Feeding Tubes: The Case of the Disappearing Numbers

Meredyth Thompson, BSN, RN / November 2016


It’s happened to all of us a time or two (or twenty)! It’s 0830 (or 2030 for you nightshifters), and you’re running late for an 0800 feed. You hurry through your assessment, get the baby settled, and go to check your feeding tube to make sure it’s secure, and check your residuals (if your unit does this).

Then you check the French size, and the depth of the tube, only to find that the silly sticker is hanging on by a thread, the writing has faded, it has gotten wet at some point, and is utterly illegible! UGH!

You check out the tube and think it “looks like” it’s a six and a half French, and that’s appropriate for this size baby. However, when you look at the tube to see where it’s taped, there are NO NUMBERS! You manipulate the tube and try to see past the tape and Tegaderm. You notice there is a marking for 20 centimeters, but below that, there’s nothing! EEK!

So, what do you do?

Well, we are all stellar nurses, so of course, we have to change the tube… which now makes the 0800 feed an 0900 feed, disturbs the baby you have just settled in, and makes you late for your entire morning routine.

Whew! Now that that’s over, I ask you: what the heck happened to the numbers?

If feeding tubes are made to last 30 days, why does the ink wear off well before it is time to change the tube?

There is some growing evidence out there to change our tubes more frequently than every 30 days (more on that in another blog) and that will help with this number thing. But, it still does not change the fact that the ink on some feeding tubes does not last. It’s like there’s disappearing ink on these things.
Unfortunately, I don’t have the answer for why they rub off. However, I do know that some very intelligent folks have given us a solution to this issue. They have found a way to make the numbers last, far beyond the life of the NG tube, and have helped to alleviate the frustration we all feel when we have to replace a tube. Thank you to the team who created this solution. You have solved the case of the missing numbers.

And for you clinicians that are in the field, I ask you, evaluate your tubes the next time you open a new one. Look at it. Feel it. Is it smooth? Does it have the bottom tip end hole and ample side holes? And, when you remove a tube, is there “sludge” at the bottom? Could this be a contributor to NEC, or feeding intolerance?

And finally, look and see if the numbers have faded or even worse, disappeared. You may need to solve your own missing numbers case.

Learn more about Medela feeding tubes, which can help you solve the case of the missing numbers in your unit.

Tell us more! Use the comments section below to share your experience with the case of the disappearing numbers.


About the Author

Meredyth Thompson, BSN, RN, is a Clinical NICU Specialist with Medela.  She has 13 years of NICU experience where she was a staff nurse, travel nurse, and nurse manager.  She has experience working in a variety of NICU’s across the nation including large children’s hospitals and small and large delivery centers.  She has a passion for developmental care, human milk, nurse mentorship, nurse manager coaching, and is a powerful change agent.  Meredyth has been trained in Lean Management Systems and has thorough experience in NICU design and expansion project management.