HINT: What type of water is used to flush an enteral tube?
Connected Care Quick Hits are up to date and evidence based recommendations for the care of children with medical complexity & technology dependence, from hospital to home.
HINT: What type of water is used to flush an enteral tube?
SITUATION:
This QuickHit was developed in response to family caregivers and home and community care providers asking what kind of water source to use when flushing enteral tubes.
BACKGROUND:
Many children with medical complexity rely on enteral feeding tubes to support nutrition, hydration, and/or medication administration. Flushing with water between enteral tube use promotes maintenance of tube patency and prevents tube blockages.
Several types of water sources exist, and some more than others may pose risk of waterborne diseases when a child relies on the use of an enteral tube feed. Water sources for home and community care may differ than what is typically used when a child is acutely ill and in hospital. Other factors like the child’s age and health condition also influence the choice of water to be used.
ASSESSMENT:
When assessing the most appropriate type of water for children with enteral feeding tubes in home and community care consider the child's age (under or over 4 mos), medical history (e.g. immune compromise) as well as the cost to the family, and ease of access and preparation. Also consider the care setting (e.g. private home vs congregate care setting) as infection control practices may differ.
There are a variety of water sources to choose from for use with enteral feeding, including:
Tap water (municipal water from the cold water tap)
Well water (that meets safety standards)
Commercially bottled water (e.g. natural spring water)
Distilled water (water that has been boiled to a vapor and condensed back into liquid)
Sterile water (water free from microorganisms via a commercial or at-home sterilization process)
RECOMMENDATION:
Connected Care recommends partnering with the child’s family and point-of-care team in reviewing these evidence-based recommendations to guide water administration in children with enteral tubes.
Additional Considerations:
Consider the above guidelines for all water use including flushing enteral tubes, preparing enteral formulas, mixing medications and rinsing enteral feeding equipment.
For the use of tap water, run the cold water tap until it becomes cold first thing in the morning to flush out the potential build-up of contaminants
Avoid vitamin, flavoured, or carbonated water as these are not appropriate for use with enteral tubes.
TIP:
For filling the balloon of any enteral tube, use sterile or distilled water
For more information on Enteral feeding, Visit About Kids Health
