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Using your Feeding Tube

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Understanding the feeding methods

There are several ways to feed through your Entuit Thrive feeding tube. Your doctor will decide which feeding method is right for you. These are the most common methods of feeding: 

Bolus (syringe) feeding

To do a bolus feeding, you use a large syringe to put liquid food into your feeding tube at mealtime.

Gravity feeding

To do a gravity feeding, you use a bag of liquid food that hangs on a hook or pole. The bag is connected to the feeding tube. Gravity causes the liquid food to flow into the feeding tube. You can tighten or loosen the clamp to control how fast the liquid food flows into your feeding tube.

Pump feeding

To do a pump feeding, you put liquid food into a container, usually a bag. A pump pushes the liquid food into the feeding tube.

Note: As long as your doctor recommends the feeding method, you can use any of these methods with the Entuit Thrive feeding tube.

When to feed

Everyone has their own feeding routine. Be sure to plan your feeding routine with your doctor.

Bolus feedings can happen at the same time as mealtime or more often throughout the day. Continuous feeding can happen throughout the entire day or night, while you walk around, and during your normal daily routine.

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Always use the feeding schedule that your doctor recommends. Record your feeding plan with your doctor and follow the schedule in that plan.

Where to feed

You can feed wherever you feel most comfortable and relaxed.

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With your head at a 30-degree angle or more, choose one of these positions:

  • Sit on a chair or a couch.
  • Sit up in bed.
  • Stand up or walk around.
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Do not lie down while feeding or within one hour after feeding. If you lie flat, you may upset your stomach or vomit.

What is liquid food?

Liquid food is liquid that is taken through your feeding tube. There are three types of liquid food:

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Record your liquid food type with your doctor when you receive your feeding tube. Don’t change your liquid food or feeding schedule without talking to your doctor first.

Ready-to-use formula

The most common type of liquid food is ready-to-use liquid formula. You can buy it in bags for gravity or pump feeding, or you can buy it in a bottle or in a can. You must pour bottled and canned formula into a feeding bag or a syringe before you can use it.

Powdered formula

You must mix powdered formula with liquid in order to use it in your feeding tube.

Home-blended food

Some people like to prepare their own blended food. Before you prepare your own food, talk to your doctor and a dietitian. They will help you make sure that the food you prepare is good for you and right for your feeding tube.

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Do not put solid or thick food through your feeding tube. Solid or thick food can clog or damage the tube.

What you need for feeding

After your doctor places your feeding tube, you will need a few devices that will help you use your feeding tube.

If your doctor prescribed bolus feeding, you’ll need to buy a 60 mL catheter-tipped syringe.  If your doctor prescribed continuous feeding, you’ll need to buy a feeding set.

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General feeding guidelines

Oley FoundationThe following guidelines are recommended by the Oley Foundation. For more information visit www.oley.org

 

 

Follow these general guidelines to ensure a safe and healthy feeding:

  • Wash your hands with soap and water before you prepare your liquid food and before you touch your Entuit Thrive feeding tube.
  • The standard-profile Entuit Thrive feeding tube is marked in centimetres. Always check these marks before you feed in order to make sure that the tube has not moved.

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If your feeding tube is out of place, do not feed. Call your doctor right away and go to the Troubleshooting page for further precautions.

 

Stop feeding and call your doctor if you experience weakness, cramping, dizziness, heavy sweating, or a rapid heartbeat.

  • Sit up straight, if possible, while you feed and for one hour afterward. If you can’t sit up straight, raise your head at least 30 degrees during feeding. Do not lie down flat.
  • Do not pull on your feeding tube. Pulling on the feeding tube may damage tissue or may cause your feeding tube to come out or stop working.
  • Contact your doctor if you see fluid leaking around your feeding tube or around your stoma.

The feeding port is the opening in your feeding tube where you put liquid food. Before and after each feeding, use a catheter-tipped syringe that is filled with 30-50 mL of water to flush the feeding tube through the feeding port (unless your doctor tells you otherwise).

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Always be sure to use the correct port for feeding. (Click here for an illustration of the ports). If you put liquid food into the balloon port, your balloon may break or your feeding tube may fail.

How to check for leftover liquid food

Your doctor may tell you to check your stomach for leftover liquid food before each feeding to make sure that your stomach is getting rid of food from your previous feedings.

