Enteral Tube Program
Home Care Instructions after Placement of a Nasojejunal Tube
Your child is going home with a nasojejunal tube (N-J tube). This tube was placed into the jejunum (the middle part of the small intestine) through the nose, stomach, and upper intestine. (See Figure 1)
The purpose of the N-J tube is to give your child feedings because he or she is unable to take them by mouth and cannot receive feedings directly into the stomach. The tube may also be used to give medications.
Giving Feedings and Medications
- Your child’s doctor or nurse will work with you to make a feeding plan that is best for your child.
- Children with N-J tubes generally receive feedings by a continuous method. A continuous feeding is given with a pump over a long period of time, usually 10 to 24 hours.
- Flush the N-J tube with warm water before and after giving feedings and medications. Use a 30-60 mL syringe. Do not use smaller syringes. They could cause the tube to break. Your doctor or nurse will tell you the right amount of water to use.
- Flush the tube every 4 hours around the clock. The tube must be flushed even when the feeding is running. This is very important to help prevent the tube from becoming clogged.
- Use liquid medications whenever possible.
- If a medicine does not come in a liquid form, crush the pill into a very fine powder. Then mix with a teaspoon of warm water. Do not crush coated or time?release pills.
- To crush pills, use the back of a spoon or a pill crusher. Ask your pharmacist about pill crushers.
- Do not mix one medication with another.
- Do not put mix medications in with the formula.
- Your child may be as active as usual during non-feeding hours.
- Have your child sit upright and play quietly when receiving feedings during waking hours.
- For nighttime feedings, place your child on his or her side. Elevate the head of the bed by putting a pillow under the mattress.
- Keep the taped area around the tube dry when bathing your child.
- Young children will be naturally curious about the tube and may try to pull on it. Check the tape often to make sure it is secure. Keep the tube behind your child's head and tuck it into the clothing in the back.
- Sometimes the tube can slip in or out of the nose. Keep the tube taped to the upper lip and cheek (See Figure 2). Use a permanent marker to draw a line on the tube right underneath the nostril. Use the mark to check that the tube is in the right place.
- Call your doctor or nurse if you think the tube has moved out of place.
- Make sure the tube is not rubbing against the nostril.
- If the tube becomes clogged, try flushing gently with warm water. Do not force the water. Remember to use a 30 mL syringe.
- If you cannot unclog the tube, you may need to return to the hospital to have it replaced in the X-ray department. Call your child’s doctor or nurse if you cannot unclog the tube.
When to Call Your Child’s Doctor or Nurse
- your child starts coughing, choking, or vomiting;
- the tube falls out or has moved out of place;
- you are unable to unclog the tube; or
- you have any questions or concerns.