Pictorial instructions on how to flush and feed a j-tube.

1. Tubey Tutorial Or, how to plug the kid in for the night

2. 1. Gather 3 cans of formula and 1 pump bag.

3. 2. Gently invert the cans to mix, but don’t shake (avoid bubbles.)

4. 3. Measure 125 mLs (half a can) because the total volume required is 2.5 cans.

5. 4. Open the bag and remove the pump bag. Remove the clear cap from the end of the tubing.

6. 6. Open the lid of the bag.

7. 6. Pour the formula in slowly to avoid bubbles. Close the lid firmly.

8. 7. Use Press-And-Seal to close up the half-can remaining and stick it in the fridge. Tomorrow you can use this.

9. 8. Hang the bag on the IV pole.

10. 9. Find the teal tubing on the pump bag. Gently squeeze at the teardrop symbol.

11. 10. Simultaneously squeeze the bag to prime the formula into the tubing.

12. 11. Behold the pump.

13. 12. Open the white door.

14. 15. The teal tubing and plastic cartridge will go in the door.

15. 14. Stretch the teal tubing over the black wheel on the left.

16. 15. Snap the plastic cartridge into the compartment until it clicks in.

17. 16. Close the door securely.

18. 17. Press the On/Off button.

19. 18. After it beeps and displays random numbers, it will show this (rate is 60.)

20. 19. Press the Rate/Dose button.

21. 20. You will see this screen (dose is 600.)

22. 21. Press the Vol/Total button.

23. 22. You will see this (Volume 600.) This tells you how much formula went in the previous night.

24. 23. Press the Clear button.

25. 24. Now the volume is 0 (e.g. she has received 0 of the 600 mLs she needs tonight.)

26. 25. Press Pause to silence the alarm if it gets impatient during your next step.

27. 26. Get a large syringe and some clean drinking water (tap is fine.)

28. 27. Draw up about 15 mLs (1/2 oz.)

29. 28. Insert the water-filled syringe into the extension set.

30. 29. Push water into the extension set until it’s primed (drops come out.)

31. 30. Close the clamp at the end of the extension.

32. 31. Expose button.

33. 32. Open the button (like a beach ball valve.)

34. 33. Insert the extension so the black hash marks line up. Push in until it clicks.

35. 42. Rotate extension clockwise.

36. 35. Open the clamp.

37. 36. Flush the water in.

38. 37. Close the clamp again.

39. 38. Remove the syringe from the extension.

40. 39. Insert the red end of the pump bag into the extension. Not TOO tight or it will never come out! About this far in.

41. 40. Get the “AMT Clamp” ready.

42. 41. Wrap the smaller half around the extension and close the band.

43. 42. Do the same with the larger side under the red part. This keeps the two pieces snugly together overnight.

44. 43. Open the clamp back up!

45. 44. Press and hold the Prime button.

46. 45. Watch the formula flow through the extension.

47. 46. When the white formula reaches the button, let go of the Prime button.

48. 47. Press Run/Pause to start the feed.

49. 48. If you press Vol/Total, it will show you how much formula has infused so far.

50. 49. See? So far, 1 mL. (it should say “run” in the corner.)

51. 50. Make sure she has an overnight diaper (sleeping Mickey.) Velcro the tube under the diaper tab like this.

52. This way if she rolls over, it won’t yank her tummy.

53. 52. Pull down her shirt, cover with blankie, and kiss good night!