🧒🧃 Gastrostomy Tubes (G-Tubes) in Children: A Parent-Friendly Guide

✅ A gastrostomy tube (G-tube) is a feeding tube that goes directly into the stomach through a small opening in the belly.
It helps children who cannot safely eat enough by mouth, need extra calories, have swallowing/aspiration risk, or need reliable medication delivery.
Many children with G-tubes still eat by mouth as much as is safe, depending on the reason for the tube.

1) 🧾 Quick “At-a-glance” box (top of page)

✅ Topic: Gastrostomy Tubes (G-tubes)
Common names: G-tube, feeding tube in the stomach, button tube (Mic-Key / MiniOne type)

Plain-language summary (2–3 lines):
A G-tube provides nutrition, fluids, and medicines directly into the stomach. It can improve growth, energy, hydration, and quality of life, and can reduce stress around feeding when eating by mouth is not enough or not safe.

Who it affects (typical ages):
Infants, children, and teens—often with medical, neurologic, heart/lung, or complex feeding conditions.

✅ What parents should do today:

  • Learn your child’s tube type (button vs long tube) and daily routine
  • Know how to clean skin and check for leakage
  • Understand signs of infection or tube problems
  • Keep an emergency kit at home

⚠️ Red flags that need urgent/ER care:

  • Tube falls out and you cannot replace it (especially if stoma is new)
  • Severe belly pain, swollen belly, repeated vomiting
  • Heavy bleeding from stoma
  • Signs of severe dehydration or lethargy

🟡 When to see clinic urgently (same-day/next-day):

  • Spreading redness, pus, fever (infection concern)
  • Persistent leaking causing skin breakdown
  • Tube blockage not resolving with safe steps
  • Granulation tissue bleeding a lot or very painful

2) 🧠 What it is (plain language)

A G-tube is placed through the abdominal wall into the stomach. Common tube styles:

  • Button tube (low profile): sits flat on the skin, connects to an extension when used
  • Long tube: longer tube visible outside the body

It can be used for:

  • full feeds
  • supplemental feeds (top-up calories)
  • overnight feeds
  • water flushes
  • medicines

What part of the body is involved? (small diagram required)

Simple diagram showing a G-tube button entering the stomach

Common myths vs facts

  • Myth: “A G-tube means my child will never eat by mouth again.”
    Fact: Many children continue oral feeding safely; the tube supports nutrition.
  • Myth: “G-tubes are only for very sick children.”
    Fact: They are often used to improve growth, safety, and quality of life.
  • Myth: “G-tube care is too complicated.”
    Fact: With teaching and a routine, most families become confident quickly.

3) 🧩 Why it happens (why a child might need a G-tube)

Common reasons

  • poor weight gain / failure to thrive
  • unsafe swallowing (aspiration risk)
  • significant feeding aversion or ARFID-like patterns
  • neurologic conditions affecting feeding coordination
  • chronic illness increasing calorie needs (heart/lung disease)
  • need for reliable medication delivery

Less common but important reasons

  • short bowel syndrome or intestinal failure (sometimes combined with other tubes)
  • severe reflux with feeding intolerance (selected cases; sometimes GJ tube instead)
  • craniofacial or airway issues affecting feeding safety

Triggers that worsen symptoms (and lead to needing tube support)

  • recurrent illness increasing calorie needs
  • long stressful feeding battles
  • prolonged inadequate intake causing low energy, poor growth

4) 👀 What parents might notice (symptoms)

  • feeding takes >30–45 minutes repeatedly
  • child tires quickly during feeds
  • choking/coughing with feeds
  • frequent chest infections (aspiration concern)
  • poor growth or weight loss
  • dehydration (low urine, dry mouth)
  • medication refusal or vomiting meds

What’s normal vs what’s not

🟢 Common:

  • picky eating phases in toddlers with normal growth

⚠️ Not normal:

  • falling off growth curve
  • choking with feeds repeatedly
  • recurrent pneumonias
  • dehydration or low intake for days

Symptom trackers

  • daily intake logs (oral + tube)
  • weights (as directed)
  • stool pattern (constipation affects tolerance)
  • vomiting and reflux symptoms

5) 🏠 Home care and what helps (step-by-step)

✅ Routine care prevents most problems.

