Tube Feeding

Tube feeding is the feeding of a kitten through a tube, inserted directly into the stomach. It is an advanced, but essential skill for people caring for newborn or critically ill bottle babies that won’t suckle on their own.

Tube feeding is particularly useful with weak kittens that may not have a strong gag reflex. This means that they are at higher risk for accidentally inhaling milk and developing aspiration pneumonia.

Tube feeding is part of an overall treatment plan to bring a kitten back to health and should be considered a “stop gap” measure while other treatments have time to take effect. Never rely on tube feeding alone to save a kitten -- there’s a good reason why they aren’t suckling, so we need to address that as well! Other treatments used in conjunction with tube feeding include the basics of good nutrition, heat support, and time. In addition, your kitten may be prescribed antibiotics, anti-nausea medications, and/or appetite stimulants.

Supplies for tube feeding

  • Red rubber catheter Fr 3.5 or 5

  • Permanent marker

  • Warmed formula

  • Large syringe for formula (usually ~12 mL), ideally luer lock, not slip top

 

Watch these great videos on how to tube feed:

Step-by-step instructions

 1.  Measure your tube from the kitten’s nose to the bottom of rib cage (last rib) and mark the tube with a Sharpie or a piece of tape.

 2.  Determine your kitten's stomach capacity using chart or calculate using 4-5 mL milk per 100 grams of body weight, e.g., a 300g kitten could comfortably eat (300 / 100 x 5 = ) 12-15 mL in one feeding.

Bottle Feeding & Stomach Capacity Chart

 3.  Fill your syringe with warm formula and firmly attach the red rubber catheter.

 4.  Remove air bubbles from the syringe by holding the syringe vertically and depressing the plunger until milk comes out the tip. This prevents air from being put into the kitten’s stomach.

 5.  Wrap your kitten in a towel burrito and hold kitten upright.

 6.  If possible, tilt the kitten’s head forward/down and then gently push the tube into the kitten’s mouth

Note

The esophagus is on the left side of the kitten, but you do not need to aim in any particular direction. The kitten’s larynx (throat) will automatically close up to protect itself (this is how we prevent food from going into our lungs and why we cough if we try to breathe and swallow at the same time).

If you feel any resistance or if the tube isn’t gliding in easily, pull out and try again. 

How do you know you are in?

  1. The tube will stop before your marking if it is in the lungs (the lungs are very short)

  2. The kitten cannot scream if you are in their airway/lungs. 

 7.  Once you are happy you are in, inject the milk (although people say slowly, if you watch the videos, they are actually going quite quickly!)​​

Tips

Keep kitten vertical, which is the opposite of normal bottle feeding.

During feeding, the kitten will scream and try to move the tube out. You can hold the tube in place using one hand or just pause giving milk and push it back in. Keeping the tube in can be a little tricky and requires some dexterity

 8.  When you are done, pinch and kink the tube before pulling it out. This prevents any drips of milk from going into the lungs

 9.  Wash your tube and syringe with hot water by flushing it with the syringe. If you use soap, make sure to thoroughly rinse with warm water.

Considerations

If your kitten is larger/has teeth, there is a risk of them biting off the tube--which can be life-threatening. To prevent them from chewing off the tube, either:

  • Keep one finger on the side of the mouth/jaw, to prevent them from fully closing their mouth. They will gnaw on your finger or their own cheeks and it’ll be mildly uncomfortable.

  • Use a thick towel or blanket to wrap the lower jaw so they can’t close their mouth on the tube. The lower jaw is quite weak and you should be able to keep the mouth open using this technique. Be careful not to pull the jaw all the way open/down as this can be uncomfortable.