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Enteral nutrition - child - managing problems

Enteral feeding is a way to feed your child using a feeding tube. Enteral feedings will become easier for you to do with practice. Your nurse will go over all of the steps you should follow to deliver the feedings.

You will learn how to care for the tube and the skin, flush the tube, and set up the bolus or pump feedings.

Sometimes a feeding does not go as planned, and you may have a minor problem. Your nurse will go over all of the things that can happen and what you should do.

What Should I Watch For?

Follow your doctor or nurse’s instructions on how to solve problems if they come up. Below are some general guidelines.

If the tube is clogged or plugged:

  • Flush the tube with warm water.
  • If you have a nasogastric tube, remove and replace the tube (you will need to measure again).
  • Use a special lubricant (ClogZapper) if your nurse or doctor has told you to use one.
  • Make sure any medications are crushed properly to prevent clogging.

If the child coughs or gags when you insert the nasogastric tube:

  • Pinch the tube, and pull it out.
  • Comfort your child, and then try again.
  • Make sure you are inserting the tube the right way.
  • Make sure your child is sitting up.
  • Check the tube placement.

If your child has diarrhea and cramping:

  • Make sure the formula is mixed properly and warm.
  • Do not use formula that has been hanging for feeding for more than 4 hours.
  • Slow the feeding rate, or take a short break. (Make sure you flush the tube with warm water in between breaks.)
  • Check with your doctor about antibiotics or other medications that may be causing it.
  • Start feeding when your child feels better.

If your child has an upset stomach or is vomiting:

  • Make sure the formula is mixed properly and warm.
  • Make sure your child is sitting up during feedings.
  • Do not use formula that has been hanging for feeding for more than 4 hours.
  • Slow the feeding rate, or take a short break. (Make sure you flush the tube with warm water in between breaks.)
  • Start feeding when your child feels better.

If your child is constipated:

  • Take a break from feeding.
  • Check with your doctor about choice of formula and adding more fiber.

If your child is dried out (dehydrated), ask your doctor about changing formula or adding additional water.

If your child is losing weight, ask your doctor about changing formula or adding more feedings.

If your child has a nasograstric tube and the skin is irritated:

  • Keep the area around the nose clean and dry.
  • Tape down over the nose, not up.
  • Switch nostrils at each feeding.
  • Ask your doctor about a smaller tube.

If your child’s Corpak feeding tube falls out, call your child’s nurse or doctor. Do not replace it yourself.

When to Call the Doctor

Call your doctor if you notice your child has:

  • Fever
  • Diarrhea, cramping, or bloating that does not go away
  • Excessive crying, and your child is hard to console
  • Nausea or vomits frequently
  • Weight loss
  • Constipation
  • Skin irritation

If your child has trouble breathing, call 911.

Update Date: 10/8/2012

Updated by: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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