How to Place an NG-Tube

Important Note:

Hospitals and physicians have different methods for measuring, placing, and checking placement of NG-tubes. In order to help as many families as possible, we have presented several common methods below and hope to add additional methods in the new future. Always follow the method that your physician, nurse, or hospital has taught you! If you have any questions about measurement, placement, or checking placement, contact your physician, nurse, or hospital.

Your doctor or nurse will teach you how to place your child’s NG-tube. Make sure you practice placing it a few times in the hospital or doctor’s office, until you are fully comfortable with doing it on your own.

The most important thing to remember when placing an NG-tube is to keep your child as still and quiet as possible. It is best to have two people available to place the tube, whenever possible. One person can hold the child, while the other inserts the tube. If two people are not available, try swaddling your baby or wrapping your older child up like a burrito to prevent little hands from grabbing the tube as you insert it.

The videos below show an older method of measuring before tube placement, and use the air “whoosh” method of checking placement. Your hospital, nurse, or doctor may instruct you to use different methods for measuring and checking placement.

When inserting the tube, place your child on a flat surface where there is no fall risk. Some parents prefer to change the tube with their child on a blanket on the floor.

If you have been instructed to remeasure your child before inserting the tube, follow your doctor or nurse’s procedures for measuring. Mark or locate how far you want to insert the tube. Apply lubricant to the tube and then quickly insert it into the nare (nostril), with a slightly downward and inward angle to the depth your doctor or nurse has told you is correct. If your child immediately starts coughing uncontrollably or is having difficulty breathing, remove the tube, because it may have been placed into the respiratory tract.

Once the tube is in place, secure it at least partially. You can learn more about taping on our Taping Nasal Tubes page.

Verify that the tube is correctly placed by following your doctor or nurse’s instruction for verifying the placement of the tube. Several methods are presented in the section below.

How To Verify Placement

You will need to check the placement of the nasal tube after you insert it. It is a good idea to confirm placement before the start of each feed and if your child vomits forcefully. Some NG-tubes have numbers on the side that allow you to see if they have moved. Or you can mark the tube before placement so that you can tell if it has been partially pulled out.

Your doctors and nurses will discuss different methods for confirming tube placement. You may be told to draw back stomach contents using a syringe, and may be asked to check the pH of the contents. An older but still frequently used method to check placement is to fill a syringe with 1 to 2 ml of air and rapidly push it into the tube while listening to the stomach with a stethoscope. If you hear a “whoosh” or “burp” as the air goes in, the NG-tube is in the stomach.

NJ-tubes, and most ND-tubes, need to be placed by a radiologist with X-ray guidance to ensure correct placement. They cannot be changed at home.