advance the rate of the tube feed as your child tolerates the feed.

      There are four options for tube feed: standard, rapid, expedited and tube feed advancement plan. Your surgeon/nutritionist will place you in one of these groups. Please follow the appropriate instructions carefully and please do not deviate from the plan.

      Please note: the G-tube will need to be flushed after every feed. The amount of flush may vary depending on your child, but the usual amount is 10 mL of water.

      Standard tube feed pathway


      • G-tube must be racked for 2 hours after surgery then you may start racked feeds with formula.
      • You will advance your tube feed as instructed by your surgeon/nutritionist.
      • If appropriate, feeds by mouth can be started when rate reaches 1/2 of goal.
      • Your child will be transitioned to bolus feed regimen before being discharged.
      • If your child has never had tube feed before, you will transition to non-racked pump feeds after 3 days.

      If your child has been receiving tube feeds via nasogastric tube, you will transition to non-racked pump feeds once at goal volume.

      Rapid tube feed pathway


      • The G-tube must be vented with a Farrell bag (or open syringe) for 2 hours postoperatively then you may start racked feeds with formula.
      • If appropriate, feeds by mouth can be started when rate reaches 1/2 of goal.
      • You will advance your tube feed as instructed by your surgeon/nutritionist.
      • You will transition to non-racked pump feeds after 3 days.

      Expedited tube feed pathway


      • You will be able to head home after surgery once your child awakes from anesthesia. You will follow up with us closely through the telemedicine platform. You will be instructed as to how to use this platform before you leave the hospital.
      • If appropriate, feeds by mouth can be started anytime after surgery.
      • Please vent the G tube with a Farrell bag for one week after surgery. You will then be instructed how to start the racked tube feeds after.
      • You will advance your tube feed as instructed by your surgeon/nutritionist.
      • You will have a copy of your feeding progression plan and a supply of formula. (Must have in hand at discharge)

      Personalized tube feed pathway


      • Due to special circumstances, your child may be on a personalized tube feed pathway.
      • Please make sure to follow your nutritionist's instructions carefully.



       


       


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