The NG tube is inserted by a doctor or nurse. They will place the tube into one nostril and gently slide it down the back of the throat and down into the stomach.

Inserting an NG tube should not be painful, but child will probably feel uncomfortable. Your child’s treatment team can give mild pain relief or anaesthetic to try make it more comfortable.

The best way to make your child feel comfortable is to stay with them if possible and give them lots of reassurance and support.

Before anything is given through the NG tube, you or your child’s treatment team will need to make sure the tip of the tube is sitting in the stomach.

Checking the position is done by removing some fluid from the stomach from the tube, using a syringe. A paper strip called litmus paper, or a pH indicator strip is used to test the sample of fluid. The paper will change colour to tell you whether the tube is sitting properly.

It can be tricky to learn how to do this, so your child’s treatment team will teach you how to do this and answer any questions you might have.

The position of the NG tube needs to be checked every time fluid, formula or medication is given. Do not put anything down the NG tube if you are not sure or cannot check the position. Speak to your child’s treatment team if you have any questions or concerns about checking the position.

Flushing is when clean water is slowly pushed through the tube to make sure it does not get blocked. You should flush the NG tube after every feed and after giving medication. If feeding and medications are given less frequently, you should flush the tube at least every 4 hours.

Your child’s NG tube will need to be flushed even if they are being fed using a pump. You will need to put the pump on hold and disconnect the NG tube before flushing.

Your child’s treatment team will let you know how much water to use based on your child’s age.

If your child’s NG tube becomes blocked, you should:

1. check that the NG tube is not kinked or bent
2. try using a smaller syringe to flush
3. try a gentle push pull movement on the syringe for several minutes to see if you can move the blockage
4. let your child’s treatment team know as soon as possible.

Remember to flush the NG tube regularly to prevent blockage.

You can also prevent NG tube blockage by:

• closely follow instructions about amount and timing of water flushing
• requesting that any medications given in liquid form are safe to go down the NG tube
• not mixing medications with formula unless you have been told to by your child’s treatment team.

Your child’s treatment team should let you know how long the tube can stay in before it needs to be replaced. Some NG tubes can stay in for up to 3 months, others may need to be changed sooner.

If your child’s NG tube comes out, you should only reinsert it if you have been properly trained by your child’s treatment team.

There is a risk that the tube will go into the lungs instead of the stomach if it is not inserted properly.

If you have not been trained, speak to your child’s treatment team.

The NG tube can irritate the skin around your child’s nose and mouth.

Good skin care will help to stop inflammation and irritation and involves:

• keeping the skin around the NG tube clean by using warm water and a washcloth
• removing any crusts or fluid from around the nose
• using adhesive remover when changing the tape that holds the tube in place
• making sure skin is clean and dry before applying new tape.

If you notice redness or irritation on one side of your child’s face, you can try putting the NG tube in the other nostril to give the skin some time to heal.

Contact your child’s doctor as soon as possible if you notice:

• there is redness and swelling around both nostrils
• the tube is blocked, and you can’t unblock it
• the tube has fallen out and you are unable to replace it
• the tube needs replacing.

If you are unable to contact child’s doctor and are concerned about the NG tube, you can go to your nearest emergency department for help.