Daily G-tube care (simple routine)

✅ Do this now:

  • Wash hands before handling tube
  • Clean skin around stoma daily with mild soap/water; pat dry
  • Check:
    • redness, swelling, discharge
    • odor
    • leaking
  • Rotate button gently if instructed (some tubes require this; follow your team)
  • Flush tube with water before/after feeds and medicines (per plan)

Feeding tips (general)

  • follow the prescribed formula and schedule
  • start feeds slowly if your child is sensitive
  • keep child upright during feeds and for a period afterward (as advised)
  • vent/decompress if your child gets gassy (only if trained)

Skin protection if leaking

  • keep skin dry
  • barrier cream/film (team-guided)
  • address fit/balloon volume if instructed by clinic

What usually makes things worse

  • skipping flushes (blockages)
  • leaving wet/leaking skin untreated (breakdown)
  • using force to flush a blocked tube
  • adjusting balloon water without guidance (unless your team taught you)

6) ⛔ What NOT to do (common mistakes)

  • Don’t push hard on a syringe if the tube seems blocked.
  • Don’t use sharp objects to clear a tube.
  • Don’t tape tightly around the tube causing pressure injury.
  • Don’t ignore persistent leaking or redness—early treatment prevents worsening.

7) 🚦 When to worry: triage guidance

🔴 Call 911 / Emergency now

  • severe breathing trouble (aspiration, unrelated but urgent)
  • child is very lethargic and dehydrated
  • severe belly pain with a swollen belly and repeated vomiting

🟠 Same-day urgent visit

  • tube falls out and you cannot replace it promptly
  • spreading redness, pus, fever (infection concern)
  • significant bleeding
  • repeated vomiting and inability to keep feeds down

🟡 Book a routine appointment

  • granulation tissue that keeps coming back
  • ongoing leaking
  • frequent tube clogging
  • poor weight gain despite tube feeds

🟢 Watch at home

  • mild redness that improves within 24 hours with proper cleaning and dryness
  • small granulation tissue without pain or bleeding (still mention at next visit)

8) 🩺 How doctors diagnose and manage issues (what to expect)

What clinicians will ask

  • tube type and size
  • feed schedule and tolerance
  • vomiting, pain, stool patterns
  • skin issues (redness/leakage)
  • how often the tube clogs or dislodges

Physical exam basics

  • stoma appearance
  • belly exam (distension, tenderness)
  • hydration and growth

Possible tests (only if needed)

  • tube position check imaging (if concern)
  • labs if dehydration/poor growth
  • swallow study if aspiration concerns

What tests are usually not needed

  • frequent imaging if child is stable and tube function is good

9) 🧰 Treatment options

First-line (most common fixes)

  • optimize tube fit and balloon volume (clinic-guided)
  • adjust feeding rate/volume
  • treat constipation to improve tolerance
  • manage reflux if contributing

If not improving (next steps)

  • change tube size/type
  • consider GJ tube if severe reflux/aspiration with gastric feeds (specialist decision)
  • dietitian recalculates calories and formula
  • feeding therapy to support safe oral skills

Severe cases (hospital care)

  • dehydration
  • severe infection around stoma
  • suspected peritonitis (rare, severe belly pain + illness)

Medications/treatments (when applicable)

  • Granulation tissue treatments: topical ointments or cautery in clinic
    • Common side effects: temporary stinging
    • Seek help: heavy bleeding or severe pain
  • Antibiotics for infection (if needed):
    • Common side effects: diarrhea, rash
    • Seek help: breathing trouble, worsening fever

10) ⏳ Expected course & prognosis

  • many children gain weight and energy within weeks when nutrition becomes reliable
  • families usually become comfortable with care quickly after teaching
  • some children use G-tubes temporarily; others need long-term support

Return to school/daycare/sports

  • usually yes once healed and routine is established
  • school staff may need training for feeds/flushes

11) ⚠️ Complications (brief but clear)

Common

  • mild redness or irritation
  • leaking
  • granulation tissue
  • clogging

Less common but important

  • infection (cellulitis)
  • buried bumper (certain tube types)
  • dislodgement
  • severe abdominal infection (rare)

12) 🛡️ Prevention and reducing future episodes

  • consistent cleaning and dryness
  • flush before/after meds and feeds
  • keep emergency supplies
  • treat constipation
  • follow scheduled tube changes and clinic checks

13) 🌟 Special situations

Infants

Growth monitoring is key; small changes in volume may matter.

