The ability to administer tube feedings from home can bring both excitement at the independence it offers and nervousness about doing it right. Here are tips to help you have a more successful home enteral nutrition (HEN) experience:
Set up a plan
Before you go home, be sure your care team has set up a comprehensive plan, which will include everything from the volume and timing of your feedings to hygiene and troubleshooting problems. Make sure to get all your questions answered before you go solo.
Gather your supplies
Before you go home, be sure to ask about all the supplies you’ll need for successful home tube feeding. This includes the brand, type and size of your tubing. For example, you might have a G-tube—a gastrostomy tube, which inserts through the belly to deliver nutrition directly to the stomach (and you’ll need a back up tube for this type as well) or a J-tube (jejunostomy tube) or combination tube. Tube size is typically measured in diameter, or units known as French sizes “Fr.” You’ll also need syringes for bolus feeding, or to flush tubing if using a pump. For pump feeding you’ll need a continuous extension set that may require an ENFit connector, plus a pump, and IV pole. For people who feed outside the home, too, backpacks specially designed for pumps can be helpful. Don’t forget the most important part: formula or blenderized food. Feed bags are also useful for continuous feeding, but some who bolus feed also use them. Finally, you’ll need some basics for securing your tube and tending to your stoma site, including tape, cotton tipped swabs, water soluble lubrication jelly, sterile water, and gauze.
Practice good care and cleaning
Be sure to clean the stoma site, where your tube inserts, with soap and water if there are no skin sensitivities. If the site seems red, raised, inflamed or painful, it’s important to consult with your care team to make sure there is not an infection.
Your hands also play an important role in good hygiene. Be sure to wash or sanitize them before and after interacting with your tube, and feeding.
Lastly, practice regular tooth brushing, even when not taking food by mouth, because it reduces the bacteria that leads to infections such as pneumonia.
If possible, take your feedings while either sitting or propped up, or with an elevated head. Flush your tube with warm water after every feeding.
Remember to refrigerate any opened, unused formula or blenderized foods right away so that they don’t spoil.
If you have a standard feeding tube (as opposed to a low-profile tube), it’s a good idea to mark your tube with a permanent marker one inch from where it enters the body. If the tube ever appears to have moved in or out more than one inch, call your doctor. If anything else seems different, painful or unusual, also seek medical advice.
Equally as important as all the nuts and bolts of feeding and hygiene is to have support in the form of your care team, support groups, friends, counselors and/or other family who can support you through any emotional ups and downs in the transition to home feeding.
While getting used to home feeding might take time, the benefits are worth it.