Use these supplies to check for leftover liquid food:

Follow these steps to check for leftover liquid food:

  1. Wash your hands with soap and water.
  2. Fully depress the plunger on the catheter-tipped syringe.
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  4. Attach the catheter-tipped syringe to the feeding port of your feeding tube and pull back on the plunger. You may see some stomach fluid enter the syringe.
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  6. Pull back very gently on the plunger until you don’t see any stomach fluid.
  7. If the syringe becomes full, empty it into a clean container and repeat steps two and three until no more fluid comes out. Stop pulling back on the plunger immediately after fluid stops coming out.
  8. When no more fluid comes out, complete the steps that your doctor recommends.
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Always follow your doctor’s instructions when you check for leftover liquid food, and call your doctor if you see an unusual amount of liquid food. If the amount of liquid food is too great, your stomach may have problems. Your doctor may also give you special instructions to not use your feeding tube if you collect a certain amount of stomach fluid. Record your doctor’s instructions when you receive your feeding tube and refer to them as needed.

Instructions for bolus (syringe) feeding

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Bolus feeding is like eating several meals throughout the day. Your doctor will tell you how many times you should feed and how much food you should take in each bolus feeding.

Use these supplies to do a bolus feeding:

Follow these steps to do a bolus feeding:

  1. Check your doctor’s instructions for the kind of liquid food that you should use, the amount of food that you should take at each feeding, and the feeding rate that your doctor recommends.
  2. Flush your feeding tube with the catheter-tipped syringe, using the amount of water and the method that your doctor prescribed.
  3. Fill the catheter-tipped syringe with liquid food and attach it firmly to the feeding port of your feeding tube.
  4. Use the syringe to inject the liquid food into your feeding tube.
  5. (If your doctor gives you different instructions for flushing your feeding tube, you should follow them instead of the instructions in this step.) When you finish feeding, use a clean catheter-tipped syringe filled with 30-50 mL of water to flush the feeding tube through the feeding port.
  6. Rinse the syringe with warm water and let it air dry.

Instructions for continuous feeding

Continuous feeding happens at a slow, steady rate. You can use a pump or the gravity feeding method for continuous feeding.

Use these supplies to do a continuous feeding:

Follow these steps to do a continuous feeding:

  1. Check your doctor’s instructions for the kind of liquid food that you should use, the amount of food that you should take at each feeding, and the feeding rate that your doctor recommends.
  2. Flush your feeding tube with the catheter-tipped syringe, using the amount of water and the method that your doctor prescribed.
  3. Insert the tip of the filled pump feeding set or the filled gravity feeding set into the feeding port of the feeding tube.
  4. Make sure that the feeding set is properly connected to the pump or bag. Make sure that the clamp on the feeding set is open.
  5. For pump feeding, follow the pump manufacturer’s instructions to set the pump rate. Follow any special instructions that you recorded with your doctor when you received your feeding tube.
  6. Close the clamp on the feeding set when the pump or bag is almost empty. Put your prescribed amount of water in the pump or bag.
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Do not allow the liquid food to completely run out before you add water. If the liquid food runs out before you add water, air may enter your feeding tube and make you uncomfortable.

    1. Open the clamp on the feeding set. Re-check the pump rate to make sure that it’s set at the prescribed rate. Begin flushing.
    2. When you finish flushing, close the clamp on the feeding set. If you’re using a pump, turn off the pump.
    3. Disconnect the feeding set from the feeding port of your feeding tube.
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    Pump manufacturers may have different guidelines. Be sure to consult your pump manufacturer’s guide and ask your doctor for complete pump feeding instructions.

    Taking medicine

    Most medicine that can be taken through your mouth can be taken through your Entuit Thrive feeding tube as long as the medicine is in liquid form.

    • Always follow the instructions that were included with your medicine, and follow any special instructions that your doctor or pharmacist gives you.
    • If you take multiple medicines, take each medicine separately. After you take each medicine, flush your feeding tube with the amount of warm water that your doctor recommends.

     

    Oley FoundationThe Oley Foundation recommends these guidelines for using feeding tubes. For more information, visit www.oley.org.

     


    Preventing infection

    1. Clean your work area before each feeding or cleaning.
      • Work at a comfortable pace. You may spread more germs if you rush.
    1. Wash your hands before you do anything with your feeding tube or feeding supplies.
      • Scrub your hands with liquid antibacterial soap for at least 15 seconds. Scrub under your fingernails, too.
      • Dry your hands with a clean paper towel. Turn off the water with the back of your wrist or with your elbow, or with a paper towel.
      • Anyone who helps you with your feeding tube must wash their hands this way, too.
    1. Do not touch things that are not clean. Touching these things can spread germs.
      • Use only clean supplies when you work with your feeding tube.
      • Focus on the task at hand. Don’t switch to other activities or handle unclean objects in the middle of cleaning.

    Cleaning your feeding tube

    To keep your stoma site clean and healthy, and to help prevent infection, clean your feeding tube once a day or as often as your doctor recommends.

