G Tube and GJ Tube Extension Care

Feeding tubes that are placed in the stomach with a balloon usually are Mic-key Buttons or Amt Mini Buttons.  Each brand has a couple different styles, but they all use extensions to attach the feeding tube from the stomach to the feeding bag on a pump.

Extensions are a very important part of daily care for a feeding tube.  If they are not cleaned properly, changed out, and maintained they will make feeding tube life harder.

How Many Extensions should you get every month?

Your doctor or surgeon will usually place a prescription for feeding tube supplies with a local DME (Durable Medical Equipment) provider for you before discharge from the hospital.

The DME will send your supplies to your home monthly.  They are usually delivered by Fedex or UPS.

Most insurance companies will cover up to 4 extensions a month. If you have a GJ tube this means 4 extensions for each side (g side and j side). The order from the doctor to the DME is not always that same amount that insurance will cover.

If you feel that you do not get enough extensions per month, you will need to contact your DME first.  They will tell you the amount on their orders and will advise if you need an updated order from the doctor.

Most doctors will write a medical necessity letter to request more extensions per month on your behalf.

How Often Should You Change an Extension?

There is no set rule for how often you should change your feeding tube extension.  In general extensions should be changed every 7-14 days.

The most common signs that it is time to change an extension are clogging, extra pressure when pushing fluids or meds, and the extension will start to feel very stiff compared to a brand-new extension.

What happens if you use an Extension for too long?

If you are properly cleaning and maintaining your extensions, they can last for much longer than 2 weeks.

If an extension is not cleaned regularly, it can lead to extra clogging in the line during feeds and can also lead to bacterial infections. When you push old milk or medicine through a dirty extension this can cause bacteria or even mold to build up in the line.  You really don’t want to push that into the stomach!

4 Ways to Clean Feeding Tube Extension

There are a couple tried and true ways to clean an extension.  

1. Soap and Water

This one is the most basic, but it works!  Simply clean the extension with dish soap like Dawn or Palmolive and warm to hot water.  You can soak the extension in this mixture to break up any formula residue if needed.

Then flush the tube with a syringe or with running water until all soap residue is removed.  Once it is clean, extensions dry best when they are hung to dry.  You will know you are hanging it correctly if some water drips out.  If no water comes out, try flipping it around!  Usually, an extension will dry in a few hours if it is drained correctly.

2. Dish Soap, Water, and Vinegar

This combination of dish soap, water, and vinegar seems really effective if you use a multivitamin like iron or real food blends.  These liquids can leave residue or stain an extension, so the addition of vinegar really helps to clean them out.

Just like the first method, you can soak the extension first, or you can use a syringe to flush the soap/water/vinegar combo through.  Once the line is clean, flush with warm to hot water to remove any remaining soap.  Hang the extension to dry.

3. Feeding Tube Brush 

I have recently come across feeding tube brushes that are basically pipe cleaners on a long wire.  These are amazing for those that get feeds in intervals.  Typically, you would flush an extension between feeds and medicines, but if you are giving a feed overnight, you may not remove the extension right away.  If your extensions get a little extra gunky or have dried spots, using a brush can really help.

You can buy a set of 4 brush sets on Amazon for really cheap, like under 10 dollars.  Keep in mind that the brushes will get pretty gunky themselves, so change them out as needed.

Tube brushes can also clear out any clogs in the extensions too!  In the case of GJ tubes, where a G side extension is used to vent, you can get partially eaten food, salvia, mucous, or other matter in the tube that can cause a clog.

Some people have noted that scrubbing too hard with these brushes can cause the brush to scratch the inside of the tubing.  If you have a particular hard to clean area, try soaking the extension in hot water and dish soap/ vinegar to loosen any residue.

4. Use the Clamp on the Extension

For those with really tough to clean extensions, try soaking the line first in soap and or vinegar with hot water for at least 15 minutes.

Then using the clamp that comes on the extension and squeeze the clamp to scrape the residue down the tube.  This can really help remove sticky or dried residue from medications or very thick formulas and blends.

Where to get Extensions if you run out?

Even when you maintain your extensions and you clean them regularly, it is still possible to run out.  Since a feeding tube is pretty much useless if you can’t hook it up to the food, extensions are a must have item.

A. Check Facebook Groups

There are quite a few Facebook groups dedicated to feeding tubes.  Most of these groups allow members to exchange surplus supplies or donate items to other members.  You will usually have to pay for shipping. 

As a good rule of thumb, only pay using PayPal Goods and Services, and don’t use the friends/family version when paying for items in Facebook Groups.  This way if a member lies and does not send the item, you can dispute the charge.  Unfortunately, not everyone in the feeding tube community is honest and some will scam you.  I always check to see if the person that is offering the item is active in the group.  If they never post and just joined recently, I am less likely to want to deal with them.

B. Buy Out-of-Pocket Supplies

Sometimes you just have to pay out of pocket for supplies.  I have heard you can request to be reimbursed by insurance, but I haven’t tried that yet.

I have recently found extensions for a very reasonable price at Carewell.  They are a family run company that not only offers 24/7 support, but they also offer tons of discounts and deals on medical supplies.  This is an awesome resource to have in your online favorites folder for when you need supplies!

Mic Key Extensions can be purchased in singles or 5 packs for continuous or bolus.

Amt Mini ONE Extensions are available as well in single packs.

Carewell offers free 1-2 day shipping on order over $49, so you should be able to get your supplies super quick!

Extension Care is Essential

In a dream world, we would just get a new extension every day like we do feeding bags.  Unfortunately, that is just not an option for most people.

If you take care of your extensions with proper cleaning, they can last for a long time.  I’ve heard some people can use the same extension for more than a month.

This is will greatly depend on your feeding schedule (continuous or bolus feeds), types of medication used, types of formula or feeds used.

Failure to clean and maintain your extensions can cause infections or illness so it’s best to make a cleaning routine and stick with it!