Many children need a feeding tube at some point in their lives. A feeding tube is an excellent way for kids to get the nutrition they need when they can’t take food by mouth. Unfortunately, feeding tubes do come with some extra work for parents. Feeding tubes of all types need to be held securely in place. Active children with stomas should have the area “waterproofed” before certain activities. In this article, we review the things parents should know when securing and waterproofing their child’s feeding tube.
Different types of feeding tubes
What type of feeding tube does your child have? The names can get a little confusing, Since the management of each type of feeding tube is a little different, is important to know which type you are dealing with.
- NG-Tube – A nasogastric tube (NG-Tube) enters through the child’s nose and ends in the stomach
- G-Tube – A gastrostomy tube (G-Tube) enters through a small hole in the child’s abdomen called a stoma and ends in the stomach
- J-Tube – A jejunal tube (J-Tube) enters through a stoma in the child’s abdomen called a stoma and ends in the first part of the small intestine (jejunum)
- GJ-Tube – A gastro-jejunal tube (GJ-Tube) enters through a stoma in the child’s abdomen, into the stomach, but ends in the jejunum.
An NG-Tube does not need a stoma because it enters the body through your child’s nose. As such the tube does not need to be waterproofed. However, an NG-Tube does need to be firmly secured to your child’s face. If the NG-Tube moves into the nose too far, it may coil in the stomach or enter the small intestine. If the NG-Tube moves out of the nose too much, the end will no longer be in the stomach, and any food that is put through the tube will end up in the esophagus.
Hy-Tape is a good choice for securing an NG-Tube because it is gentle on the fragile skin of a child’s face. While Hy-Tape can hold an NG-Tube right where it needs to be, it comes away easily and cleanly when it is time to change tape, dressings, or tubes.
Securing G-Tubes, J-Tubes and JG-Tubes
Feeding tubes that are placed through stomas or small, surgically created holes in the abdomen, need to be secured. Modern feeding tubes like the MIC-KEY are specially designed to stay inserted (they have a balloon that inflates inside the stomach). However, not all feeding tubes have this design feature and all need additional securement. Since kids tend to move around a lot and handle almost everything they can touch, it is a good idea to reinforce the securement on the outside of the belly with a high-quality medical tape. Hy-Tape works very well for securing G-Tubes, J-Tubes and JG-Tubes because it is occlusive, washable, and resists soiling. Hy-Tape’s zinc oxide adhesive is soothing to the sensitive skin around a stoma. It is also latex-free, so kids with latex allergy can use it.
Waterproofing G-Tubes, J-Tubes and JG-Tubes
Once a stoma has fully developed—usually about 2 months after placement—most kids with G-Tubes, J-Tubes and JG-Tubes can bathe or shower. While parents are surprised, most kids can even go swimming in well-maintained, chlorinated pools or many ocean beaches. Of course, parents should first check with their child’s doctor to find out if it is safe to swim or bathe.
Even after you get medical clearance, it is also a good idea to waterproof the stoma site. You can cover the entire outside of the site with a clear dressing like TegaDerm, though a less expensive but effective option is to use high-quality plastic wrap like Press’n Seal reinforced with Hy-Tape. The plastic wrap has some adhesive properties and will resist water, while Hy-Tape is waterproof and will hold strong in a warm bath, in a pool, or on the beach.
Learn more about safly securing tubes in a skin friendly way:
- Nephrostomy Tube & Sensitive Skin
- Securing Gastrostomy Tubes & Tape Sensitivity
- Endotracheal Tubes, IV, & J Tubes
- Tetralogy of Fallot: Overview and Update on Surgical Wound Care
Caring for your child’s stoma
Stoma care is a daily ritual for a parent of a child with a G-, J-, or GJ-Tube. Follow these steps for proper stoma care:
- Always make sure your hands are clean and before touching the stoma
- Gather all the supplies you will need before you start the dressing change. This usually includes a mild soap, a soft washcloth, sterile water, sterile gauze/pads, barrier cream, and medical tape
- Partially open the packages immediately before you start the dressing change (keep the items sterile as long as possible, but make sure you can access everything quickly and easily)
- Carefully remove medical tape and dressings
- Clean the tube with soap and water, then rinse the area with sterile water
- Using a sterile water and sterile pads, clean the stoma site first and work outward to the surrounding skin
- Dry the area with sterile pads and apply barrier cream if the skin looks irritated
- A split sterile dressing can be very useful for surrounding feeding tubes
- Secure the dressing with high quality medical tape
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