Tips for Home Feeding

MAKE A PLAN

Before you leave the hospital with your new feeding tube, make sure you have a plan in place. Your healthcare team will help you set up a feeding schedule, including the timing and volume of your feedings. Before you go home, you should know:

• The amount of feeding and how often to give
• The brand and type of formula you will be using
• Where to get the formula
• The equipment and supplies needed
• Where to get supplies
• How to care for your stoma site as it heals
• When you can return to some of your regular activities
• When and who to contact with any concerns

Do not be afraid to ask questions. You should have the chance to talk to your healthcare team before any decisions are made. This is your time to ask all your questions. You should be taught how to care for the tube, how to feed through the tube and everything else needed to live with the tube. There will be printed care instructions too. Create a folder to keep all this useful information. Some people will keep a paper folder. Some people will keep an electronic folder on their phone or computer. Some people record videos of themselves. Do whatever you need to do to remember important things. There is a lot of information, and it is common to forget some of it.

Here are some links to other useful information about feeding tubes:

• Tube types page
• Troubleshooting tips
• Guides for those new to tube feeding

Now is also a good time to get on a tube feeding blog or support group. Members often have tips and tricks that can help with any anxiety. Follow your healthcare team’s instructions, which are specific to your body and your tube.

LEARN THE LINGO

There are many words that you may not understand at first. It helps to know some common enteral feeding terms.

• Tube and tubing sizes are not measured in inches but in French. No, this is not the language. French means the measurement from one side of the tube to the other or the diameter. There is an internal diameter and outside diameter for tubes because the tube wall varies in thickness. The French size on your tube represents the outside diameter. One French unit equals 0.33 millimeters.
• There are different types of feeding tubes that go into different parts of the body
  • A gastrostomy tube (G Tube) goes to the stomach
  • A gastro-jejunal tube (GJ Tube) goes through the stomach and into the middle part of the small intestine
  • A jejunal tube (J Tube) goes into the small intestine. (1)
• There are different ways to feed through the tube.
  • Your feedings can be continuous, using a pump that moves nutrition into your body over a long period.
  • Your feedings can be given by bolus, where a certain amount of nutrition is given through the tube over a short period of time. This can be done using either a syringe or a bag, or both. (2)
• A stoma is the place where the tube enters your body. This is the opening through the skin.

GET YOUR SUPPLIES ORGANISED

There can be a lot of supplies when having a feeding tube. At first, it can be stressful as you are learning about all the different supplies needed. Below are some tips that can help you stay organized.

• Make note of the brand, type, and size of your new feeding tube.
• For those with a G Tube, have a backup of the tube on hand. Often, these can be changed at home.
• You will need syringes for bolus feedings and to flush your tube.
• Depending on how you feed, you may need an extension set. The packaging of your tube will tell you what types of extension sets are needed.
• You may need a feeding pump, a pole, or a hanging feed bag.
• Make note of your brand and type of formula if you are using packaged formula. Many people on continuous feedings using a pump get nutrition while on the go. A backpack is handy for carrying the pump and supplies.
• It is helpful to have this information written down. It might also be helpful to take pictures of your supplies and their labels. Keep this information handy in a folder on your phone.
• Do not forget the supplies you may need to secure your tube and care for your stoma site. These can include tape or skin adhesive, gauze, cotton swabs, water soluble lubricant, and sterile water.

KNOW YOUR HYGIENE HOW-TOS

• Stoma care
  • Caring for the stoma site right after surgery will be like caring for any surgical incision
  • As your site heals, you can start cleaning it with mild soap and water if you have no skin sensitivities. Follow the instructions from your healthcare team on when and how to care for the site.
  • Keep an eye on the site and note if you feel any pain. If the skin around the stoma is red, raised, bleeding, or leaking fluid, see your doctor right away to make sure there is not an infection.
  • To help avoid infection, always wash your hands thoroughly before touching your tube or stoma site. (3)
• Oral care
  • o If you are not eating by mouth, your teeth still need cleaning. Bacteria in the mouth can be inhaled and cause pneumonia (4), and studies suggest gum disease is linked to high blood pressure and heart problems. (5)
  • Your feedings can be given by bolus, where a certain amount of nutrition is given through the tube over a short period of time. This can be done using either a syringe or a bag, or both. (2)

SEEK SUPPORT

You are not alone as you take the first steps into a new and different way of living. It is more than okay to lean on friends and family for support, especially in the beginning. As your tube journey continues, it will get easier but it is helpful to continue having support. Join support groups with people who have similar conditions. Never doubt the value of talking to others who have walked the same path and can offer advice and comfort.