Infants/
Children

If your child is old enough to understand and is alert, he or she will be told what is going to happen and why. They’ll be encouraged to hold very still during the feeding tube placement. A nurse may help hold your child while the tube is being placed. Parents might want to offer a reward or a treat to encourage their children to cooperate with the nurses. Providing older children a distraction, such as an iPad, book, or toy may help take their mind off the procedure.

If your child is a baby or toddler, they may be swaddled in a blanket for greater comfort.

Infants and children respond best if a parent is there beside them, offering consolation and support. If you don’t feel like you can do this, it’s OK. You can leave the room and return after the procedure is done.

An NJ-tube can be placed in a variety of ways. Your child may be taken to a special procedure room in the X-Ray department, or may be taken after the tube was placed to get an X-Ray, or may not have to be taken to another room at all, based on the equipment available at the facility. When a special room isn’t needed, placement is done at the child’s “bedside”.

Tube placements done by nurses at your child’s bedside may include a piece of equipment called CORTRAK*. This device allows the staff to watch the tube’s passage on a screen. If used, your child will have a triangle-shaped sensor unit placed on the lower chest area and you can be present to watch. If the hospital you’re in does not have this device, nurses may still place the tube at bedside, repositioning your child as needed, during the procedure. The tube will pass through the nose and throat, into the oesophagus, down into the stomach and finally be guided through the small opening (called a pylorus) into the small intestine. This procedure may take several minutes.

Please know that the procedure may be uncomfortable, and your baby may cry. This doesn’t mean anything is wrong.

After the placement is done, the tube will be taped onto the cheek or nose. Your nurse may mark the tube with ink at the nose so they can see if the tube moves. If a CORTRAK* device wasn’t used, your child will be taken to have an x-ray to confirm the tube is in the right place to start feeding.

It’s normal if your baby or child has a stuffy nose or a little discomfort after the procedure, so don’t be alarmed. Pain medication usually isn’t needed.

You’ll want to watch your child and make sure they don’t remove the tube, since babies and children sometimes will try. You won’t be taught how to replace the tube at home. The home care team will discuss tube replacement and management with you before you go home.

Ask the nurse any questions you may have before you go home. You might even want to keep a list of questions with you, such as how to give feedings, what problems you should watch for, who to contact if you have questions, and what supplies you’ll need and where to get them. Even if your child isn’t allowed to take liquid by mouth, you’ll still want to practice oral care and should ask for or get an infant swab or toothbrush to have on hand to clean your childs mouth and keep it moist.

One more tip: in some cases, you’ll need to give medications down the NJ-tube. If so, ask if the medicine needs to be diluted first. You’ll also need to flush the tube before and after giving the medicine and feeding to prevent clogging.

The first thing you’ll want to do when you get home is find a place to store your supplies that is out of your child’s reach. If your child needs a feeding pump, keep the tubing off the floor so it doesn’t create a tripping hazard. You’ll also want access to a clean space where you can prepare the formula. Your dietitian, nurse or homecare company will advise you and arrange for your ongoing supplies before leaving hospital.

You will have been advised to check the tube with a pH test several times a day to make sure it hasn’t moved (you will be shown how to do this before leaving hospital). If you ever have any doubts about tube placement, don’t use the tube and seek advise from your homecare professional.

Also remember, that even if your child isn’t eating or taking medication by mouth, oral care is still very important. Frequent toothbrushing or using infant oral swabs are necessary to clean and keep the mouth moist.

Refer to your notes or discharge information as you get started. Keep your urgent and emergent handout on hand for quick reference.

Remember: the first day at home after any big change is going to require some adjustment. But before long, you’ll become more used to what to do and how to do it and you’ll develop a new routine that’s second nature to you. One more tip: in some cases, you’ll need to give medications down the NJ-tube. If so, ask if the medicine needs to be diluted first. You’ll also need to flush the tube before and after giving the medicine and feeding to prevent clogging.