4. Gavage feeding
Gavage feeding is an artificial method of
giving milk , fluids and nutrients to children .
The process of feeding with the tube inserted
through the nose , pharynx and oesophagus into
the stomach to provide nutrition to the child
5.
6.
7. Definition
A tube placed through
child`s nose (called a
Nasogastric or NG tube )
carries breast milk /formula
,and nutrients to the
stomach.
8. Purpose and indications
To feed the children who are unable to
take feed orally .
Feed the children who are undergoing oral
surgery like cleft lip or cleft palate , fracture
or jaw and in condition of difficulty in
swallowing .
9.
10. When patients is unconscious or
semiconscious
When the condition is not supportive to
take large amount of food orally e. g.
severe burns ,malnutrition ,prematurity
,acute and chronic infections .
Conditions when the patient is unable to
retain the food e. g anorexia nervosa and
vomiting .
11. Types of Tube Feeding
Intermittent : The feeding tube
may be inserted and remove
at each feeding .
Indwelling : The feeding tube
is inserted and left taped
securely .
12. Advantages of Nasogastric feeding
All types of nutrients including
distasteful foods and medications can
be given in adequate amount.
Without any danger, feeding can be
continued for weeks.
According to need, stomach can be
aspirated at any time
14. Principals involved in Gastric Gavage
Tube feeding is a process of giving liquid
nutrients or medications through a tube into
the stomach when the oral intake is
inadequate or impossible
A thorough knowledge of the anatomy and
physiology of the digestive tract and
respiratory tract .Ensure safe induction of
the tube (avoid misplacement of the tube ).
15.
16. POLICY
6 ft feeding tube is used for infants <1000
grams .
6 ft or # ft feeding tube are used for infants
>1000 grams.
Never force the feeding under pressure.
17. CONT…………
If possible, the infant should be held in semi – up-
right
Possible during the feeding ; if not possible
,position infant on right side or prone as this will
facilitate gastric emptying .
If respiratory rate > 70, check with physician
about withholding feeding .
18. Feeding tube of baby and child size
Stethoscope
5 -10 cc syringe
Ryle`s tube in a bowel
Adhesive tape
Sterile formula Feed .
19.
20. Cotton tipped “ application to clean the
nostrils
Examine the mouth of patient with tongue blade and light
source
21. Procedure
Explain the procedure to child and
relative
Give recumbent position with his neck
hyper flexed with a rolled towel place
under the , sometime restrain may
required .
Measure the tube by measuring from the
bridge of the nose to umbilicus in infants
and mark it .
22. In older children , measure from the nose to
earlobe and then to the tip of the xiphoid
process of sternum
23. Lubricate catheter with water
Insert the catheter with water
Insert the catheter through nares and or
mouth in case of nasogastric feeding
.slip the catheter into nostril and direct
towards the occiput in a horizontal plane .
In case of orogastric feeding pass the
catheter through the mouth towards the
back of throat.
24. Clamp the catheter and withdraw it
Burp child and place on the abdomen.
Observe for vomiting ,apnea ,abdominal
distension
Observer for abdominal distension
,regurgitation ,vomiting , gastric residue
,25 -50% or more than of that of the
previous feed indicates poor tolerance to
enteral feeding.
25. Record the procedure including
type and amount of feeding ,time
and observe child responses
during feeding.
26. Gastrostomy feeding
A gastrostomy is a feeding tube that is
surgically placed through the abdominal wall ,
to feed formula ,liquids and medication directly
into the stomach . The tube usually has a
balloon or disk placed under the skin that
holds the tube in place . It also has a retention
device ( often called a button )
On the outside of the skin to seal the tube
between feeds.
27. Definition
The process of feeding a child through a tube directly
inserted into stomach through the abdominal wall is
known as gastrostomy feeding .
Gastrostomy feeding may be an option when a child has
swallowing problems (dysphagia) making it difficult for
the them to safely swallow food and drink , or
28. Indication of Gastrostomy tube feeding
Congenital abnormalities of the mouth ,esophagus , stomach ,or
intestines
Sucking and swallowing disorders , which are often related to
prematurity , brain injury , development delay , or certain
neuromuscular conditions , like severe cerebral palsy
Failure to thrive , which is a general diagnosis that refers to a
child`s inability to gain weight and grow appropriately
Extreme difficulty taking medicines
When maintaining healthy rates of growth and nutritional wellbeing
cannot be achieved by oral feeding alone.
29.
30.
31. Purpose
To feed a child who is unable to feed orally
To provide nourishment in child with congenital
anomaly ,such as trachea esophageal fistula
To decompress the stomach
33. Procedure of feeding
Collect and check articles for functioning
Place the child in proper position : hold child elevated
Place mackintosh and towel on child`s abdomen
Attach tubing to syringe and elevate syringe to 10-20 cm .
Aspirate gently
Pour feed and allow flow them with the help of gravity .
Feed for 20- 30 minutes.
Irrigate with clear water .
34. After feeds , the tube may be :
Left unclamped to provide constant
decompression
Elevate and covered with gauge to
prevent gastric reflux and abdominal
distension
Clamped if patient is to be prepared
for home care .
35. CONT……….
Don’t apply pressure
Record types , amounts of feed , and child`s
activity
Keep child in fowlers position or turned right
Tube should be secured in place to minimize
traction .
Keep the tube area clean and dry.