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If a child is unable to eat after surgery, a gastrostomy tube may be inserted directly into the stomach so the child to continue to receive nutrition.
Use our guide in reference to:
The information contained in this material should not be used as a substitute for the medical care and advice of your physician. There may be individual circumstances of your child's healthcare that cause a variation in treatment.
For more additional information and patient testimonials, view our guide, Supporting Nutrition: Understanding Tube Feeding .
If your child has a Malecot tube with a drain tube attachment device, the first visit will be one week after the operation, where you will learn how to change the dressing. Call the surgeon's office to schedule the appointment. The second appointment is eight weeks after the operation. At that visit, the Malecot will be changed to a MIC-key.
Important note: The first tube change for patients with a Malecot is only done on Tuesdays at 1 or 1:30 p.m. This appointment may take 1 to 2 hours. After the tube is changed from the Malecot to the MIC-key, your child will have to go to radiology to check placement.
If your child has a MIC-key placed at the time of the operation, the first visit will be two weeks after the surgery to have the incision and GT site checked.
MIC-keys are changed every 4 to 6 months. You will be taught how to change the tube.
At the end of each feeding and after every medication, the tube must be flushed or rinsed with 5 to 10 ml of water to prevent the tube from becoming clogged with formula or medication.
Note: When possible, have your physician order a liquid form of the medications that you will be giving through the tube. Some pills can be crushed, mixed with water and given through the tube. However, when capsules are opened, they will clump together in the tube and may clog it.
Children with reflux who have a fundoplication may have difficulty with gas pain. To relieve this, attach a 30 cc or 60 cc syringe, without the plunger, to the tube for 10 to 15 minutes after each feeding to allow air to escape. Children that receive continuous feedings may have their feeding interrupted for 10 minutes every 3 to 4 hours for venting.
Children can take a bath four days after the operation. Change the dressing after the bath if it is wet or loose and no longer stabilizes the tube.
Several dressing types may be used to secure the gastrostomy after surgery. The dressing is very important because it:
A 2x2-inch gauze or split gauze pad and tape should be used.
These pages have been adapted from materials developed by Susan Luck, MD; Marleta Reynolds, MD; Srikumar Pillai, MD; Teri Coha, APRN-CNS, CWON; and Kerri Keller, CNP.