Tube Feeding

Tube feeding is typically recommended when a person cannot consume enough nutrients and fluids by mouth, or if swallowing is unsafe due to medical conditions. Common scenarios include: Conditions with swallowing difficulties like stroke, neurological disorders, or head and neck cancers that can impair swallowing, for patients in intensive care or recovering from major surgeries where they are unable to eat or digest food normally. Tube feeding is usually determined by a healthcare provider based on individual medical needs and circumstances.

In surgical oncology, tube feeding play a pivotal role in care of patients operated for oral cavity cancers, for patient those on NJ feeding (gastric outlet obstruction), patients on FJ feeding. Ryle’s Tube feeding constitute important aspect of care of these patients.

This article summarizes important aspects of Ryle’s Tube feeding. NJ and NJ feeding will be summarized in other articles.

How to give Ryle’s tube feeding?

Verify Tube Placement: Always confirm the correct placement of the Ryle’s tube before initiating feeding to prevent aspiration.

Maintain hygiene: Thoroughly wash your hands with soap and water to maintain hygiene. Use clean equipment to prevent infections. Clean and flush the tube regularly

Position the Patient: Keep the patient’s head elevated at least 30-45 degrees during feeding and for 30–45 minutes afterward to reduce the risk of aspiration and gastroesophageal reflux.

Check Residuals: Before each feeding, check for gastric residuals to ensure the stomach is emptying properly and to prevent overfeeding. Do not feed forcefully if patient is signaling that he is well-fed and can’t take more feed.

Prepare the Formula: Shake the feeding formula well and ensure it is at room temperature.Flush the Tube: Use a syringe to flush the tube with a small amount of water (typically 30 mL) to ensure it’s patent.

Administer the Feeding: If using a syringe, connect it to the tube and slowly administer the formula.If using a feeding pump, set the pump according to the prescribed rate and connect it to the tube.

Monitor the Patient: Observe for any signs of discomfort or complications during and after feeding.

Flush Again: After administering the feeding, flush the tube with water to clear any remaining formula and prevent blockage.

Content of RT feed- should be rich in protein. We recommend giving following in RT feed-

Daal water, Coconut water, sattu powder, protein powder, milk after dilution, paya soup, chicken soup, egg white mixed in water, buttermilk, vegetable soup etc

Can make home feed by blending food material at home. Give extra salt with feed to avoid Hyponatremia if medical condition of patient permits. Always filter the content before feeding to avoid tube blockage. Tube must be flushed with water at the end of feeding to avoid tube blockage.

How much amount to feed and when to feed?

Start with 50 ml/hour gradually increase to 100ml/hour then 200 ml/hour. Do not increase beyond 200 ml/hour.

Start feeding after patient wakes up in morning (from 6–7 am generally) and give till bedtime (10 pm). Do not give feed when patient is asleep. Give 200 ml feed every hour from 6-7 am till 10 pm; Amounting to around 3–3.2L feed/day. Caution about tube dislodgement and aspiration.

Disclaimer- This post is meant for patient and care-giver education only.