Neonatal gastric tube insertion

Inserting a gastric tube into a newborn is actually a relatively common situation. If the physical condition of a newborn is not ideal when it is born, it will be necessary to insert a gastric tube to provide nutrition to the child. When a newborn is given a gastric tube, the food can be mixed with milk to make it liquid food, which is easier for the newborn to absorb.

Nasogastric feeding of newborns

Dietary content

(1) Mixed milk: Food is mixed in milk to form a liquid food containing milk, eggs, sugar, oil and salt.

(2) Lubricate the front section of the gastric tube with paraffin gauze and gently insert the gastric tube along one nostril. During the intubation process, if nausea occurs, pause for a moment and then quickly insert the tube. If coughing, difficulty breathing, cyanosis, etc. are found, it means that the tube has entered the trachea by mistake. It should be pulled out immediately and reinserted after a short rest. If the insertion is not smooth, check whether the gastric tube stays in the mouth.

(3) For infants who are comatose, whose swallowing and coughing reflexes have disappeared and who are unable to cooperate, the pillow should be removed and the head tilted back before intubation. When the gastric tube is inserted into the epiglottis, the left hand should be used to support the infant's head and bring the lower jaw close to the manubrium of the sternum to increase the curvature of the throat passage and facilitate the insertion of the tube end along the back wall.

(4) Use a syringe to aspirate and gastric juice will be drawn out, confirming that the gastric tube is in the stomach.

(5) Use adhesive tape to fix the gastric tube to the nose and cheek.

(6) Connect the syringe to the open end, tap back first to see gastric juice being drawn out, then slowly inject a small amount of warm water, and then infuse nasogastric fluid or liquid medicine. After the injection is completed, a small amount of warm water must be injected again to flush the gastric tube.

(7) Fold the open end of the gastric tube, wrap it with gauze, clamp it, and then fix it next to the baby's pillow with a safety pin and record the nasogastric feeding volume.

(8) Make the bed and clean up the items.

The extubation method is used when the newborn stops feeding or needs to replace the stomach tube during feeding.

(1) Prepare all supplies and bring them to the bedside. Check the bed number and name, and explain the purpose to the baby's caregiver.

(2) Place the curved disc under the baby’s jaw and gently remove the adhesive tape that secures it.

(3) Wrap the gastric tube near the nostrils with gauze and wipe the tube with gauze while pulling it out. When it reaches the throat, it should be pulled out quickly and the gastric tube should be pinched with hands to prevent the liquid in the tube from dripping into the trachea. Place the gastric tube in the curved tray.

(4) Clean the baby’s mouth and nose, wipe off any traces of adhesive tape, help the baby rinse his or her mouth, place the baby in a comfortable position, and tidy up the bed and other items.

Key points

Before each nasogastric feeding, it is necessary to confirm that the gastric tube is in the stomach before it can be inserted. One of the following methods can be used to confirm

(1) Connect the syringe to suction and gastric juice will be drawn out.

(2) Place the end of the gastric tube in a bowl of water and ensure that no gas escapes.

(3) Place a stethoscope on the stomach and use a syringe to inject 10 ml of air into the gastric tube. You can hear the sound of air passing through water.

The tablets need to be crushed and dissolved before injection.

The amount of nasogastric feeding each time should not exceed 250ml, and the interval should be no less than 2h. People who receive long-term nasogastric feeding should perform oral care every day and change the gastric tube once a week, removing it at night and inserting it again through the other nostril the next morning. Start with a small amount and gradually increase the amount. If there are no gastrointestinal symptoms, you can increase the amount daily.