Hellobee

I’ll be rounding on 2 years as a tubie mom in the fall. I can’t believe that a) it’s been this long and b) I haven’t tackled this particular topic yet! I am proud of the feeding tube tips posts I’ve done in the past (here, here, and here), but there are some major gaps in my coverage which I am working on remedying.

Changing out D’s G tube was one of my most feared tasks when he first got it in. It’s supposed to get swapped out every 3 months, but I managed to not do it on my own until he was 8 months old. Thankfully I asked the GI docs to show me at an appointment, because a few days later K pulled it out for the first time! I had to scramble around the house grabbing supplies and comfort a screaming D to change it out. That hectic scene has only repeated a few times – each time I have to do it it gets easier. I’ve even talked my MIL through it on the phone! Tubie mamas and papas, it’s not as scary or hard as you think.

Please note that this is not official medical advice and you should absolutely have a medical professional demonstrate this for you before trying it on your own. Think of this as more of a quick reference guide for you or other caregivers.

Let’s get familiar with the g tube. If you’re new to the world of feeding tubes, you may have not checked out what a G tube looks like outside of a person. It’s not so scary!

Inside v. Outside!

The way the tube stays in the tummy is by inflating the little rubber balloon with water using a syringe.The balloon ends up on the inside of the tummy and the port on the outside. The length of the tube (for D, 1.2 cm) is the thickness of the stomach lining and abdomen that the tube goes through. The “french” size is the diameter of the tube (for D, 14 fr). When it’s inflated, it looks like this!

Ok, now let’s talk about how to change it out. I’ll assume that your LO has a tube already in. If the tube has been pulled out, just skip to the step when the tube is out.

Changing a G Tube 

1. Open up your new G tube kit. It has a new G tube, a small syringe, a big syringe, some gauze, and some extensions. Ignore the extensions and big syringe for now.

2. Grab some KY Jelly (yes, really), a Q tip, and a small amount of water. Cut one end off the Q tip and stick the non-fuzzy end into the middle port of the new G tube. This keeps the balloon segment stiff and makes it much easier to stick in the tummy – without it, it’s like trying to stick a flexible, rubber post in your earring hole, without being able to grab the back of your ear! Thanks to the wonderful blog A Girl and Her Tube for this idea!

3. Coat the end of the new G tube balloon lightly with KY. Water based lubricants are preferred over Aquaphor or Vaseline since they won’t damage the plastic on the balloon. Keep it ready on a clean piece of gauze. Ok, the new tube is prepped, let’s move on to your LO!

4. Remove any extensions and cloth pads or gauze. Use the empty syringe and stick it into the port on the side of the G tube on your LO’s tummy. Make sure you have a good handle on your LO! The syringe will either automatically start filling up with water, if not, just pull it slightly to get it to empty all the water out of the balloon. Apologies for no pictures of these next steps but I’m sure you can imagine that I need both hands!

5. Once the balloon is empty, the G tube should be able to slide right out. Your LO may react negatively, but I’m pretty confident it doesn’t hurt, since I’ve replaced it with no protest when D was awake and distracted, and have replaced it while he was sleeping without waking him. If you can choose when to do this, I would change it out a few hours after a feed – full bellies will start squirting out of the hole! Use the gauze to either cover the hole or wipe up any spillage.

6. Grab the new, stiffened, lubricated tube and stick it in the hole. Use either the water you just pulled out of the old balloon to fill up the new one (as you press the new tube down on their tummy) or empty it out/top it off with the water you grabbed earlier. D’s balloon gets filled with about 5mL of water – please refer to your LO’s docs for the correct amount, it can vary.

7. Remove the syringe – this can be tricky to do while keeping all the water in the balloon – just slip it out after pushing all the water in while keeping your other hand on the tube. Use some gauze to wipe around the site and clean up any more lubricant or tummy spillage.

8. You’re all done! Pop a new cloth pad (or gauze) on there and pat yourself on the back! Hooray for you!

Packing an Emergency G Tube Swap Kit

Ok, now let’s talk about a good use of that old tube. Assuming it’s not damaged, you can make an emergency G tube change kit! This idea is also courtesy of A Girl and Her Tube. I really should have been carrying around this emergency kit from the beginning – I’ve so far been lucky that D’s tube has only ever been pulled out when we’re at home. Now I keep this kit in the diaper bag (I mentioned it briefly in my diaper bag post) and a duplicate at D’s school. It just takes the guesswork out of some of the steps above – I made a kit for the spare G tube set at my in-laws’ house so next time my MIL has to change it, she doesn’t have to think about the amount of water, or finding lubricant, etc.

Just prepare clean syringes (with caps!) for the correct amount of water and a small amount of KY – 1 mL is fine – good luck getting it in a syringe, it’s super slippery and awkward! Also include some gauze, alcohol or other sanitizing wipes, an empty syringe, a spare G tube (which you conveniently now have!), the aforementioned cut off Q tip, and an extra cover. I clean the G tube and stick it in its own in a bag so it’s ready for use next time. I am probably OCD but I label everything to make it as clear as possible. I’ve also discovered that Sharpie wipes easily off ziplock bags, so I write on paper and stick it inside the bag instead.

Tubie moms and dads, am I missing any good shortcuts or steps? What’s the craziest place that you’ve swapped out a tube? Do share!