Enteral Tube Program
What to Expect during the Hospital Stay after PEG Placement
Your child will be admitted to the hospital for the placement of a Percutaneous Endoscopic Gastrostomy (PEG) tube. The main goal while your child is in the hospital is for you and your child to learn and feel comfortable with the PEG tube.
How long will my child be in the hospital?
If your child is admitted for the PEG tube placement only, he/she will probably be in the hospital for 2 nights.
If your child is already in the hospital and having a PEG tube placed, talk to your inpatient care team about when your child will go home.
During your child’s inpatient stay at Children’s Hospital Boston, we would like to partner with you to best meet your needs. You are part of the clinical care team and your input is important!
Other members of the Inpatient team include:
Nurse Case Manager: a nurse who follows your child’s care from before the admission to after discharge.
You may receive a phone call at home from one of our Nurse Case Managers before your child’s admission to go over your child’s home care needs. The Nurse Case Manager may refer your child to a home medical supply company or a Visiting Nurse Association (VNA). If your child already has a home medical supply company and/or VNA, the Nurse Case Manager will go over your child’s current home care plan. While your child is inpatient, you will work with the Nurse Case Manager to make sure the necessary equipment, supplies and services will be in place before your child leaves the hospital.
If the Nurse Case Manager is not able to reach you before your child is admitted, these home care needs will be reviewed with you during the hospital stay.
Someone from the home care company may also meet with you and your child during your inpatient stay to help you learn about your child’s new PEG tube equipment. If this teaching does not happen during your inpatient stay, the Nurse Case Manager will arrange for the home care company to help you learn about the equipment when you arrive home.
Nutritionist: One of our inpatient nutrition staff will go over your child’s nutrition history and help decide your child’s feeding plan. The nutritionist will help to come up with a feeding plan using the PEG tube that will fit your child’s energy needs and your home routine.
Inpatient Nursing Staff: Our inpatient nursing team will help you and your child learn how to
- care for and monitor the PEG tube,
- give feedings, and
- give medicines.
The nursing staff will also help manage any pain your child has and will be watching for any PEG tube problems or signs of infection.
Gastroenterology (GI) Inpatient Team: The GI team includes doctors and nurse practitioners who will check your child’s PEG tube every day for any signs of skin infection or other problems after placement of the PEG tube. They will also make sure your child is tolerating their PEG feedings.
What will happen to my child in the hospital?
The following is an outline of a typical inpatient hospital stay after the placement of a PEG tube. This will help you prepare for your child's needs ahead of time.
Your child will recover in the Post-Anesthesia Care Unit (PACU) or Gastroenterology Procedure Unit (GPU) until he/she wakes up from anesthesia. Once your child is awake, the Operating Room Liaison Nurse or GPU nurse will come to the family waiting room area and bring you to your child. Your child will be given pain medicine as needed to help with any discomfort at the new PEG tube site.
Transfer to Inpatient Medical Unit
When your child is ready, he/she will be transferred to an inpatient unit. Your child will be greeted by his/her nurse and inpatient clinical team. This team will monitor the new PEG tube site, teach you how to use and care for the PEG tube, and start plans to help your child go home safely.
PEG Tube Feedings
The inpatient medical team will decide the safest timeline for starting PEG tube feedings after the procedure.
- Right after the procedure, the PEG tube will be attached to a drainage bag to keep air out of the stomach for at least 4 hours.
- After at least 4 hours, the PEG tube will be closed for 2 hours. During this time, your child will not be allowed to eat or drink. He/she will receive IV fluids to stay hydrated.
- If your child tolerates the PEG tube being closed, the inpatient team will start PEG tube feedings. The PEG tube feeds will then be increased until your child is tolerating their goal volume and rate of feeding.
While your child is inpatient, nursing staff will teach you how to use, monitor, and care for your child’s new PEG tube. You and your child (if appropriate) should be able to demonstrate all PEG care skills before hospital discharge. This will help make sure your child goes home safely. Be sure to let your team know if you or your child have any questions or concerns about using and caring for the PEG tube.
Going Home from the Hospital with a PEG Tube
Your child will be discharged from the hospital when:
- Your child is tolerating PEG tube feeds and is medically stable
- You and your child are able to demonstrate all needed aspects of daily PEG tube care
- Follow up appointments are scheduled (your child will typically need a 2 week PEG check with one of our GI nurses and a 1 month visit with your child’s GI doctor and nutritionist)
- Arrangements for equipment and home services are completed and confirmed
Who can I call if I have questions?
Please call the GI office at (617) 355-6058 if you have questions or concerns. Our GI nurses can help you with all types of PEG tube questions:
- Monday-Friday, 8:00am-4:30pm, a nurse in the GI clinic will be available to help you.
- Weekdays after 4:30pm, Weekends, and Holidays, you can use the same number to reach a GI doctor on-call for urgent questions and emergencies.
If your child is followed by General Surgery:
Call the General Surgery outpatient nurses at (617) 355-7716 or (617) 355-7704.
- Monday–Friday, 8:30am–5:00pm
Call the Children’s Hospital page operator at (617) 355-6369 and ask for the General Surgery Senior Resident on-call.
- Weeknights, 5:00pm–8:30am, Weekends, or Holidays