Setting up:

1. Prior to starting the feeding, be sure to wash your hands thoroughly, check the formula expiration date, and disinfect the formula can or container with an alcohol swab.
2. Mix the formula well by shaking the can or mixing the powder in the container as directed.
3. Pour the formula into a clean liquid measuring cup or directly into the syringe.

Starting the feeding:

1. Make sure your child sits upright, at least at a 30–45 degree angle.
2. Pinch the end of the feeding tube closed to stop the flow (does not apply to nasogastric tubes). Then, open the feeding tube.
3. Attach the syringe to the end of the feeding tube, releasing the pinch to open the flow.
4. Flush your child's feeding tube with clean, room temperature water.
5. You can raise or lower the height of the syringe to increase or decrease the feeding rate.
6. If the diet prescription indicates, add more formula to the syringe as formula flows into the feeding tube.

After the feeding:

1. Use the syringe to flush the feeding tube with clean, room temperature water.
2. Pinch the tube closed, then detach the syringe from the feeding tube and close the feeding tube.
3. Have your child continue to sit upright for an hour after feeding.
4. Clean with soap and water, rinse and dry your equipment after each feeding and be sure to replace your equipment as directed by your healthcare professional.

Setting up:

1. Prior to starting the feeding, be sure to wash your hands thoroughly, check the formula expiration date, and disinfect the formula can or container with an alcohol swab.
2. Mix the formula well by shaking the can or mixing the powder in the container as directed.
3. Flush your child's feeding tube with clean, room temperature water.

Starting the feeding:

1. Make sure your child sits upright, at least at a 30–45 degree angle.
2. Pinch the end of the feeding tube closed to stop the flow (does not apply to nasogastric tubes). Then, open (unclamp or uncap) the feeding tube.
3. Connect the tip on the end of the tubing to the feeding tube.
4. Fill the feeding syringe with formula.
5. Have your child sit or lie with their head elevated at least 30–45 degrees (or about the height of two pillows) and remain in this position 30 to 60 minutes after the feeding.
6. Open the flow regulator clamp to adjust the flow rate.
7. Ask your child's healthcare provider how long each feeding should take.

After the feeding:

1. Use the syringe to flush the feeding tube with clean, room temperature water.
2. Pinch the tube closed, then disconnect the feeding set and close (reclamp or recap) the feeding tube.
3. Have your child continue to sit upright for an hour after feeding.
4. Clean with soap and water, rinse and dry your equipment after each feeding and be sure to replace your equipment as directed by your healthcare professional.

Setting up:

1. Prior to starting the feeding, be sure to wash your hands thoroughly, and check the formula expiration date.
2. Mix the formula well by shaking the can or mixing the powder in the container as directed.
3. Flush your feeding tube with clean, room temperature water.
4. If you are using a feeding bag:
   1. Disinfect the top of the formula can or container with an alcohol wipe.
   2. Fill the feeding bag with formula.
5. If you are using a sealed formula pouch:
   1. Close the roller clamp on the tubing.
   2. Remove the cap on the spike set. Remove the protective cap on the port site. Stabilize the port area between your thumb and your forefinger. Do not touch the port opening or spike with your hands or fingernails.
   3. Push the spike all the way into the open port with a twisting motion.
6. Hang the feeding bag or sealed formula pouch on the pole above the feeding pump.
7. Since every pump is different, follow the instructions provided by your healthcare professional to set up and operate your pump.

Starting the feeding:

1. Have your child sit upright, at least at a 30–45 degree angle.
2. Pinch the tube closed, then open (unclamp or uncap) the feeding tube.
3. Insert the tip on the end of the tubing into the feeding tube.
4. Set the flow rate on the pump (your healthcare provider will tell you your child's feeding rate, or how many mL per hour of formula should be given).
5. If applicable, open the roller clamp on the feeding set.
6. Start the pump.

After the feeding:

1. Pinch the tube closed, then disconnect the feeding set and close the feeding tube.
2. Use the syringe to flush the feeding tube with clean, room temperature water.
3. Have your child continue to sit upright for an hour after feeding.
4. Clean with soap and water, rinse and dry the equipment after each feeding.
5. Replace the feeding container and tubing as directed by your child's healthcare professional.
6. If the sealed formula pouch is not empty after 48 hours, dispose of it.

 
In order to provide the nutrition your child needs, your healthcare professional will provide guidelines to help develop schedules for intermittent or bolus tube-feeding and water flushes, including information such as:

• The name of your child's tube-feeding formula
• The number of feedings your child will need to get each day
• The amount of formula each of your child's feedings should be (or how many cans or containers should be used at each feeding)
• The amount of room temperature water needed to flush the tube after each feeding

 
In order to provide the nutrition your child needs, your healthcare professional will give you a schedule for continuous tube-feeding and water flushes, including information such as:

• The name of your child's tube-feeding formula
• The amount of formula your child should get each day, or the number of cans/containers of formula your child will need each day)
• Your child's feeding schedule
• As you become more familiar with your child's feedings, you may want to vary the feeding times. Check with your healthcare professional before making any changes to the feeding schedule.
• The pump flow rate setting
• To assure adequate fluid intake, the total amount of room temperature water that should be given to your child each day in addition to the formula
• The amount of water to use to flush the tube

 
Water is part of your child's formula, but extra water and sometimes medications are needed to keep your child's body healthy and the feeding tube working.

Your child's healthcare professional will tell you how much water or medication your child needs to take.

Crush medications into fine particles or use liquid medications when available. Consult with your nurse, doctor or pharmacist to get specific instructions on:

• How to crush medications
• How much water to mix with the medication
• Which medications should not be crushed
• Which medications should not be given together
• Medications that need special considerations when given through a feeding tube

When administering water and medications, follow all the steps below.
When administering water only, start at step 3 and follow the
remaining steps.

1. Using a syringe, rinse or flush the feeding tube with 15–30 mL of room temperature water before administering medication (unless instructed otherwise by your healthcare professional). Do not force the water through the tube. If you have difficulty flushing the feeding tube, contact your healthcare professional.
2. Using a syringe, draw up the correct dose of medication or water for flushing into the syringe. Open the feeding tube and connect the syringe into the feeding tube.
3. Gently push the water and medication (or water only) into the tube. When administering water only, you may remove the plunger of the syringe and allow the water to run in by gravity.
4. Remove the syringe from the feeding tube and refill the syringe with room temperature water as needed until desired amount of water is given or to flush all the medication out of the syringe.
5. Close (reclamp or recap) the feeding tube when finished and place the cap back on the tip of the syringe.