Emergency and Urgent Care - Short Term Paediatric Nasogastric (NG) Tubes - Information for parents/carers

What is a Nasogastric Tube and what is it used for?

A Nasogastric tube (NG) is a narrow tube which is passed into the nose and down the throat into the stomach, which allows liquid feed to be delivered directly to the stomach.

In paediatrics, Nasogastric tubes are used to provide an alternative method of feeding to the oral route, for children who attend with respiratory problems and infants unable to meet full fluid requirement from the breast cup or bottle. They can also be used to prevent swelling of the stomach by gas or pressure e.g. in the resuscitation process.

How is the nasogastric tube inserted?

A trained staff member will insert the NG tube into your child’s nostril. Staff will discuss and explain the procedure to you and offer you the opportunity to remain in the room or wait outside during insertion to minimise anxiety. Staff will measure the tube against your child and once measured will gently insert the tube into the chosen nostril and slide backwards and downwards along the floor of the nasal passage into the stomach.

Once staff are confident the tube is in the correct place, they will then obtain a small amount of aspirate (fluid from the stomach) from the tube via a syringe. Aspirate will be placed on a special strip which tests the PH and a reading of <5.5 should be obtained to ensure the tube is in the stomach. The tube will then be fixed down to the skin on top of a barrier dressing to protect the skin.

Occasionally an x-ray may need to be obtained to confirm placement. During insertion children may retch, cough and breath hold for a short period which is normal. Insertion is uncomfortable but does not hurt.

Potential complications

As with all medical interventions there may be some potential complications of NG insertion some complications are listed below

• A small risk of the tube may enter the lungs
• The tube may coil up in the patients throats particularly if they retch during insertion
• Stomach acid or food/fluid can flow back up the throat and could go back down the wrong way into the lungs
• Damage to the skin on the face
• The tube may move out of the stomach if pulled accidentally or child vomits or coughs excessively
• Can increase nasal secretions when first passed or if child has a cold
• Repeat attempts at insertion may be needed if unable to obtain aspirate or if tube needs removing on insertion due to patient distress

Benefits of NG insertion

• Adequate nutrition and hydration
• Safety for aspiration risk
• Symptom improvement - for babies with increased work of breathing the use of the NG stops tiredness when feeding
• Effective for medication administration

The nursing staff will care for the NG tube throughout your time in the department. Please don’t hesitate to discuss with nursing staff any concerns you may have regarding the tube.