3.2 Describe equipment and materials that may be used for extended feeding

This guide will help you answer 3.2 Describe equipment and materials that may be used for extended feeding.

Extended feeding refers to supplying nutrition to someone who cannot eat or drink in the usual way over a prolonged period. People may need this type of support due to swallowing problems, serious illness, disability or recovery from surgery. Extended feeding may happen in care homes, hospitals or people’s own homes. You play a key part in helping them stay healthy and safe.

Several methods and tools are available to meet individual needs. Choosing the right equipment and materials depends on medical advice, the person’s condition, and where the care takes place.

Methods of Extended Feeding

The main types include:

• Enteral feeding: Nutrition through the gastrointestinal tract. Uses tubes to deliver liquid food directly to the stomach or intestine.
• Parenteral feeding: Nutrition direct into the bloodstream. Used if the digestive system cannot process food safely.

This section focuses mainly on enteral feeding, as it is more common in health and social care settings. However, some material about parenteral feeding is included where relevant.

Feeding Tubes

Feeding tubes are central to extended feeding. These flexible tubes allow liquid nutrition, fluids and sometimes medication to be given without swallowing.

Types of Feeding Tubes

• Nasogastric tube (NG tube): Inserted through the nose, down the throat, and into the stomach. Used short-term, often under six weeks.
• Nasojejunal tube (NJ tube): Similar to NG tube but placed further, ending in the small intestine (jejunum). Chosen if feeding into the stomach is risky.
• Gastrostomy tube (PEG tube): Inserted directly into the stomach through the abdominal wall. ‘PEG’ means ‘percutaneous endoscopic gastrostomy’. Suited for medium to long-term use.
• Jejunostomy tube (JEJ tube): Inserted into the small intestine through the abdominal wall. Used if the stomach is not suitable for feeding.

General Design Features

Most tubes are soft and flexible to avoid damage or discomfort. They may have capped ports for feeding or medication. They come in different widths and lengths suitable for adults or children.

Many have markings to show correct positioning. Some have radio-opaque lines—visible on X-ray—for position checks.

Fixation Devices

Securement devices hold tubes in the right place and prevent movement. For example:

• Adhesive tapes or nasal bridges for NG tubes
• Skin-friendly anchor devices for gastrostomy tubes
• External retainers or bumpers

Proper fixation protects the site from infection, pulling, and accidental removal.

Equipment for Caring for Feeding Tubes

Feeding tubes require cleaning and monitoring. You will need equipment such as:

• Sterile water or saline for flushing tubes to prevent blockages
• Syringes (usually 20–60 ml, often enteral specific with purple plungers) for flushing, giving feeds or medicines
• Feeding tube clamping or closure devices for safety between feeds

Care must be taken to maintain cleanliness and prevent infection.

Enteral Feeding Pumps

An enteral feeding pump delivers nutritional fluids at a steady rate.

Features of Feeding Pumps

• Accurate control of flow rates
• Alarms to signal blockages, empty feed bags, air or missing tubes
• Portable options for use at home or during outings
• Battery backup for continuous use

Some models have touch screens, loading guides, and helpful safety features for carers. Each pump must be programmed carefully in line with the care plan.

Gravity Feeding Sets

Where pumps are not suitable, feeding may happen by gravity. The setup includes:

• Enteral feed bag (hung from a hook or stand)
• Length of giving set tubing with a drip chamber, connectors, and flow regulator
• Connection to the feeding tube

Staff monitor the flow using a roller clamp or similar device.

Syringes for Bolus Feeding

Bolus feeding means giving a measured amount of liquid feed at intervals by hand.

You will often use large-barrel enteral syringes. These attach to the feeding tube’s entry point. The feed is pushed through the tube slowly.

Key points for bolus feeding:

• Suitable for people who tolerate larger but less frequent servings
• Used for liquids, purees or thickened fluids (can be given at room temperature as advised)
• Syringe parts are cleaned and stored according to guidelines

Feeding Bottles and Containers

Feeds come in ready-to-hang bags, prescription bottles, or powder form for mixing. All containers and bottles used should be:

• Food safe and sterile
• Clearly labelled with contents, expiry dates, and patient details
• Disposed of as advised after use

Some feeding systems are closed (never opened before use), reducing infection risk. Others are ‘open’, requiring care staff to pour feed in.

Extension Sets and Adapters

Feeding tube sets sometimes need extra parts for security or function. Typical extension sets and adapters include:

• Extension tubing to join the feeding tube to the giving set or syringe
• Y-connectors to deliver feed and medication at the same time
• Enfit connectors (unique shaped ends found in most UK products)—prevent wrong route administration (e.g., IV vs. feeding tube)

Suction Equipment

Some service users may need oral or respiratory suction as part of their feeding support.

• Portable or wall-fixed suction machines
• Suction catheters or tubes
• Collection canisters

Suction equipment is used to remove saliva or other fluids before or during feeding if the client cannot clear their own mouth or airways.

