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A jejunostomy tube (j-tube) enters through your abdomen into your small intestine. You will use this tube for tube feeding formula, water, and medicine (instead of taking them by mouth). Tube feeding formula is a liquid source of nutrition that provides calories, protein, water, vitamins and minerals. You will start your tube feedings in the hospital and require follow-up with a registered dietitian after you go home.

Tube Feedings

You will receive your tube feeding formula through a feeding pump over a specific time frame. Follow these instructions for your j-tube feedings, or as directed by your healthcare provider.

  1. Wash your hands with soap and water. Dry them with a clean towel.

  2. Use room temperature formula. Very cold formula may cause lower stomach pain.

  3. Wash the lid of the can and dry the lid with a clean towel.

  4. Only open containers of formula that you will need for the feeding.

  5. Shake the can(s) before opening.

  6. Only place 8 hours’ worth of formula into the bag or as otherwise directed. Store opened leftover formula in the fridge with a cover. Discard formula that has been open for more than 24 hours.

  7. Open the cap on the feeding tube and using a syringe, insert at least 30 mL of warm water into your tube.

  8. Remove the syringe and put the tubing from the pump into your feeding tube.

  9. Pour the formula into the feeding bag and start the pump at the prescribed rate.

  10. Keep your head elevated at least 30 degrees while you receive a feeding.

  11. To prevent clogging, flush the tube with 30 mL water every 4 hours while the tube feeding is running.

  12. When the feeding is complete, disconnect the feeding bag. Flush the tube with at least 30 mL of warm water and cap the tube to prevent leaking.

Cleaning

  1. Rinse the feeding bag and tubing with water and then swish with warm water and a small amount of liquid dish soap. Rinse and allow to air dry.

  2. Clean the syringe with warm, soapy water and allow to air dry completely between feedings.

Change the tube feeding bag every 3 days and change the syringe each week.

To allow you more freedom, there are special backpacks you can get for feeding pumps. Check with your medical supplier about this option.

Water Flushes

Your body needs enough fluid each day to stay hydrated. Your tube feed formula will provide some fluids. The rest of your fluid will be met by oral intake (if safe) and/or by doing water flushes through your feeding tube. You may not be getting enough fluid if you have: dizziness, dry mouth, dry lips, lower urine output than normal and darker urine.

Medicines

You can give medicine through the feeding tube if you cannot swallow them. Follow these instructions:

  1. Do not add medicine directly to the formula. Give each medicine one at a time; do not mix together.

  2. Flush the tube with 30 mL water before giving a medicine. If giving more than one medicine at one time, flush in between each dose with 10mL water.

  3. Crush and dissolve pills in at least 30mL water before flushing them through the tube. Never crush enteric-coated or time-release capsules. Flush the tube again with30 mL water after you give the medicine.

My Tube Feed and Hydration Plan

Tube Feed Formula

_________________

Goal Tube Feeding Schedule

You need a total of _____ cartons. Set your pump to a rate of ______ mL per hour, this will run for _____hours. Start your feeding at _________. End your feeding at _______. You can adjust these times as needed.
Tube Feeding Advancement

If you prefer to shorten the total time of your tub feeding increase the rate. Do not advance the tube feeding if you are not tolerating the feedings well. Here are some options:


______ mL per hour for _____ hours
______ mL per hour for _____ hours
______ mL per hour for _____ hours

Additional Water Flushes

In addition to goal tube feeds, you need______ mL of water per day

Hydration Schedule

____________________________________

When to Call

  • The tube clogs. Your tube may clog at times because of medicines or if you are not flushing with water often enough. This is not an emergency. First try to flush the tube with 30 mL of warm water. Never force fluid into the tube. If this does not unclog the tube, call the clinic.

  • Tube falls out. It becomes harder to replace the tube the longer it is out.

  • You are losing weight. Weigh yourself 3 times a week at the same time of day on the same scale. Early morning is best, after urinating. Keep a record of your weight. If you notice weight gain or loss of more than 2-3pounds per week contact your healthcare team.

  • Nausea or upset stomach for more than 24 hours.

  • Diarrhea (3 or more loose, watery bowel movements) for more than 2days.

  • Constipation (lack of bowel movement) for more than 5 days.

  • Anything that causes you to stop giving tube feedings for more than one day.

Who to Call

If you are a UW Health patient and have more questions, please contact UW Health at one of the phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at: (608) 287-2770.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.