    Use these supplies to clean your feeding tube:

    • Gauze pads
    • Cotton swabs
    • Soap
    • Water

    Follow these steps to clean your feeding tube:

    1. Use warm water or a mixture of soap and water to clean your feeding tube. Your doctor may recommend a cleaning solution.
    2. Clean the inside of each port with a moistened cotton swab for at least 15 seconds.
    3. Scrub the outside of the ports with a moistened gauze pad.
    4. Twist the gauze pad back and forth at least 10 times, as if you were juicing an orange. Use friction and a twisting motion when you clean the ports. The friction is important to this cleaning method.

    Cleaning your stoma site

    Clean and disinfect your stoma once a day. Do not routinely use antimicrobial ointments on or around your stoma.

    Use these supplies to clean your stoma site:

    • A clean cloth
    • Cotton swabs
    • Soap
    • Water

    Follow these steps to clean your stoma site:

    1. Wash your hands very well before and after you gather your cleaning materials.
    2. Clean the skin around your stoma with a clean cloth, soap, and water. Work in circles outward from your stoma site.
    3. Clean under the bolster and hubs of your feeding tube with cotton swabs, soap, and water.
    4. Rinse the area around your stoma with warm water and let it air dry.
    5. Always check the area for signs of infection. Call your doctor immediately if you see drainage, swelling, or redness, or if you notice unusual tenderness.
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    For more information about preventing infections and taking care of your feeding tube, visit www.Oley.org.

    Flushing your feeding tube

    Flushing your feeding tube regularly with water will help prevent clogs and keep your tube clean for your regular feeding. Regular flushing can also make your feeding tube last longer and may prevent problems.

    Refer to the flushing schedule that your doctor gave you when you received your feeding tube.

    Use these supplies to flush your feeding tube:

    Follow these steps to flush your feeding tube:

    1. If your doctor instructed you to, check your stomach for leftover liquid food.
    2. Attach the catheter-tipped syringe to the feeding port of your feeding tube.
    3. Gently flush the prescribed amount of water through the feeding tube.
    4. Remove the syringe when you finish flushing.
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    Your doctor may place a dressing over your feeding tube. If your feeding tube has a dressing, your doctor will show you how to clean and change the dressing. Change your dressing right away if it becomes wet or soiled. Otherwise, change it every day or as often as your doctor instructed you to.

    Storing your liquid food

    Read and carefully follow the instructions that come with your liquid food.
    Store any unused liquid food in a clean, sealed container according to the manufacturer’s instructions.

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    Check the volume of your feeding tube’s balloon weekly, or follow your doctor’s recommendation. Compare the balloon’s volume to its volume when you first received your feeding tube. If the balloon volume changes, call your doctor.

    Caring for your mouth

    Even though you are not usually eating with your mouth, you still need to take care of your teeth and gums to prevent bacteria and germs from building up.

    • Brush your teeth, gums, and tongue every day.
    • Keep your lips and mouth moist. This is important. When you don’t eat or drink with your mouth, your skin gets dry more easily.
    • Call your doctor about anything unusual about your mouth, such as bleeding gums.

    What to do if you have an upset stomach

    You may get an upset stomach if too much liquid food is given or if it is given too quickly. Do not feed if your stomach is upset.

    • If your stomach is upset, wait about an hour, or until the feeling goes away, before trying to feed.
    • Check with your doctor to see if you can add more water to your liquid food. You can also ask your doctor if you can take smaller, more frequent feedings.
    • Stop feeding if you vomit. Wait about an hour and then try feeding again. If you vomit again, stop feeding.
    • Call your doctor if, for more than 24 hours, you feel too sick to continue your regular feedings.

    What to do if liquid food enters your lungs

    You may accidentally get liquid food in your lungs. Liquid food can get into your lungs if you burp up small amounts of liquid food, or if you vomit.

    • Stop feeding immediately if you choke or have trouble breathing.
    • Call your doctor.

     

    Having a feeding tube can be a big change. But you can still do most of the things that you did before you got your feeding tube.

    Physical activity

    You can walk and exercise regularly. Be sure to notify your doctor before you make any big changes to your lifestyle or your exercise routine.

    Bathing

    For a short time after you get your first feeding tube, your doctor may ask you to limit bathing, swimming, and showering. In many cases, these limitations are temporary. Ask your doctor about the precautions that you need to take.

    After your doctor places your first feeding tube, you may have a dressing over your feeding tube. Be sure to keep the dressing dry by covering it in a watertight wrap before you bathe.

    Diet

    Pay attention to any changes to your diet and weight. If you see changes, tell your doctor. Your doctor may recommend that you change your feeding plan.

    • Weigh yourself at least once a week or as often as your doctor recommends.
    • Write down any changes in your weight and report them to your doctor.
    • If you often have an upset stomach, talk to your doctor about your feeding plan.