Infants/
Children

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Gastrostomy (G) Tubes

Before the Procedure

If getting a tube for the first time, surgery will be required. Before the procedure, you will be shown an actual G tube (or button) or a picture of one. You’ll be told specific information about how the tube will be placed. If your tube is being replaced, such as moving from a PEG to another type of tube, or you are moving from a standard-length tube to a MIC-KEY* button, you may have your tube changed in a clinic or office setting.

For surgical placements, your child may be in the hospital for a few days. Your care team will provide details on what to expect and how to prepare prior to coming in. 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 surgery. You’ll be told a specific number of hours to hold fluids and food the day before 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 will be given to you again after the procedure.

During the Procedure

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

The tube can be placed using a variety of methods. Your doctor will choose the one that is best suited for your child.

Tube placements or replacements that do not require surgery can be done quickly and without pain or discomfort in a clinic or office. For button tubes, like the MIC-KEY* tube, your physician may use a tool to measure the size of your stoma (called a stoma measuring device or SMD) to ensure they select a tube that fits correctly.

After the Procedure

A few hours after surgery, Pedialyte will be given down the G tube and, if tolerated, feedings will be started after that.

The stoma site may be tender at first. Pain medication will be given as needed. Expect to see some drainage (clear, cream, or blood-tinged) at the site. Your care team may use a dressing to absorb the drainage. Dressings will be used only in the initial days of post op, if drainage occurs.  Be sure to change the dressing as often as needed to keep the site dry, as wet and soiled dressings can cause the skin to breakdown around the stoma site.  Some redness after the procedure is normal and should go away in about three days.

The tube will need to be rotated a full turn every day. Your care team will begin showing and teaching you how to care for your tube and stoma site.

Upon discharge, you should be given further instructions on what to do for daily tube and stoma care.  You’ll also be taught how to administer feeds and medication using your tube and extension sets (for MIC-KEY* tubes), how to flush the tube, what additional feeding supplies will be needed and where to get them and when to call your doctor.

If the child has a mature stoma and was given a tube as a replacement tube, you may be shown how to replace the tube at home.

Your First Day at Home

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

When bathing, don’t have the bath water above the level of the stoma until you’re told it’s safe to do that.  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.

Rotate the tube daily to prevent it from sticking in the track or to the stomach lining.

You’ll need to clean the site, tube, and extension set (for MIC-KEY* tubes) daily.  Follow flushing recommendations, which can be found in your Instructions For Use (IFU) or Care Guide to help prevent tube clogs.

You’ll 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’ll become more used to the feeding tube and you’ll develop a new routine that’s second nature to you.

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