Tube feeding - Common tolerance problems your child may experience while tube feeding

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

PDF Versions Available

This fact sheet is available to print in the following languages:

There are several common problems that your child may experience while tube feeding.

  • Constipation
  • Dehydration
  • Diarrhoea
  • Stomach fullness/Bloating
  • Nausea/Vomiting

Constipation

Constipation is when your child has difficulty passing a bowel motion or stool because it is hard, painful and or infrequent.

It can be caused by not enough fluid, not enough fibre, not enough exercise, in some cases medications or a combination of these.

Signs of constipation can include:

  • stomach pains or cramps.
  • bowel motions that are uncomfortable or painful.
  • no bowel motions for more than 3 – 4 days.
  • passing small, hard, pellet-like stools.
  • passing runny stools, which the child can't control, caused by an overflow of liquid stool which bypasses older, hardened stool.
  • feeling full or bloated.
  • a small amount of blood or mucus with bowel motions.

If you suspect your child may have constipation contact your health professional or seek medical advice.

Dehydration

Dehydration occurs when more water and fluids are exiting the body than are entering it.  Dehydration can be a serious problem.

Your child may be at risk if:

  • for some reason you are unable to get him/ her to take in the right amount of fluids.

or if he / she:

  • is vomiting.
  • has diarrhoea or
  • is sweating (due to hot weather or a fever).

Signs of dehydration include, but are not limited to: dry mouth, sticky tongue, cracked dry lips, thirst, small amounts of dark yellow urine, fewer wet nappies and or headaches.

Infants or younger children with other health problems can become dehydrated very quickly.

 If you think your infant or child is dehydrated, contact your health professional or seek medical advice.

Diarrhoea

Depending on your child’s formula loose bowel motions may be normal.  Diarrhoea means very frequent, persistent watery stool and should be investigated. 

If your child is experiencing persistent diarrhoea for:

  • 4 hours if your child is under 3 months of age.
  • 8 hours if your child is 3 to 6 months of age.
  • 24 hours if your child is 7 months and over. 

Or you are otherwise concerned, you should contact your health professional or seek medical advice.

Diarrhoea can be caused by feeding too quickly, formula being too concentrated or too cold, unhygienic formula preparation or feeding practices and or perhaps illness.

Check your child’s temperature if you think he/ she has a fever or feels warmer than usual.  A fever is an underarm temperature of:

  • above 38°C if the infant is under 3 months of age – seek medical advice immediately.
  • above 38.5°C if the infant or child is over 3 months of age -  contact your health professional or seek medical advice if concerned.

Always ensure preparation and storage of the formula is hygienic.

Stomach fullness / Bloating

Stomach fullness / bloating may be caused by a few things some of these include: the formula being given too quickly, gas building up in the stomach and or constipation.

Signs of stomach fullness / bloating may include:

  • pain (or discomfort).
  • restlessness.
  • burping more than usual.
  • vomiting.
  • infrequent bowel motions.

If your child is having trouble tolerating his/ her normal volume of formula contact your health professional or seek medical advice. 

If your child has a gastrostomy button and you suspect there may be gas trapped in the stomach, letting this air out, a process known as ‘venting the tube’, may help. 

To vent the tube: 

Attach a syringe, outside only (without the plunger), to the feeding port.

Hold the syringe barrel below the stomach to allow gas to escape.

Allow stomach juices and air to fill the syringe.

Drain contents back into the stomach by raising the syringe above the stomach.

To prevent fullness and bloating refer to your child’s tube feeding plan to ensure the type of formula, volume and rate of delivery is correct.

Nausea / Vomiting

Nausea / vomiting may be caused by feeds given too quickly, the stomach being too full, lying flat during or after feeding, a build-up of gas in the stomach, constipation or illness.

If nausea / vomiting occur while feeding:

  • Stop the feed and allow the child to rest.
  • Position the child in a sitting position in a chair / wheelchair so that his/ her head is elevated.
  • There may be air trapped in the stomach, try venting your child’s tube (see  stomach fullness / bloating section above).
  • Start feeding again slowly.  If your child tolerates the feed, slowly increase the volume to the normal rate.

If the vomiting continues, your child seems ill or has a fever, contact your health professional or seek medical advice.

To prevent nausea / vomiting:

  • Give the formula at the recommended rate, do not rush.
  • If your child has a gastrostomy button, you could try venting the feeding tube regularly.
  • Position your child’s upper body to a minimum angle of 30 degrees during and for 30 – 60 minutes after feeding,

Remember:

  • The above advice is a guide only.
  • If you are concerned about your child or symptoms persist you should seek medical advice
logo
The Children's Hospital at Westmead
logo
Sydney Children's Hospital, Randwick
logo
Hunter New England Kids Health
www.hnekidshealth.nsw.gov.au

For publications recommended by our hospitals' experts, please visit the Kids Health book shop.