GAVAGES'

FEEDING
GAVAGE FEEDING
It is a methods for
providing feeding via
catheter passed through
the nose or the mouth
pass the pharynx , down
the esophagus into the
. stomach
 Indication of gavage
feeding
Poor sucking reflex .

Post
operatively
Respiratory distress

Loss of consciousness

Cyanosis after feeding by bottle

or medication dropper .
Congenital abnormalities. As

cleft lip and cleft palate.

Swallowing disorder

Neurological impairment.

 Contraindication
of gavage feeding
Absent of bowel
sound
 :-Purpose To provide
A safe method of feeding or
administrating medication where the
infant is unable to suck or swallow.
A route that allows adequate caloric
or fluid intake.
A safe method of feeding in sick
infant.
To prevent fatigue or cyanosis
from. bottle feeding.
Equipments

o sc o p
Steth a dh es i v e
l er g i c
e Un al
taepreent size of s yri n g e
Dif t si ze of
D i ff eren
NGT

gloves
an d b i b
Towel
 procedure
Steps of procedure Rational
.Wash hands.1 prevent cross-
.infection
.Prepare equipment &supplies. 2 save time and-
.effort
Explain the procedure to the child and. 3 To facilitate
.family cooperation an
decrease fear
Position the child on the back or right side with .4
the head of the bed elevated, a small child can be
held in a parents arms with the childs head on the
parents shoulder. An older child may sit up in the
.bed, restrain if necessary
 Procedure Cont

Measure the length of the tube to be inserted, .5

.and mark with a waterproof marker or with tape
 Procedure Cont
6.To place a nasogastric tube in a child,
measure the distance from the tip of
the nose to the earlobe and then down
to the xiphoid process. to place an oro-
gastric in an infant, measure the tube
from the tip of the nose to the earlobe
and to the midpoint between the end of
the xiphoid process and the umbilicus
7. Lubricate the tube with water or To facilitate
saline or childs saliva. In neonates passage
and for orogastric placement, use through the
water only. nasophayrnx
Insert the tube gently but firmly. 8
through the mouth or nose and down
 Procedure Cont
N.B. If the child gasps, Swallowing will
coughs, gags, or turns ease insertion
cyanotic, withdraw the tube into the
and wait for the response to . esophagus
subside before proceeding,
if you encounter
obstruction or if the tube
curls in the mouth, remove
the tube and repeat this
.step
 Procedure Cont
Continue to advance the tube gently. 9
to the predetermined mark, while
advancing the tube, ask the cooperative
child to swallow repeatedly when the
tube reaches the pharynx advance the
.tube 5 to 10 cm with each swallow

Giving an infant a pacifier.10 Pacifier encourages swallowing

direct the tube toward the back
of the throat
Temporarily secure the tube with.11
tape to stabilize it while you check the
.tube position
 Procedure Cont
Check the placement of the.12
tube: attach the syringe to the
end of the tube, and insufflate 1
to 5 ml of air while auscultation
over the stomach area, then
withdraw the air, or attempt to
aspirate the gastric contents for
.PH testing litmus paper

Once tube placement is.13

confirmed, tape the tube securely
in place and label the tube with
.the data and time of insertion
 Procedure Cont
Prepare formula, check.14
its temperature, it should be
in room temperature,
reconnect the syringe to the
tube; fill the syringe with
the right amount of food, if
necessary, push gently with
plunger to start flow of
formula, then remove the
plunger and allow the
.formula to flow by gravity
 Procedure Cont
Continue adding food until the right amount has been fed.. 15
.Do not allow the syringe to become empty

When the food is at the bottom of the syringe, add 1-2. 16

. teaspoons (5-10 ml) of sterile water to rinse the tube

After feeding place the clamp on the tube if it will be left. 17

. in place between feedings

.Observe the patient carefully. 18

. Dispose equipment properly. 19
 Procedure Cont

:Record. 20
Type of feeding
Amount taken
Vomiting if happened.
Reaction of patient (normal,
cyanotic, irritable).
 Procedure Cont
: To remove the tube. 21
Loosen the tape that is holding the tube.
Fold the tube and pinch it tightly together.
Pull the tube quickly
Hold, cuddle and burp the child.

.Observe the patient carefully. 22

. Dispose equipment properly. 23