Gastrostomy Tube Feeding Procedure

The Skills Check List for Gastrostomy Tube Feeding Procedure can be found in the Forms Section.

Purpose: To provide feedings for the student who is unable to receive adequate nourishment by mouth.

Action to be performed by: Person trained by a licensed health care professional.

Doctor’s orders: Required.


  1. Review the physician’s treatment order.
  2. Assemble equipment:
  3. Feeding solution at room temperature (Should sit at room temp for 1 hour) (Excessive heat coagulates feedings and excessive cold can reduce the flow of digestive enzymes and cause abdominal cramping).
  4. 20-60 cc syringe with catheter tip.
  5. Tubing clamp or plug.
  6. Container of water.
  7. Encourage student to participate as much as possible.
  8. Position student sitting or semi-reclined with head of bed or chair at a 45° angle. These positions enhance the gravitational flow of the feeding and help prevent aspiration into the lungs.
  9. Use standard, universal, precautions throughout the entire procedure.  Wash hands and apply


  • Observe the peg/button and skin around gastrostomy for bleeding sores or leakage. Report any signs of infection, irritation, or leakage. If ordered, clean with prescribed cleaning solution.
  • Check for proper placement:
  • Draw 1-5 cc of air into a syringe. Place stethoscope on the left side of the abdomen just above the waist. Attach syringe and/or adaptor to the tube or button.
  • Unclamp the tube.
  • Gently inject air into the feeding port and listen to the stomach for a “air rush” (gurgling or
  • growling sound.)
  • If checking residual was ordered, then aspirate all the stomach contents and note the amount; then re-instill all the aspirate. If quantity of residual is greater than physician ordered, do not feed. Delay 30 minutes; then repeat aspiration. If residual continues to be greater than ordered, contact parent.  This is done to evaluate absorption of last feeding, i.e., whether or not there is undigested feeding solution remaining from previous feeding (residual). If residual is present, adjust the feeding according to orders.
  • Clamp the tube, remove the syringe, and reattach the syringe (without the plunger) or the feeding bag to the clamped tube or into button.  Clamping the tube keeps excess air from entering the stomach, preventing distention.
  • Unclamp the tube; allow air bubbles to escape; fill the syringe with feeding solution or attach prepared feeding bag containing solution (room temperature). Elevate the tube and syringe to about 4-6 inches above the student’s abdomen to start the feeding.

Allow the feeding to flow by gravity, adding solution slowly as contents empty, keeping solution in the syringe at all times until feeding is complete.  Never force solution through the tube.  If the tube is obstructed, do not feed. Contact parent. If using feeding