To care for feeding equipment:

• wash with warm soapy water, rinse well, air dry and store in a clean container
• sterilise for babies under six months
• check daily for leaks or damage
• replace damaged parts through EnableNSW or NDIS
• wipe pumps with a damp cloth, removing any spills immediately
• follow servicing and replacement schedules closely.

Ask your child’s team if you're unsure about how to clean, reuse or store your child’s specific feeding equipment.

Formula usually comes as a liquid or powder that you mix with water.

• babies under 12 months usually have expressed breast milk or infant formula
• children over 12 months usually have formula only.

Some children need a special formula. This is prescribed by a dietitian, based on how your child feeds and what equipment they use.

Do not change the formula amount or add anything to it unless your doctor or dietitian tells you to.

It is important to take care when preparing and storing formula, so it does not become contaminated. 

Store formula properly to prevent contamination by:

• keeping containers covered and in a cool, dry place
• using older stock first and checking expiry dates
• throwing away:
  • expired formula
  • formula in damaged packaging
  • open formula after 4 weeks.

Powdered formula:

1. wash hands with soap and water
2. clean your table, countertops and equipment
3. use clean, sterilised bottles and cooled, boiled water for children under 12 months
4. measure water carefully
5. scoop formula using the scoop in the tin
6. level the scoop by scraping the top along the tin’s edge or using a knife
7. add powder to water, using the number of scoops recommended by your child’s treatment team and not the measurements on the package
8. seal and shake until dissolved
9. store prepared formula in fridge for up to 24 hours.

Liquid formula:

1. check expiry and throw away if out of date
2. shake the bottle well and wipe the top with a clean, damp cloth before opening
3. cover and store in the fridge for up to 24 hours after opening.

Do not use formula left at room temperature for over two hours, as this increases the risk of bacteria.

Ask your child’s treatment team for advice if longer hang times are needed.

Some children can slowly return to eating small amounts by mouth after tube feeding. This depends on your child’s condition and recovery.

The treatment team will consider:

• if your child’s health has improved
• their growth and overall health
• their ability to swallow safely
• whether they need a speech pathologist assessment for swallowing
• if they have the oral skills to eat enough to meet nutrition needs
• if they show signs of hunger.

The feeding tube should stay in place until your child can consistently eat and drink enough, even when sick. Removing it too soon may lead to poor growth or malnutrition.

Before starting oral feeding, your child should have oral stimulation to increase saliva and practice eating skills. Watch your child closely, and make sure they can swallow and manage saliva safely.

A speech pathologist may suggest:

• positive touch to the face and lips
• bringing their fingers or hands to their mouth, between and inside their lips
• using mouth toys like chews and bites
• gently swiping food on lips, gums and then tongue
• pairing oral stimulation with tube feeds.

Some children need tube feeding because they can’t swallow safely. These skills may improve with time and therapy.

Your child will be monitored by their treatment team, and a modified barium swallow test may be used to check how their swallowing skills are developing.

Signs of swallowing problems may include:

• coughing or gagging when eating
• vomiting when eating
• more drooling than usual
• more congestion than usual
• gurgly voice
• food refusal
• long mealtimes over 30 minutes
• feeling food is stuck behind the breastbone
• needing lots of water while eating to wash food down.
   

Your child may need special food textures, fluids and equipment to help with safe swallowing when moving to oral feeds. 

A speech pathologist can recommend:

• thickeners
• teats, bottles, or cups
• utensils or chew tools
• special seating.

Introduce new foods slowly and carefully. Offer them regularly to help your child get used to new tastes and textures as they develop.

Follow all instructions and recommendations for a modified diet closely and speak to your child’s treatment team if you have any questions or concerns.

Good oral hygiene is still important, even with tube feeding. Clean your child’s mouth and teeth twice a day for two minutes, including before bed.

If you are unsure how to clean your child’s teeth safely, speak to your local dentist or speech pathologist.

Book regular check-ups with your child’s dentist every six months to prevent any issues.