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Orogastric (OG) Feeding Tube Insertion

Important information about orogastric (OG) feeding tubes:

  • An OG tube is a soft, thin, flexible tube used to deliver liquids to the stomach. It can be used for nutrition or medicine.

  • A caregiver inserts the tube through the mouth, down the throat, through the esophagus (food pipe), and into the stomach.

  • The OG tube can be used for a short time or longer, depending on your child’s needs.

Preparing for OG tube placement

  1. Wash hands with soap and water or clean with hand sanitizer for 15 seconds and allow to dry.

  2. Gather supplies:

    • Feeding tube without stylet or feeding tube with stylet

    • Oral syringe

    • Water

    • Medical tape or Tegaderm™

    • Duoderm™

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

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

    • pH strip

    • Scissors

    • Waterproof permanent marker or pen

      Close-up of a purple tube with a purple tube attached to it AI-generated content may be incorrect.

      Close-up of a wire connected to a cable AI-generated content may be incorrect.

      Feeding tube without stylet

      Feeding tube with stylet

      Used with permission from Avanos Medical, Inc.

  3. Remove feeding tube from package.

  4. Measure the distance to insert the feeding tube. Start with the feeding hole at the end of the tube. Measure from the center of your child's lower lip to the bottom of the earlobe, and then to the stomach, halfway between the bottom of the breastbone and the belly button. Mark this point on the tube with a waterproof permanent marker.

    How to measure distance to insert the OG tube.

  5. Prepare supplies that will be used to secure the tube.
    Cheek taping:

    • Measure and cut Duoderm (to protect skin).

    • If using Cavilon No Sting Barrier Film, apply it to the skin where you will be putting the Duoderm and let it dry.

    • Peel backing off the Duoderm to uncover adhesive and place Duoderm near the corner of the mouth where you are going to tape the tube.

    • Cut medical tape to form a Y.

    Chin taping:

    • Measure and cut Duoderm (to protect skin).

    • If using Cavilon No Sting Barrier Film, apply it to the skin where you will place the Duoderm. Let the skin barrier dry.

    • Peel backing off the Duoderm to uncover adhesive and place Duoderm on the chin where you will tape the tube.

    • Prepare Tegaderm to keep tube in place. Measure and cut the Tegaderm to same size as the Duoderm.

Instructions for inserting OG tube:

  1. Explain to your child what you are going to do. If your child is young, it may be helpful to have someone help you hold them.

  2. Place your child in an upright position. This may be sitting or with head elevated 30-45 degrees. They should not lean forward or tilt their head or neck back.

  3. Lubricate the end of the tube by dipping it in water or water-soluble lubricant (such as K-Y jelly).

  4. Insert end of the tube into the mouth towards the back of the throat and downward.

  5. Thread the tube downward to the marked point on the tube. Encourage your child to swallow. It is normal for your child to gag when you are placing the tube. Remove the tube if:

    • You meet resistance.

    • Your child starts choking.

    • Your child has trouble breathing.

    • Your child turns bluish gray in color.

    • Your child keeps gagging, coughing, or throwing up after the tube is placed.

    • Your child remains very restless and irritable after placing the tube.

    • Your child's behavior is not normal.

  6. Once the tube is in place, secure it with the tape or Tegaderm. There are different ways to secure the tube.

    Cheek taping

    Chin taping

     

    • Cheek taping: place the wide part of the Y tape on the Duoderm. Place the top arm of the Y above the lip. Spiral the other arm of the Y around the tube.

    • Chin taping: place the tube over the center of your child's lower lip. Put the Tegaderm or tape over the tube and secure it to the Duoderm.

Instructions for confirming OG tube placement:

Once the tube is secured, check for proper tube placement.

                                                       Used with permission from Avanos Medical, Inc.

  1. Attach an oral syringe to the side port.

    • If the feeding tube does not have a stylet, make sure the straight port is closed.

    • If the feeding tube does have a stylet, make sure the stylet is firmly in the straight port.

  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 3-5 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.

    • After rechecking, if you are still unable to pull back any fluid, remove the tube and reinsert it. After reinserting the tube, if you are still unable to pull back any fluid, call your healthcare provider.

  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, follow these steps:

    • Wait 15-30 minutes and recheck the pH.

    • After rechecking, if the pH is still greater than 5, remove the tube and reinsert it. After reinserting the tube, if the pH is still greater than 5, call your healthcare provider.

  4. Once you have confirmed that the tube is in the stomach with a pH of 1–5, make sure the straight port is closed or the stylet is firmly in the straight port. Then attach an oral syringe with 5 mL of water to the side port and push the water through the tube. This clears stomach fluid from the tube and activates a lubricant inside, making it easier to remove the stylet (if one is present).

  5. If the feeding tube has a stylet, remove the stylet and close the straight port. Save the stylet. If the tube comes out, you will need the stylet to reinsert the tube. Do not reinsert the stylet while the feeding tube is in your child. Do not use the stylet if it is bent.

  6. Write down the number marking where the tube is secured.

  7. Change the tube to a new one if there is a leak in the tube or you can no longer read the markings on the tube.

  8. If you need to reinsert the tube and are reusing a tube:

    • Clean the tube by rinsing the tube with warm water only. Air dry on a paper towel.

    • Remeasure the tube.

    • Clear the tube by flushing with 3-5ml of air.

    • If the feeding tube has a stylet, coat the stylet with water-soluble lubricant before placing it in the tube.

    • Discard the tube if you are unable to get the tube clean, it has an odor, or the stylet no longer reinserts properly (if present).

  9. Call your healthcare provider if your child’s mouth, lips, or face become irritated.

Instructions for OG tube care:

  • Before giving medicine or formula through your child’s feeding tube, always check the pH.

  • Make sure the mark on the feeding tube hasn’t moved. If it has, reposition the tube and check the pH again.

  • Check the tube placement (pH) if your child is not tolerating feeds or medicine, or if you think something is wrong.

  • Keep a backup OG tube at home. Contact your home care provider when your supplies are running low or when you insert your last OG tube. 

  • Clean the ENFit connection of the OG 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 January 2026 by Carly Ehritz, MSN, RN, ACCNS-P

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