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Nasogastric (NG) Feeding Tube Care

Patient instructions: 

Supplies for NG tube care:

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  • Oral syringe

  • Water

  • Tegaderm™

  • Duoderm™ (optional)

  • Cavilon™ No Sting Barrier Film - optional for use over 1 month of age

  • Water-soluble lubricant (such as K-Y jelly®)

  • pH strips

  • Scissors

  • Waterproof permanent marker or pen

Taping the NG tube:

  • It is important to secure the tube with tape to prevent it from falling out or moving out of place.

  • There are numbers along the tube. Your provider will tell you what number should be showing at the edge of your child's nose.

  • Mark the tube at this number with a permanent marker or a piece of tape. Use this mark to know if the tube has moved.

  • If the tape that holds the tube becomes loose, you must secure the tape to prevent the tube from falling out or moving. Follow the steps below:

    1. Measure and cut Duoderm.

    2. Measure and cut the Tegaderm to the correct size.

    3. If using a skin barrier, apply it to the skin where you will be putting the Duoderm.

    4. Peel backing off of Duoderm to uncover adhesive.

    5. Place Duoderm on your child's cheek.

    6. Place the NG tube on top of the Duoderm.

    7. Peel the backing off of the Tegaderm to uncover adhesive.

    8. Place the Tegaderm over the tube onto the Duoderm.

    9. When re-taping the tube, hold the tube firmly in place to prevent movement. After re-taping, check the mark you have made on the tube to determine if the tube has moved.

Checking NG tube placement:

  1. Attach an oral syringe with 5ml of air to the side port. Flush the tube with air to clear the tube of any fluid.

  2. Slowly pull back on the plunger of the syringe to get stomach contents. Completely cover the test area on the pH strip with the fluid.

    • If you are unable to pull back any fluid, push 2-5 ml of air into the tube and try again to pull back fluid. You may repeat this 2-3 times.

    • If you are still unable to pull back any fluid, lay your child down on their left side. Wait a few minutes and try again to pull back fluid.

    • If you are still unable to pull back fluid, leave the tube open for 10 minutes and try again.

    • If you are not sure the tube is in the stomach, call your healthcare team.

  3. Check the pH by comparing the pH strip with the color scale. Gastric (stomach) pH should be 1-5.

    • If the pH is greater than 5 and your child is not having any trouble breathing or changes in behavior, wait 15-30 minutes and recheck the pH.

    • After rechecking, if the pH is still greater than 5, call your healthcare team.

  4. Once you have confirmed that the tube is in the stomach, flush the tube with the amount of water or air as you have been taught.

Preventing clogs:

  • Always flush the tube before and after each medicine and feeding with the amount of air or water as you have been taught.

  • For continuous feeds, flush every 24 hours.

  • If the tube becomes clogged, attach a 30 ml or 60 ml oral syringe to the tube and pull the plunger back to help loosen the clog. Fill the 30 ml or 60 ml oral syringe with warm water and attach it to the end of your feeding tube. Try to flush the tube. If you are unable to flush, gently pull back on the plunger of the syringe to help loosen the clog. Try to flush the tube. If you still cannot flush the tube, remove the syringe and clamp the tube. Let the warm water soak in the tube for up to 20 minutes, then attach the 30 ml or 60 ml oral syringe to the tube and try to flush.

Care of NG tube:

  • Check the pH before giving anything through your child's feeding tube, such as medicines or formula.

  • Always check that the mark on your child's feeding tube has not changed. If the mark has moved, reposition the tube and check your child's pH.

  • Always check the pH of your child's feeding tube if they do not seem the same and you think something is wrong.

  • Remove the tube and call your healthcare team if:

    • The tube comes out or is clogged.

    • Your child starts choking.

    • Your child has trouble breathing or their face turns bluish-gray in color.

  • Clean the ENFit® connection of the NG tube ports with a toothbrush and water every day.

Watch the video below on cleaning ENFit feeding tube ports:

https://info.chop.edu/3NdBDAr

Reviewed May 2025 by Patty Burns-Lynch, MSN, RN, January 2026 by arly Ehritz, MSN, RN, ACCNS-P

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