How to Care for Feeding Tube

Always keep the skin around your child's stoma clean and dry. Each time you clean or dress the area, look closely for signs of skin irritation or infection.

If the skin around the tube or button looks red and irritated, please read "Do You Know… Troubleshooting Feeding Tube Problems."

You need to know what type of feeding tube your child has so you can care for it correctly. Below are the different types of tubes and how to care for each one.

Mushroom tubes

These tubes are held in place by a secure dressing. Clean the skin around the tube at least one (1) time every day or any time you see fluid draining from around the tube.

Use a cotton swab and water to clean the area. If the skin looks red or irritated, call your St. Jude team. If the dressing is starting to come off or look old, contact your child's clinical nurse specialist to have it changed.

All other tubes

Clean the skin around the gastrostomy site every day with soap and water. You might be able to do this when your child takes a bath or shower. Change the dressing every day or when it gets wet or dirty if a dressing is present. You might need someone to help hold your child while you change the dressing.

Gastrostomy tubes (G-tubes) or low profile gastric tubes (G-buttons) should be turned one-quarter turn each day. Your clinical nurse specialist will show you how it should be turned. Gastrojejunal tubes (GJ-tubes) or low profile gastrojejunal tubes (GJ-buttons) should never be turned. Turning a GJ-tube or button can move it out of place and keep it from working correctly.

Check with your child's clinical nurse specialist to be sure you know if your child's feeding tube should be turned or not. If you see any redness or irritation around the tube, tell your child's St. Jude team right away.

Steps for skin care

• Wash your hands with soap and water. Dry them well. See "Do you know. . . Clean hands."
• Have someone hold your child's hands if needed.
• Gather your supplies in a clean work area.
• A germ-free (sterile) saline wipe, cotton swab or washcloth
• Water (tap or sterile)
• Soap
• Towel or gauze to dry the site
• Barrier cream or other medicine, if needed
• Split gauze or other dressing, if needed
• Open each package, making sure the items stay clean.
• Clean around the tube using a washcloth with soap and water, a sterile saline wipe, or a cotton swab and water. Start next to the place where the tube goes into the stoma and swab outward. You might also need to wipe the tube, the stabilizer wings, or the disc that holds the tube steady (retention disc).

• Remove any extra soap and dry the area well.
• If needed, apply a barrier cream or other medicine as directed.
• If needed, apply a split gauze dressing or other dressing.

Checking the balloon on a low profile tube (button)

If your child has a low profile gastric tube (G-button), you need to check the balloon for leaks one (1) time each month. The balloon valve is a white port on the button labeled BAL. Only use a slip tip syringe to check the balloon through the balloon valve. Do not use a Luer Lock syringe because it could damage the one-way valve. Never feed your child through the balloon valve.

Follow these steps to check the balloon:

Gather supplies

• 10 ml slip tip syringe
  
• Sterile water

Steps to check the balloon

• Hold your child's tube in place with one (1) hand during the entire balloon check.
• Attach the slip tip syringe to the BAL (balloon) port.
• Pull back on the plunger to remove all water from the balloon.
• Note the amount in the balloon. Your child's balloon will hold _____ml of water.
• Put the water back into the balloon after you see that it has the correct amount.
• If the balloon has less water than it needs, add the correct amount to the slip tip syringe and put the water into theballoon.
• Disconnect the slip tip syringe.
• Check the balloon one (1) time each month unless you think it might be leaking. If you think it might have a leak, check it more often. Talk to your clinical nurse specialist if you have questions.

Attach tip to port

Pull back on plunger

Push water back in balloon

Protecting the tube

All types of feeding tubes must be held in place. Otherwise, one of the following things can happen with the tube:

• Move into your child's body, possibly blocking the opening of the small intestine.
• Come out (replacing the tube is an emergency).
• Move back and forth, stretching the stoma so stomach contents leak onto your child's skin.
• Move back and forth, causing granulation tissue. See "Do You Know… Skin Problems with a Feeding Tube" to learn more about granulation tissue.

The tube must be held in place so the loose end cannot be pulled out. Mushroom tubes, conventional tubes, and low profile tubes (buttons) with extension tubing have long, loose ends. Keep the tube in place by taping the loose end to your child's belly or using a secure dressing to keep the tube from pulling.

If the tape irritates your child or he pulls at the tube, you might want to dress your child in a onesie, an Xspan shirt, or a form-fitting T-shirt. This clothing holds the tube close to the body. You can also try tucking the tube inside your child's shirt. Avoid direct pressure on the feeding tube site and protect it from injury.

Questions?

If you have questions about skin care or dressings used for feeding tube sites, please talk to your child's clinical nurse specialist.

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Source: https://www.stjude.org/treatment/patient-resources/caregiver-resources/patient-family-education-sheets/feeding-tube-information/skin-care-and-dressings-for-feeding-tube-sites.html