Your child has had a Mic-Key Gastrostomy (G.T.) Button placed. Depending on the reason that the Button is needed, it can be used either short term or long term. The Button is used to give fluids, feedings, and medications to those that cannot take them by mouth. The Button allows for feedings to be given straight into the stomach. The Button may be used to give your child supplemental nutrition (your child is able to eat, but cannot get enough nutrition from what they eat by mouth alone), total nutrition (because he/she is completely unable to eat by mouth), and it provides a way to decompress (burp) your child's stomach.
Before you leave the hospital you should be able to answer these questions:
How do I care for my child's G.T. Button site?
- You can expect a small amount of yellow/clear drainage at the site as it is healing.
- Wash the site at least once a day with soap and water. You should wash the site more than once a day if it is draining, to keep the site clean and dry.
- Do not put alcohol, Hydrogen Peroxide or ointments on the site.
- There should be no need to keep a dressing over the Button. A dressing may cause skin problems at the site.
- 7 days after surgery, the Button site can be underwater during your child's bath.
- If your child has stitches on the Button, these will be removed 7 days after surgery. Start turning the Button once the stitches are removed. If your child does not have stitches on the Button, start turning the Button at least once a day starting the day after surgery.
- 2 weeks after surgery, your child may go swimming with the Button in place.
- Granulation tissue - This is pink/red tissue that may grow around the Button. It will have yellow drainage and may bleed a small amount. If you notice this, call our office and we will schedule a clinic appointment. There are two treatments for granulation tissue:
(1) Triamcinolone Cream - a low-dose steroid cream.
(2) Silver Nitrate - which is used to remove the tissue if the steroid cream does not cause it to heal.
- If your child has increased redness, pain or swelling at the site, call our office and ask to speak to the Surgery Specialty Nurse.
When does the G.T. Button need to be changed?
- Your child will NOT have to have another surgery to have the Button changed. It will be changed in Surgery Clinic. The first change is 3 months after surgery. DO NOT REPLACE THE BUTTON AT HOME BEFORE IT IS FIRST CHANGED IN THE SURGERY CLINIC 3 MONTHS AFTER SURGERY.
- Do not use the side port on the MIC Button to deflate or inflate the balloon until you are taught in the Surgery Clinic 3 months after surgery.
- When the Button is no longer needed, call our office to make an appointment to have the Button taken out.
What tubes are used with the G.T. Button and where will I get extra ones?
- The same tube may be used to feed and decompress (burp) your child.
- You may use each tube for 4 weeks.
- Rinse the tubes with warm water after each use. Wash the tubes once a day with hot soapy dishwater and let air dry. Do not put the tubes in the dishwasher. They will melt.
- Before you are discharged from the hospital, a referral will be made to a medical supply company for extra tubes. If you are already receiving medical supplies, we will call that company to get your tubes.
How do I bolus (gravity) feed my child using the G.T. Button?
- A bolus feed is when your child is fed a set amount of formula over 20-30 minutes using a catheter-tipped syringe. The amount of formula and the times to feed will be decided by your doctor.
- Only formula, water, liquid medication and other liquids should go in the Button.
- The formula should be room temperature.
- Position your child with his/her head elevated.
- Allow the formula to fill the feeding tube to get the air out. Connect the feeding tube to the G.T. Button then unclamp the feeding tube so the formula will flow into the G.T. Button. Be sure to line up the black line on the feeding tube and the Button before connecting.
- The rate that the formula goes into the Button is controlled by how high you hold the syringe and tube. The higher you hold them, the faster the formula will go in and the lower you hold the syringe, the slower the rate will be.
- Bolus feedings should go in over about 20-30 minutes. Feedings that are given too fast can cause abdominal pain, abdominal cramping, vomiting or gagging.
- When the formula is almost finished, flush the G.T. Button with 5 ml of water (water from the tap is fine). Do not let all the formula run out before adding water or air will get in your child's stomach and cause gas.
- When the water is almost gone, disconnect the feeding tube and close the flap on the Button.
How do I do a continuous feeding through my child's G.T. Button?
- A continuous feed is when your child is fed a set amount over several hours. A continuous feed is done using a feeding pump and the feeding tube.
- A referral will be made to a supplier for a feeding pump.
- The supplier will teach you how to use the feeding pump.
- You will be told the rate (how fast) to set the pump and for how long to leave your child connected to the pump before you are discharged home.
How do I decompress (burp) my child using the G.T. Button?
- If your child is unable to burp by mouth, you may burp (decompress) your child's stomach using the Button. You will need the feeding tube and a catheter-tipped syringe.
- For babies, always try burping by mouth first.
- If burping by Button, you usually wait until about 20 minutes after feeding.
- If your child acts uncomfortable during a feed: stop the feed, try to burp using the Button, then restart the feeding.
- Lay your child flat or semi-flat.
- Connect the feeding tube (with the catheter tipped syringe attached) to the Button.
- If your child has air in his/her stomach, you will hear it gurgle out.
- If no air comes out, try rolling your child on his/her side.
- Once the air is out (the gurgling sound has stopped), take the tube out.
- If your child's stomach is full of formula, some of the formulae may back up in the tube. If so, allow the stomach contents to go back into the stomach before taking the tube out.
What should I do if the G.T. Button comes out?
- If this happens before the first change in the Surgery Clinic, you must come to the Emergency Room at Arkansas Children's Hospital.
- ***DO NOT put the Button back in. Insert the 8FR feeding tube provided in the hospital, as instructed, and come to the Emergency Room.***
- If you go to a local Emergency Room and they replace the Button in the first 12 weeks after surgery, they MUST get an x-ray study to confirm placement before you can feed your child.
- The first change will be done in our clinic, 3 months after the Button was placed in surgery. Changing the Button at home before it has been in place for 3 months (12 weeks) is not safe for your child and may result in your child getting very sick and requiring another surgery.