HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 11-9
Pediatrics: Gavage Feeding __RN
12. If the tube does not appear to be in place, insert it
several centimeters further and test again. Do not
begin feeding until you're sure the tube is positioned
properly.
13. When the tube is in place, fill the feeding reservoir
or syringe with the formula or breast milk. Connect
the feeding reservoir or syringe to the top of the
tube, and then release the tube to start the feeding.
Pinch the top of the tube or give a gentle push with
the plunger to establish gentle flow.
14. If the infant/child is sitting on your lap, hold the
container 4" (10 cm) above his/her abdomen. If
lying down, hold it 6 to 8" (15-20 cm) above his/her
head.
15. Regulate flow by raising and lowering the container
so that the feeding takes 15 to 20 minutes, the
average time for a bottle feeding. To prevent
stomach distention, reflux, and vomiting, do not let
the feeding proceed too rapidly. Use a pump if
feeding is ordered to be administered over one hour
or longer.
16. When the feeding is finished, clamp nasogastric
tube if it is to be removed. Pinch off the tubing
before air enters the infant/child's stomach to
prevent distention. To avoid leakage of fluid from
entering the pharynx during removal, with possible
aspiration, withdraw the tube smoothly and quickly.
If the tube is to remain in place, flush it with 1 to 2cc
of sterile water for small tube and 5cc for larger
tubes.
17. Unless contraindicated, place infant on stomach or
right side one hour after feeding to facilitate gastric
emptying and to prevent aspiration if regurgitation
occurs. For an infant with gastroesophageal reflux
or other problems, it may be necessary to position
the infant upright for one to two hours.
18. Cleanse equipment with hot, soapy water, if it is to
be reused.
19. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Size and type of tube inserted.
b. Amount of residual and the amount of feeding
administered.
c. Type and amount of any vomitus.
d. Any adverse reactions to tube insertion or
feeding.
e. Patient's response to procedure.
f. Instructions given to caregiver.
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