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I was a little overwhelmed taking my son home from the hospital four days after his G-Tube was placed. Not only was I worried about taking care of the tube site and feeding him with a pump, but he was 5 weeks old, less than 6 pounds, and had spent his whole life in the NICU.
I was bound to make a few mistakes. Here are just a few that maybe someone can learn from:
Not taking the cap off the tube
Every morning we throw out the old pump bag and start with a new one. So, every morning we have to prime the new tubing.
The first couple of days home I didn’t think to take the cap off the end of the tube. When the milk is pumped through the tube, the air in the tube needs to go somewhere. That air creates a lot of pressure and sends the cap flying. I’m just glad nobody got hurt!
Repriming the floor
For some reason I don’t always put enough milk in the bag. (I seriously don’t understand it. I measure the same every time.) When the tube gets an air bubble, you have to reprime the pump.
To avoid wasting milk, it’s best to stick the end of the tube (without the cap š) in the bag so the milk just cycles through. On several occasions I have absent-mindedly started priming with the tube just hanging there feeding the floor.
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Spilling milk on the pump
When the home health company delivered our EnteraLite Infinity pump, the guy who taught me how to use it explained that it was water resistant and could be rinsed when, not if, we spilled milk on it.
I didn’t understand how I would spill on it, but after only a few days home, I learned. Pouring milk into a bag in the dark at 3 am when you are sleep deprived from finally having your baby homeā¦ it’s difficult. Plus, the bags are like suctioned tight to themselves. The milk tends to puddle in the opening.
Thank goodness the pump is water resistant.
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Sleeping through a feeding
I know, this one sounds bad. My son is on continuous feeds at night from 9 till 6. That sounded awesome until I was told breastmilk can only be out for 4 hours. So I wake up at midnight and three oāclock to add milk and restart the pump. Or at least, I’m supposed to.
I’m not proud of it, but I’ve slept through my midnight alarm more than once. Luckily I woke in a panic at 12:30 and we were only a little off on his night feeds. This goes back to that sleep deprivation. I felt bad, but, at least for my son, being a half hour off for a few hours wasn’t detrimental.
Not restarting a feed
Along with not having quite enough milk came the beeping that alerted me the pump didnāt have enough food. It usually happens right at the end of the feed when thereās just a few millileters left. At first Iād just turn off the alarm and be done with the feeding and reprime before the next feeding.
Turns out, if the pump settings are the same, it remembers how much was left in that last feed. Then it finishes the last feed just a few minutes into a new feed. This happened a few times when I had the pump and bag in the backpack and didnāt realize my baby didnāt get the feed until I noticed there was way too much milk left!
If a feed didnāt quite finish, make sure to restart the pump for the new feed or to move the dose or rate up or down a little to reset the pump before the new feed.
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Not flushing the tube
On a more serious note, don’t forget to flush the tube with water! After every feed. I took a g-tube class and spent days in the NICU after my baby had the tube placed, but I only remember being told to flush the tube after medications. I even specifically asked several nurses who told me it was fine to leave the milk in the tube between feedings. And they did just that.
This was a big mistake. I feel like I should have known better. What held me back was my worry about giving him too much water. Since we weren’t supposed to take the tube off for several weeks and there was always milk in it, it took a while to notice the build up. I started flushing the tube, but it got worse and worse.
When we could finally take it off, I tried to clean it over and over, and eventually replaced it. Even not flushing it during his night feeds results in a foggy tube that becomes difficult to clean.
Forgetting to clamp (or unclamp) the tube
They also warned me about this one at the hospital, and I’m not sure I’ll ever stop making this mistake. Whenever you hook the tube thatās attached the the baby to the pump tube or give medicine, you have to clamp the tube or its contents come spilling out. Sometimes I absentmindedly forget. Sometimes there are so many steps in giving medications that I miss one. Heck, sometimes I start the feeding only to have the pump beep at me because I forgot to unclamp the tube and there is no flow.
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Not venting
Another of my more serious mistakes. When my baby was in the NICU, he was generally happy until he wasn’t. Everything changed when he started to have reflux, couldn’t eat by mouth, and was diagnosed with laryngomalacia.
He was fussy. A lot. I often walked into his room to see someone else holding him trying to keep him calm. I often heard how upset he always was. So when we took him home and he was fussy, I figured that was his normal.
This is something else I feel I should have known. My sister-in-law asked about venting once and the pediatricianās office suggested it once. Since he burped just fine and I hadn’t seen or heard anything about it at the hospital, I didn’t think much of it.
I started venting after more than two weeks home. It was like I had a different baby. I could set him down. My toddler would get excited and say, āHeās still happy!ā after only five minutes. Seriously, my best advice would be to vent.
Iāve made mistake after mistake and have learned so much! I remember when we took the g-tube class and I was told Ā I would get so used to managing the g-tube that it would be like second nature. I had a hard time believing it. Now it seems strange to me that people can just feed their babies with bottles!
If you have experience with g-tubes, what other mistakes have you made? If you know someone who has a g-tube or is caring for someone with one, share this post with them!
Great tips. I’ve been there. Don’t forget to close ther med port! I’ve fed the bed numerous times because it wasn’t closed.
Done that! Pretty sure I didn’t close it well enough one time cause it popped off at the end of a feed.
Oh man brings back memories from when I first brought my son home 3 years ago. He still had his g-button and probably will for many years. It is true though… it becomes second nature once you’ve been doing it so long. I now have a 2 month old daughter and it is still strange feeding her with a bottle. I always feel like I’m forgetting to do something with her because she just so simple to care for.
I made the venting mistake when we too our son home. They briefly showed us how to vent, and I did do it when we first brought him home but I wasn’t doing it enough. Once I figured out that he needed it more often he was a different baby.
I also make the mistake of not priming the extension before giving meds. They never told us to in the hospital. I had to learn that on my own.
For foggy extensions and bolus tubes for venting we use hot water and vinegar. Use a syringe to draw up he water mixture into the tube and clamp and let sit for an hour or so and rinse clean! Works for us.
And still to this day the clamp gets us haha during the night when we pause the marchine to vent we forget to unclamp.
Thanks for sharing your adventure. Nice to hear I’m not the only one that’s had to learn along the way and made mistakes.
Thanks for the vinegar and water tip! I will have to try that. It’s also good to know I’m not the only one to do some of these things.
I’ve so done these. Especially feeding he bed through the med port and spilling milk all over the carpet while “filling” the bag. Thank you for sharing.