Infants/
Children

Before your child’s feeding tube placement, you’ll be shown an actual gastrostomy tube or a picture, along with specific information about how the tube will be placed. Your child may be in the hospital for a few days after the procedure. You’ll be told what to expect regarding a timeline when the procedure is scheduled.

Bathe your child the night or morning before the procedure. Your child shouldn’t be allowed to eat or drink anything for several hours before the procedure is scheduled. You’ll be told a specific number of hours to hold fluids and food before the day of the procedure.

Your care team will talk to you about the tube and how it works, along with how to care for it. This information should be given to you again after the procedure.

Expect the endoscopic procedure to take one to three hours. Your child will receive anaesthesia for the procedure and will then be in the post-anaesthesia recovery area for a few hours.

The care team will watch your child closely after the procedure, from anywhere from a few hours to 24 hours. Tube feeds will be started gradually.

For the first two weeks after placement the stoma site should be cleaned daily using gauze and sterile water. Start near the stoma site and move outwards in circular motions. Do not adjust the retention disc that keeps the PEG tube in place.

Expect to see the first days after placement some drainage (clear or blood-tinged) at the site. Gently remove any residue. Be sure to thoroughly rinse and dry the area afterwards. Some redness after the procedure is normal and should go away in about three days.

After two weeks, the tube and stoma site can be cleaned with soap and water, rinse and dry the area afterwards. From that moment onwards the tube and disc need to be turned daily to make sure the skin doesn’t stick to it.

The gastrostomy tubing may pull to one side, which may not be comfortable for your child. Try looping the tubing in a gentle arch and tape it to the abdomen. Sometimes a small roll of gauze near the stoma site can be used to rest the looped tubing on and then it can be taped in place. You will need to make sure your child doesn’t touch or pull on the tube.

Your child will be given some pain medication post-op, along with a prescription to take at home as needed for comfort. Be sure to flush the tube with water before and after giving medication to prevent the tube from clogging.

It’s important to remember about oral care even if your child doesn’t take any food or medication by mouth. Regular tooth brushing or using an infant swab is helpful.

Your care team will provide you with instructions on what to do when you get home. These details will include how to use all your feeding supplies, as well as what you’ll need and where to get more supplies. They may discuss the timeline for next appointments or go ahead schedule your follow-up appointments to see your child’s progress and discuss future tube options, such as moving to a low-profile button.

You’ll want to find a good place to store supplies once you get home. Set up your supplies, including your enteral feeding pump.

Until the stoma site is fully healed, do not immerse your stoma site in water. Have showers not baths. Your healthcare professional will advise when you can have a bath or go swimming.

Clean the site during the first two weeks daily using gauze and sterile water, be sure to clean under the retention disc as well. Be sure to keep the tube and stoma site clean and dry at all times. Expect some drainage to occur in the first few days, but also be on the lookout for major skin or stoma changes that your care team has described before you were discharged.

After a period of two weeks: If the tube feels too tight, contact your care team. They may advise you to loosen the disc, as weight gain occurs. As part of your daily tube and stoma care, you’ll need to rotate the tube daily. You’ll also want to refer to your written directions for feeding instructions. This includes when to feed, what to feed, how much to feed, and pump-setting information if relevant. Be sure to understand what issues may require urgent (attention within 24 hours) or emergent (immediate) care. When in doubt, call your care team.

Remember: the first day at home after any big change is going to require some adjustment. But before long, you and your child will become more used to the feeding tube and you’ll develop a new routine that’s second nature to you.