What to Know About Tube Feeding Babies

Medically Reviewed by Renee A. Alli, FAAP, MD on July 09, 2023
4 min read

Premature babies aren't usually mature enough to take a bottle or nurse at the breast. If your baby needs help eating, your pediatrician may suggest a nasogastric tube (NG tube) that goes into your baby’s nose and into their stomach. 

Tube feeding helps your baby by providing much-needed nutrients and hydration so they can thrive.

A nasogastric tube is thin, soft, and flexible. The tube feeds directly into your baby’s stomach and food is processed through normal digestion. It shouldn't make your baby uncomfortable. The tubes are specially designed to prevent discomfort.

While nasogastric tubes can be used across all ages, they're most commonly prescribed for infants and children. Your child’s pediatrician may talk to you about an NG tube if your baby:

  • Needs nutrients or medication in the short term
  • Isn’t gaining weight well enough by nursing or taking a bottl‌e
  • Has a health condition that decreases their ability to swallow effectively 
  • Had surgery or contracted an infection that restricts their ability to eat or drink
  • Isn’t getting enough nutrition from nursing or a bottle and needs supplementation

Nasogastric tubes are a short-term solution only. There are other options meant for long-term tube feeding. If your pediatrician expects you to feed your baby via a tube for a longer period of time, they may prescribe a different treatment plan.

Ask your doctor how long they expect your baby to need a feeding tube once it's prescribed.

When your baby is in the hospital, medical staff handle inserting the tube into your baby’s nose for feeding. But if your baby needs to go home with a tube, it’s important to learn the procedures so you can handle feeds yourself.

Your doctor will give you instructions for caring for, cleaning, and inserting the tubes based on your child’s needs. You may need to replace the tubes at certain intervals. 

It’s crucial for your baby’s tube to be placed correctly, or the food can drain into their lungs or throat. Even if you pay close attention to instructions, you may still struggle once you’re home. If so, talk to your doctor about your concerns. They may suggest a home health nurse who comes to help you with feedings until you’re comfortable. 

Tips for tube feedings. You’ll insert the nasogastric tube for each feeding and remove it when you’re finished. Every time you insert the tube, it’s important to extract a small sample of fluid from your child’s stomach and test it. 

By completing this test, you ensure that the tube placement is correct and food won’t enter the wrong part of the body. You have two options for feeding your child, and the option you choose may depend on your specific needs. 

Continuous feeding. With this tube feeding option, the tube is inserted for longer, and food enters a little at a time. Your baby’s tube is hooked up to a machine that drips the food into the tube. When you leave the hospital, your pediatrician tweaks the settings on the machine for your baby’s needs. 

Don’t change the settings once you’re home unless your pediatrician asks you to.

Bolus feeding. You’ll give less food at a time compared to continuous tube feeding. You may still use a machine, but also have the option to insert food manually via a syringe. 

If you have any concerns about tube feeding your baby, call your pediatrician right away. Reasons to be concerned may include:

  • It’s difficult to place the tube in the right spot, and you’re not confident it’s correct. 
  • Your baby’s breathing changes after inserting the tube or once a feeding is complete.
  • Your baby’s skin surrounding the tube is swollen, red, raw, or oozing.
  • You notice blood in the tube, in your baby’s stomach fluid, or when your baby poops.
  • Your baby is coughing, choking, or vomiting after inserting the tube.
  • You notice your baby’s stomach sticking out farther than usual, and it doesn’t feel soft when you apply gentle pressure.
  • Your baby doesn’t have normal poops after a tube feeding. They may experience diarrhea or constipation. ‌
  • Your baby’s temperature reaches or exceeds 100.4 degrees Fahrenheit. This is especially important if your baby is recovering from surgery or an infection. 

A nasogastric tube should be safe if you follow the procedures for use. But the tubes have some risk, especially for fragile infants. Be aware of potential side effects so you know what to expect. 

Discuss with your doctor what to do in case of accidental removal of the tube.  

While an NG tube shouldn’t be painful, it may cause mild discomfort from continuous insertion and removal. Irritation may lead to sinusitis, also called a nasal infection, or epistaxis, also called a nasal hemorrhage. Once your baby’s tube treatment is complete, these symptoms should resolve on their own.

Incorrect placement can have life-threatening consequences for your baby. Tubes may puncture your baby’s esophageal tissue or enter their lungs instead of their stomach. Long-term tube feeding for babies can lead to stomach irritation, including bleeding or ulcers.