G-tube leaking :(

So I am taking care of an approx 6kg baby girl who it fed via gtube and hers leaks something awful! Due to her resp issues she is positoned prone or on her side 90% of the time, she cannot tolerate her back. She is fed bolus over 90mins during the day and cont olvernight, neither seems to make a difference. Surgery has one already removed the button (mickey) for four hours to make the hole smaller and it seemed to work temporarily but we are back to leaking again. Any suggestions? The site looks great but she is soaking through clothes & blankets, and she in on some pretty important po meds too
Are you sure the site is leaking and not the tube having a whole in it? If it is the site....to keep her dry seal an ostomy bag around the stoma and thread the tubing through the appliance bag and gently secure the end with tape.

Quote from Esme12Are you sure the site is leaking and not the tube having a whole in it? If it is the site....to keep her dry seal an ostomy bag around the stoma and thread the tubing through the appliance bag and gently secure the end with tape.

In my experience, Mickeys are prone to malfunction with littluns who are prone or crawl and scooch on their belly. Have you looked at other low profile devices?

Quote from systolyIn my experience, Mickeys are prone to malfunction with littluns who are prone or crawl and scooch on their belly. Have you looked at other low profile devices?

Quote from umcRNwe have changed the extension tubings a few times now (due to the med port stretching out, and we always have a back up clean one). The bubble inside is filled properly but I never thought of the ostomy idea! To at least keep her dry and get a measurement of how much is leaking! I will try that next time i'm at work, thanks!

We had a baby who had this happen. Does her gtube have a lot of play? Can you insert a larger size Mic? Here a few things we did:Exudry sponge with Allevyn sponge over it (cut to fit around the Mic), with Mepitac tape reinforced with two strips vertically and two strips horizontally over the sides of the button, to tack it down. We also used duoderm on her belly and secured to extension to that to reduce pulling on the Mic-Key. After that, we placed an ABD over the whole thing, with a surgilast retention band (basically an elastic kerlex type thing that holds it in place), for extra hold. We would weigh the dressing every shift to see how much the baby lost, and replace 1:1 with Pedialyte if it was over a certain amount. We also used stomadhesive powder, Desitin, and Maalox to reduce irritation and protect the skin from gastric contents. One of our babies was so bad that the doctor ended up inserting an NJ, and placed an ostomy bag around the Mic site to collect the contents because it was leaking so badly. We would refeed the contents every 8 hours through the NJ so that the baby didn't lose electrolytes. In the case of that baby, the only thing that helped was doing this and giving the site time to heal and close. The baby was an extreme micropreemie and was slow to heal.

Quote from NeoPediRNWe had a baby who had this happen. Does her gtube have a lot of play? Can you insert a larger size Mic? Here a few things we did:Exudry sponge with Allevyn sponge over it (cut to fit around the Mic), with Mepitac tape reinforced with two strips vertically and two strips horizontally over the sides of the button, to tack it down. We also used duoderm on her belly and secured to extension to that to reduce pulling on the Mic-Key. After that, we placed an ABD over the whole thing, with a surgilast retention band (basically an elastic kerlex type thing that holds it in place), for extra hold. We would weigh the dressing every shift to see how much the baby lost, and replace 1:1 with Pedialyte if it was over a certain amount. We also used stomadhesive powder, Desitin, and Maalox to reduce irritation and protect the skin from gastric contents. One of our babies was so bad that the doctor ended up inserting an NJ, and placed an ostomy bag around the Mic site to collect the contents because it was leaking so badly. We would refeed the contents every 8 hours through the NJ so that the baby didn't lose electrolytes. In the case of that baby, the only thing that helped was doing this and giving the site time to heal and close. The baby was an extreme micropreemie and was slow to heal.

Is she trached or did they tube her for the procedure? Critical airway from subglottic stenosis? Poor thing. I hate when our babies have to go for caths. They always seem to bounce back though!

Quote from NeoPediRNIs she trached or did they tube her for the procedure? Critical airway from subglottic stenosis? Poor thing. I hate when our babies have to go for caths. They always seem to bounce back though!

Laryngomalacia is tough. They're usually pretty stridorous at baseline and it always makes intubations tough. I'm lucky to be in Boston, with some of the best pediatric cardiologists and IR ain the country. The success rate of cardiac caths also depends on what they're doing once they're in. Warm thoughts and well wishes for your kiddo. Its amazing how attached we get in the homecare setting!

I am in a major childrens hospital, they do great with their cicu kiddos but for some reason the nicu ones tend to struggle

It's that damn pulmonary hypertension in the itty bitty ones.