Gavage feeding involves passing nutrients directly to the neonate’s stomach by a tube advanced nasally or orally.

If a neonate can’t suck (because of prematurity, illness, or congenital deformity) or is at risk for aspiration (because of gastroesophageal reflux, ineffective gag reflex, or easy tiring), gavage feeding may supply nutrients until he can take food by mouth.

Unless the neonate has problems with the feeding tube, the nurse usually inserts it orally before each feeding and withdraws it after the feeding. This intermittent method stimulates the sucking reflex.

If the neonate can’t tolerate this, the nurse advances the tube nasally and leaves it in place for 24 to 72 hours.

Gavage feeding is contraindicated for neonates without bowel sounds or with suspected intestinal obstruction, severe respiratory distress, or massive gastroesophageal reflux.

Feeding tube (#3½ to #6 French for nasogastric [NG] feeding of premature neonate; #8 French for others)

Feeding reservoir or large (20- to 50-ml) syringe

Prescribed formula or breast milk

Sterile water

Tape measure

Tape

Stethoscope

Gloves

Allow the formula or breast milk to warm to room temperature if necessary. Wash your hands, and open the sterile water if it comes in a small-sized disposable container. Remove the syringe or reservoir and the feeding tube from the packaging.

Identify the neonate and verify the physician’s orders.

Using a tape measure, determine the length of tubing needed to ensure placement in the stomach. You’ll usually measure from the tip of the nose to the tip of the earlobe to the xiphoid process. Mark the tube at the appropriate distance with a piece of tape. Measure from the bottom. Alternatively, you may also measure using the feeding tube itself.