Your baby is being cared for in the NICU at Emma Children’s Hospital, Amsterdam UMC. Many babies in the NICU are too young or too unwell to feed by themselves. They are therefore fed through a thin feeding tube that passes through the nose or mouth into the stomach. This is called tube feeding.

Why learn to give tube feeding?

At Emma Children’s Hospital, we encourage parents and guardians to be as involved as possible in their baby's care. Being involved helps strengthen the bond between you and your baby. One way you can participate in your baby's care is by learning how to give tube feeding.

If both parents or guardians would like to learn how to give tube feeding, each person must read this information and demonstrate the procedure independently.

How will you learn to give tube feeding?

Although tube feeding is a common and safe way to feed babies in the NICU, it must be done carefully. Giving tube feeding incorrectly could be harmful to your baby.

This information sheet explains how you can learn to give tube feeding safely. You will learn through education, instruction, and supervised practice. Your baby's nurse will guide you throughout the process.

You will:

  • Read this information sheet
  • Receive an explanation from the nurse, who will demonstrate the procedure
  • Explain the procedure back to the nurse in your own words
  • Give two tube feeds under the nurse's supervision
  • Then give tube feeds independently

There are two ways to give tube feeding: syringe feeding and gravity feeding. Your nurse will teach you the method that is most suitable for your baby.

Once you have demonstrated that you understand the procedure and can perform it safely, the nurse will complete the checklist in your baby's electronic medical record.

After completing the training, you will know how to give tube feeding safely and how to observe your baby during the feed.

From then on, you may give tube feeds independently and are responsible for following the procedure correctly.

If you do not feel confident after the training, please tell your nurse. Together, you can discuss what additional support you may need.

If your baby would benefit from the other method of tube feeding, you will be taught that method separately.

Sometimes the nurse may decide that it is not appropriate for you to give the tube feed. This may be because your baby is too unwell, restless, or unstable, or because you are feeling very emotional or very tired. If this happens, the nurse will give the feed instead. We appreciate your understanding.

Giving a tube feed

1. Preparation by the nurse

Before each feed, the nurse will:

  • Check that your baby is stable enough for you to give the tube feed.
  • Check that the feeding tube is at the correct depth.
  • Make sure the feeding tube is securely in place.
  • If necessary, check whether any milk remains in your baby's stomach from the previous feed.
  • Check your baby's milk and scan the label on the syringe.
  • Connect the syringe to the feeding tube. For safety reasons, only the nurse may do this.
  • Hand you the warmed syringe of milk and remain nearby while you give the feed.

2. Giving the feed

  • Clean your hands with hand disinfection.
  • Give the feed slowly while watching your baby for any signs of discomfort or stress.
  • Make sure the feeding tube is not pulled or moved.
  • Give your baby your full attention throughout the feed.
  • While feeding, gently encourage your baby to suck by bringing their hands towards their mouth so they can suck on their fingers or knuckles.
  • You can also offer a pacifier or a cotton swab moistened with a small amount of breast milk or water, if advised by your nurse.
  • When the feed is finished, call the nurse. The nurse will either flush the feeding tube with air or disconnect the syringe. This should always be done by the nurse.

3. Stop the feed and call the nurse immediately if:

  • You are unsure about anything.
  • The monitor alarm sounds.
  • You feel resistance while giving the feed (the tube may be blocked).
  • Your baby vomits during the feed.
  • Your baby coughs or gags.
  • Your baby's colour changes.
  • Your baby becomes very restless, cries, arches their back, or spreads their fingers or toes.

Do you have any questions?

If you have any questions, please ask the nurse who is caring for your baby.