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Percutaneous Endoscopic Gastrostomy in Children: What to Expect at Home

Percutaneous endoscopic gastrostomy (PEG) is a procedure to make an opening between the skin of your child's belly and stomach. The doctor put a thin tube called a gastrostomy tube (also called a G-tube, PEG tube, or feeding tube) into your child's stomach through the opening. The tube can put liquid nutrition, fluid, and medicines directly into the stomach. The tube also may be used to drain fluids or air from the stomach.

Your child's belly may feel sore for several days. It will take about a week for the skin around the feeding tube to heal. Your child may have some yellowish mucus where the feeding tube comes out of the belly. This is normal. It's not a sign of infection.

You will need to learn how to use and care for your child's feeding tube. Your doctor may recommend that you have a nurse or dietitian visit you at home to help you get started with the feeding tube.

A feeding tube can break down over time. If this happens, the tube will be removed and replaced. Sometimes a tube is removed if your child has an infection that is getting worse. Sometimes a tube will come out by itself. Your doctor will give you instructions about what to do if this happens.

This care sheet gives you a general idea about how long it will take for your child to recover. But each child recovers at a different pace. Follow the steps below to help your child get better as quickly as possible.

How can you care for your child at home?

Activity

  • Have your child rest when your child feels tired.
  • Encourage your child to be active. For many children, walking is a good choice.
  • If your child is an infant, follow your doctor's instructions about any activity that involves placing your child on their stomach.
  • Allow the area to heal. Don't let your child move quickly or lift anything heavy until your child is feeling better.
  • Your child may shower as usual. Pat dry the skin around the feeding tube. Do not let your child take a bath unless your doctor tells you it is okay.
  • If your child is an infant, follow your doctor's instructions about when and how to bathe your child after the procedure.

Diet

  • Follow the doctor's instructions about eating and drinking.
  • Follow the doctor's instructions about what nutrition and fluids to feed through your child's tube.

Medicines

  • Your doctor will tell you if and when your child can restart any medicines. The doctor will also give you instructions about your child taking any new medicines.
  • If your child takes medicine through the feeding tube:
    • Follow exactly your doctor's instructions about how to do this. Don't try to put whole pills in the feeding tube. They may get stuck. Ask your doctor if liquid medicine is available.
    • Do not mix your child's medicine with tube-feeding formula. This can cause a clog in the feeding tube.
    • Do not put more than one medicine down the feeding tube at a time.
    • Flush the tube with water before and after you put each medicine down the tube.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
    • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
    • Store your child's prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.

Incision care

  • Your care team will show you how to care for the skin around your child's tube. Be sure to follow the instructions on keeping the area clean.
  • Wash the skin around the feeding tube daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • You may cover the area with a gauze bandage if it oozes or rubs against your child's clothing. Change the bandage every day.
  • Keep the area clean and dry.

Using the feeding tube

  • Follow your doctor's instructions about using the feeding tube. Your doctor or nurse will:
    • Tell you what to put through the tube.
    • Teach you how to watch for a leaking tube, infection at the tube site, or a clog in the tube.
    • Tell you what activities your child can do.
  • Keep the feeding tube clamped unless you are using it.
  • Keep the tube taped to your child's skin at all times. Leave some slack in the tube. This helps prevent pain and keeps the tube from coming out.
  • Wash your hands with soap and clean, running water for at least 20 seconds before and after you handle the tube and tube-feeding formula. Wash the top of the can of formula before you open it.
  • Keep the formula in the refrigerator after you open it. Follow your doctor's instructions about how long formula can sit out at room temperature.
  • Help your child sit up or keep their head up during the feeding and for 30 to 60 minutes after.
  • If your child feels sick to their stomach or has stomach cramps during the tube feeding, slow the rate that the formula comes through the tube. Then gradually increase the rate as your child can tolerate it.

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and contact your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

When should you call for help?

Call 911anytime you think your child may need emergency care. For example, call if:

  • Your child passes out (loses consciousness).
  • Your child has trouble breathing.
  • Your child has chest pain, is short of breath, or coughs up blood.
  • Your child has severe belly pain.

Contact your doctor now or seek immediate medical care if:

  • Your child has new or worse pain.
  • Your child is fussy or seems to have pain that is not helped by pain medicine.
  • Your child coughs a lot or has other trouble during tube feedings.
  • Your child's belly feels hard.
  • Your child's feeding tube is clogged, or liquid will not go down the tube.
  • Your child has nausea, vomiting, or diarrhea.
  • Your child has symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever or chills.
  • The stitches that hold the feeding tube in place are loose or come out.
  • The feeding tube comes out.

Watch closely for any changes in your child's health, and be sure to contact your doctor if:

  • You have any problems with the feeding tube.
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