Supporting Materials for Tube Care

Beyond feeding, care of the tube site is vital. Materials you might use include:

• Sterile gauze and dressings for wound or stoma care
• pH paper or strips to test gastric aspirates (to check placement of NG tubes)
• Disposable gloves for infection protection
• Aprons and protective wear to keep staff and the environment clean

All products chosen must be skin safe and appropriate for the care setting.

Feeds and Liquids

The actual nutrition is just as important as the delivery equipment. Extended feeding routes need specially prepared blends.

Types of Feeds

• Ready-to-use liquid feeds—professionally prepared in sterile packs, with balanced nutrients
• Powdered feeds—require careful mixing as per instructions, using cooled boiled water
• Special milk or hydrolysed feeds for allergies, gut disorders, or specific diseases
• Thickened fluids or purees (for some tube types or severe swallowing problems)

All feeds should meet prescribed dietary requirements. Food safety is critical, and fresh feeds must be stored properly and used within stated timeframes.

Water and Hydration

People on tube feeding risk dehydration if they do not get enough fluid. Sterile or cooled boiled water is the preferred liquid for flushing tubes and providing hydration.

All water must be checked for safety, measured accurately, and given as instructed.

Personal Protective Equipment (PPE)

When managing extended feeding, you need to reduce the risk of infection. Use appropriate PPE like:

• Disposable aprons
• Single-use gloves
• Face masks (for high-risk cases)
• Hand hygiene materials (alcohol gel or handwashing facilities)

Consistent use of PPE protects both the worker and the service user.

Cleaning and Maintenance Supplies

Hygiene is vital for extended feeding. Equipment for cleaning includes:

• Cleaning brushes for tubes (for some long-term devices)
• Disposable cloths and wipes
• Surface sprays (suitable for food areas)
• Disposable bowl and water for rinsing reusable items

Keeping all equipment visibly clean and dry prevents bacteria build-up and cross-infection.

Monitoring and Recording Equipment

Keeping good records reduces risk and supports high standards of care. Materials may include:

• Fluid balance charts for recording all feeds and flushes
• Intake and output charts (such as urine output)
• Labelling materials for feed bottles, bags and tube sites

Accurately recording use, volume, dates and times is important for ongoing care.

Disposal Equipment and Materials

Used feeding equipment must not be reused unless designed for that purpose. Safe disposal ensures infection control and safety.

• Sharps containers for used needles, if any are employed for drawing up medicine
• Clinical waste bags (yellow or orange) for contaminated items
• Secure storage points for used materials before collection

All carers should follow up-to-date waste policies for their organisation.

Troubleshooting and Emergency Equipment

Sometimes tubes become blocked, displaced or cause complications. Carers may need access to:

• Spare tubes or connectors
• Emergency removal kits (for peg tubes or balloon buttons, as directed)
• Emergency phone numbers for clinical help

Knowing where to find replacement equipment or expert support speeds up help in urgent cases.

Aids for Independence and Comfort

Where possible, extended feeding should respect the person’s dignity and comfort.

Some equipment can help, for example:

• Discreet covers or pads to keep tubes out of view
• Non-slip feeding tray mats for those able to participate
• Soft supports, slings, or vests to reduce discomfort or pressure from feeding tubes

Involving people in their own care, where safe, promotes their wellbeing.

Handling Medication

Many people with feeding tubes need regular medicines. Special equipment and materials support safe medication administration.

• Crushing devices or dissolvers for tablets (if safe and agreed by pharmacy)
• Liquid medication syringes (enteral only, not for intravenous use)
• Measuring spoons or cups for liquid medications
• Medication charts

Always take specialist advice before putting any medicine down a feeding tube, to avoid tube blockages or drug errors.

Training and Reference Aids

Extended feeding equipment only works safely when carers are confident and well informed.

• Manufacturer instructions and quick-reference guides
• Local policies and training materials
• Posters showing tube placement checks and enteral feed set-up

Staff should have access to these at all times, in printed or digital format.

Storage Solutions

Secure and organised storage avoids confusion and keeps equipment safe from contamination.

Common storage materials:

• Lockable cupboards for feeds, medicines, and sterile items
• Clearly labelled boxes or trays for individual service users
• Racks or hooks for hanging feed bags

Good storage practice supports infection prevention and organised care.

Final Thoughts

Supporting someone with extended feeding calls for several types of equipment and materials. These range from tubes and pumps to syringes, cleaning items, PPE and storage solutions. Each part of the process helps to provide the right nutrition, keep the service user safe, reduce infection risk and maintain dignity.

It is important to use only the equipment and materials specified in a person’s care plan or by a health professional. Always follow instructions carefully, practise regular hand hygiene, and make sure everything is ready before starting a feed. Keep up to date with local policy and updates.

Proper use of these materials helps to support health, promote comfort, avoid complications and make extended feeding as positive as possible for both the worker and the individual receiving care.