Naso-jejunal (NJ) Tube discharge information for children
This page provides information and advice following the insertion of your child’s nasojejunal (NJ) tube). It is important that you are aware of after-care, any problems you may experience following discharge and when you should seek advice. You will be shown what to do and told how to get the equipment you need.
How to care for the NJ tubeShow [+]Hide [-]
To prevent infection, always wash your hands well, before and after touching the tube or after giving feeds and medicines.
Your child’s tube will be secured onto their face with soft tape. They will also have a soft dressing applied directly to their cheek to prevent the skin from becoming sore. This tape needs to be changed whenever it becomes wet, dirty or loses its stickiness. Your ward nurse will show you how to do this.
Before feeding/giving medicationShow [+]Hide [-]
Checking tube position
- When your child’s NJ tube is inserted in hospital an x ray will be taken to check that the end of the tube is in your child’s bowel.
- At this time the measurement by your child’s nostril will be written down and this is how you will check that the tube has not moved at home.
- Before using the tube, check that the tape is still secure and not loose.
- Before using the tube, check the measurement by your child’s nostril on the tube is the same as when the tube was first put in. Your ward nurse will show you how to do this.
- If the measurement has changed or if your child begins to get symptoms they had before with feeding into their stomach, i.e pain or vomiting, the NJ tube may have moved from your child’s bowel. If this happens contact your children’s community nurse for advice on numbers provided.
Flushing and feedingShow [+]Hide [-]
- The NJ tube should only be used for prescribed feed, water or medication.
- Before using the NJ tube check the tube position (as advised above)
- Make sure the prescribed amount of water (at least 10mls of water) is flushed through tube using a stop/start action after feed and medications. If your child is on a continuous feed the jejunostomy should be flushed every four hours as described above.
- Medicines given should always be in liquid form (as prescribed).
- You should use water that has been boiled and cooled. This water should be stored in a lidded container/bottle in the fridge for no longer than 24 hours.
- Unopened bottles of feed may be stored in a cool dark place, away from direct sunlight. Once opened, bottles should be stored in the fridge.
- Any opened feed that has not been used within 24 hours should be thrown away.
- A feeding set cannot be used for longer than 24 hours.
- If the tube blocks, cool boiled water (cold or warm) can be used to try and unblock the tube. Use a push/pull action with a 60mls syringe to try and unblock the tube.
- A smaller gauge syringe can be used to try and unblock a tube – reasonable caution needs to be taken when applying pressure with a smaller gauge syringe to prevent any tube damage.
- If unable to unblock the NJ tube contact your children’s community nurse for advice on numbers provided.
NB It is recommended that 60mls syringes are used when flushing the tube. Cool boiled water is necessary when flushing the jejunostomy tube.
If your NJ tube comes out accidentallyShow [+]Hide [-]
If your child tube comes out accidentally contact your community nurse or the hospital ward you were discharged from as you may need to have another NJ tube put in.
How to get suppliesShow [+]Hide [-]
Feeds/feeding sets/pump and other equipment
When your child leaves hospital you will be given the equipment you need to feed and your nurse will explain how you get equipment in the community. This will be from a home delivery company.
If required, a feeding pump will be supplied by the hospital. You will be taught how to use the pump by your nurse on the ward.
The GP should send the prescription for the special milk to the company, so that the feed can be delivered each month.
If you choose to continue to collect feeds from a local chemist, then the other equipment can still be delivered by the company.
Waste disposal at homeShow [+]Hide [-]
Ask your community nurse how you get rid of used equipment and any feed that is left.
What to do if you have you any questions?Show [+]Hide [-]
If you have any questions these can be answered by the nurse on the ward. After you go home, these can be answered by your children’s community nurse. It is sometimes a good idea to write them down.
Checklist for healthcare professionals and parents for minimising risk of NJ tube feedingShow [+]Hide [-]
The child should sleep in the same room as the parents/carers or a suitable alarm or monitor should be fitted in child’s room.
The child needs to be positioned at a minimum of a 30 degree angle, preferably using a wedge or sleep system as recommended by an Occupational Therapist or Physiotherapist.
Feeding regimes should be reviewed regularly as the child grows and develops, especially at the stage where movement during the night is likely to change.
The feeding pump should be positioned at the top end of the cot or bed with the feeding set threaded through the bars of the cot rather than dangling over the top.
Monday to Friday between the hours of 9.00am to 5.00pm: Please contact your child’s community nurse or telephone the ward that you were discharged from.
Outside the hours stated above: please telephone the ward that you were discharged from.
For further information
The Patient Advice and Liaison Service (PALS) can offer on-the-spot advice and information about the NHS.
For further information about health conditions and treatment options, you may wish to have a look at the NHS Choices website. On this website there is an information prescription generator which brings together a wealth of approved patient information from the NHS and charity partners which you may find helpful.
You can download the information on this page as PDF leaflet.pdf