Teens

Privacy and independence: teach self-care gradually when appropriate.

Kids with chronic conditions

May need higher calories or special formulas; coordinate with specialists.

Neurodevelopmental differences/autism

Routine and predictability help; feeding therapy and sensory supports may be needed.

Travel considerations

Bring:

  • extra extension sets
  • spare button/tube (if provided)
  • syringes, gauze, tape
  • written emergency plan

School/daycare notes

Provide:

  • feeding schedule
  • flush schedule
  • who to call if tube issues happen

14) 📅 Follow-up plan

  • routine tube clinic follow-up
  • dietitian follow-up for growth and calorie adjustments
  • earlier follow-up if:
    • weight gain stalls
    • leaking worsens
    • frequent clogs/dislodgement

15) ❓ Parent FAQs (G-tube-specific)

“What should I do if the tube falls out?”

Act quickly. The stoma can narrow. Follow your child’s emergency plan; if you cannot replace it, seek urgent care.

“Is leaking around the tube normal?”

A small amount can happen, but persistent leaking can damage skin and may mean the tube is too loose/tight or balloon needs adjustment.

“Why does my child vomit during feeds?”

Common reasons include feeding too fast, large volume, constipation, reflux, or illness. Rate/volume adjustments and constipation treatment often help.

“What is granulation tissue—and is it dangerous?”

It’s extra healing tissue that can look red and bumpy and may bleed. It’s usually not dangerous but can be uncomfortable and treatable.

“Can my child still eat by mouth?”

Often yes—if swallowing is safe and your team approves. Feeding therapy may help maintain skills.

16) 🧾 Printable tools (high-value add-ons)

🧾 Printable: One-Page G-Tube Action Plan

Daily

  • Clean + dry stoma
  • Check redness/leakage
  • Flush before/after feeds and meds

Call clinic if

  • increasing redness, pus, odor
  • ongoing leaking/skin breakdown
  • frequent clogs or vomiting with feeds

Urgent / ER if

  • tube falls out and cannot be replaced
  • severe belly pain + swelling + vomiting
  • heavy bleeding or high fever with worsening redness

🧾 Printable: Medication Schedule Box (Tube)

Medication: ______ Dose: ______ Time: ______
Flush before: ____ mL Flush after: ____ mL

🧾 Printable: “Red Flags” Fridge Sheet

⚠️ Urgent: tube out and can’t replace, severe belly pain/swelling, heavy bleeding, severe infection signs.

17) 📚 Credible sources + last updated date

Trusted references:

  • Children’s hospital G-tube care education pages
  • Pediatric nutrition and GI patient resources

Last reviewed/updated on: 2025-12-31
Tube care details vary by tube type and center—follow your clinic’s plan.

🧡 Safety disclaimer

This guide supports—not replaces—medical care. If you are worried about your child, trust your instincts and seek urgent medical assessment.

This guide was fully developed & reviewed by Dr. Mohammad Hussein, MD, FRCPC ROYAL COLLEGE–CERTIFIED PEDIATRICIAN & PEDIATRIC GASTROENTEROLOGIST Board-certified pediatrician and pediatric gastroenterologist (Royal College of Physicians and Surgeons of Canada) with expertise in inflammatory bowel disease, eosinophilic gastrointestinal disorders, motility and functional testing, and complex nutrition across diverse international practice settings.

To book an online assessment Email Dr. Hussein’s Assistant Elizabeth Gray at: Elizabeth.Gray@pedsgimind.ca
In the email subject, please write: New Assessment Appointment with Dr. Hussein

Important: This appointment is completely online as Dr. Hussein is currently working overseas. This service is not covered by OHIP