ENFit Information

In 2016, feeding tubes, extension sets, and syringes will be changing to a specially designed system called ENFit. This system is designed to make connections between different enteral components safer, and to make sure misconnections with other devices do not occur. We have detailed information about ENFit on our ENFit Information page.

Once these products begin to be released, we will update this page with detailed information on the new tubes, extensions, and syringes.

Extension Sets

If you have a button style feeding tube, rather than a nasal or long tube, you will need extension sets that attach to the button. These extension sets connect from the button to a syringe or a feeding pump bag to allow you to feed, give medications, and administer liquids.

Each button manufacturer produces extension sets that fit their buttons, and offers multiple styles in terms of length and port options. Know there are many options available, so you can request what will work best for your needs.

Before using the extension set, prime it (fill it) with water or food/formula to get the air out. Priming should always happen prior to connecting the extension set to the button, otherwise the air in the empty extension will be pushed into the stomach. The easiest way to prime the set is to open the straight-port on the top, hold it under a faucet, and run water directly into it. Be sure to close the side medication port first (if one is present), and pinch the clamp closed once there is no more air in the extension set. You can also fill the extension set by using a syringe if the extension set is not connected.

Another option is to connect the extension set to the feeding set and prime the entire length of tubing at one time. After use, extension sets can be cleaned with dish soap and hot water. They should be rinsed well so that no soap remains in the tubing. Extension sets are usually replaced every 1 to 2 weeks, but can be used up to a month, if necessary.

Straight vs. Right Angle

May 13_0021A90 Degree Angle: Connects at a 90 degree angle laying flat against the body; smaller diameter tube; best for continuous feeds and giving medications.

Straight: Connects straight into the button and sticks straight out; has a larger diameter tubing to accommodate larger volumes and thicker formulas; best for bolus/gravity feeds and venting.

*Exact product names will vary by manufacturer.

 

 

 

AMT Extension Sets

May 13_0020A12” Straight Single Port
12” Right Angle Y-Port
12” Right Angle Single Port
12” Right Angle Y-Port (Clear)
24” Right Angle Single Port

24” Right Angle Extensions are also available for AMT  (not pictured)

 

AMT Mini One and MIC-KEY Extensions are compatible for the AMT Mini One G-tube button and the MIC-KEY G-tube and GJ-tube buttons

MicKey Extension Sets

mickey extensions2” Right Angle Y-Port
12” Straight Single Port
12” Right Angle Y-Port
12” Right Angle Single Port
24” Straight Single Port

24” Right Angle Extensions are also available for MIC-KEY (not pictured)

AMT Mini One and MIC-KEY Extensions are compatible for the AMT Mini One G-tube button and the MIC-KEY G-tube and GJ-tube buttons

 

 

Frequently Asked Questions

  • Extension sets clean pretty easily if you use very hot water. You can hold the extension directly under the faucet or use a 60 mL syringe to push hot soapy water through it. After washing, close the clamp and drag it down the extension to “strip” the extension of its residue. You can also use the back of a butter knife, as if you were curling ribbon, to loosen residue. Wash again to rinse any remaining residue out of the extension. Rinsing the extension after every feed seems to extend the life of the extension a little. You can also just store it in the refrigerator between feeds to prevent build-up.
  • Pipe cleaners can also help to get stuck-on gunk from the ends of an extension, and soaking and filling extensions with Efferdent denture cleaner can help bubble off residue.
  • Depending on the formula used, some extension sets may only last a week. With proper care, some can be extended to last a full month.
  • See the videos on this page for a video on cleaning the extension set.
  • At some point you will feed something other than your child; there is just no way around it. The extension will come unhooked from your child or the feeding bag, or the med port will pop open. Keeping everything clean and dry gives you the best chance of avoiding an accident.
  • Wipe the connector from the food bag before connecting to the extension. If you use the med port to give meds, use a Q-Tip to wipe inside the med port before you close it again.
  • There are also a lot of products out there to try to hold the med port closed or to keep the extension and food bag connected. There are also extension sets available without a med port. Click here to view Med Port Covers and Clamps.
You should also prime the extension set before attaching it to your child’s button. You can do this in several ways:

  • Connect it to the delivery set (feeding bag) and prime at the same time.
  • Use a syringe to fill it with water.
  • Hold it under the faucet and run water directly into it. Be sure to close the med port first, and just clamp once there is no more air in the tube.
Children with G-tubes typically only need a small flush, 3-5ml for a 12 inch extension, and 6-10ml for a 24 inch extension. The amount of flush should clear the extension set and button of formula or medication. For children with long tubes, the amount required depends on the length of the tube. Your child’s doctor may request you flush the tube with additional water if the child needs additional fluids or if you have a problem with the tube clogging frequently.

Children with GJ-tubes need a flush that will clear their extension set or tube on the outside plus the J-tube on the inside. Depending on the length of the inner J tube (22cm, 30cm, or 45cm), the size of the flush may vary. In general, a minimum of 10ml is recommended, though less may be used for a shorter inner J tube. For the 45cm length, at least 15mls should be used to ensure that the flush clears the J.

Ideally, you should flush before administering medication, between each medication, and after all medications are administered or the formula has finished. In reality, this may be too much water for many children. You should always flush after a series of medications have been administered, or when the formula is finished.

For children on continuous feeds, it is still wise to flush frequently, at least once every 4-8 hours, to prevent clogging.

Cleaning Extension Sets

Bard Compatible Extension Sets

There are two types of Bard Extension sets.

Decompression/Venting Extension: The extension on the left is the decompression extension, which is used to vent.

Feeding Extension: The two extensions on the right are both used for feeding.

Syringes

There are many different types and sizes of syringes. Many families who use a syringe for feedings or venting prefer larger 60ml syringes. Most medications can be dosed using 1, 5, or 10ml syringes. Catheter (large, long tip) or slip tip (short, thin tip) syringes are good choices to start. Syringes may or may not be covered by insurance.

Some pharmacies will give syringes out for free with medications. Syringes can be reused at home. They can be washed with soap and hot water and rinsed well. Do not put syringes in the dishwasher.

Tape

There are many types of tape with varied uses.

  • Hypafix: This is a flexible, breathable cloth tape that must be cut with scissors. It has a strong hold even when wet but is gentle on skin. It works well for securing NG-tubes and G-tube/GJ-tube extension sets.
  • Micropore: Micropore (paper tape) is a gentle adhesive that comes off easily when wet. It is the most versatile kind of tape and it works well for securing G-tube or GJ-tube extension sets to the skin.
  • Medipore: Medipore is a flexible, breathable cloth tape similar to Hypafix except that it is pre-perforated so no scissors are necessary. The adhesive is not quite as strong as Hypafix.
  • HY tape: This is a non-breathable waterproof tape that works well for sensitive skin and for taping NG-tubes.
  • Durapore: Durapore is a silky cloth tape with a very strong adhesive. It is not good for sensitive skin but has a strong hold unless it gets wet. It works well for taping NG-tubes and extension sets to clothing.

Adaptors

Currently, families are receiving Adaptors to connect between Feeding Sets, which now use the ENFit connectors, and tubes or extension sets, which do not yet use ENFit connectors. There are other adaptors available to add clamps or medports to long feeding tubes or otherwise connect syringes and tubes. See Extension Sets and Adaptors for Feeding Tubes from Complex Child, though this article is now somewhat outdated.

NOTE: Not all specific products will be supplied by every supplier or covered by every insurer. You may be able to get specific products covered or request more of a particular product (such as extension sets) by requesting a letter of medical necessity from your doctor or nurse practitioner.