When parents become old, in some cases, they may not be able to swallow or even get enough nutrition through the mouth. Physicians in these cases try feeding the patient via a thin tube to insert food, water, and some medications directly into the stomach. The tube feeding method can be used on all those in need, whether infants or the elderly. The main principle involved is providing easy-to-feed formulas via a tube. Proper training is provided to the home nurses for safe administration of food and medications via tubes like nasogastric, gastrostomy, or orogastric.
What Is RT Feeding
RT Feeding refers to feeding by use of a tube that passes into the nose into the stomach (Ryle tube). It is typically a 3 to 6-month intervention to maintain nutrition and hydration following a stroke, in head and neck cancer management, in some neurological diseases, or during the post-operative period. To ensure safety, X-ray is used as the initial position for the first placement; subsequent examinations usually involve stomach pH and other nurse-directed measures.
Why do families hear about this so often? Swallowing trouble after a stroke is common in India. A recent analysis found nearly half of stroke patients (47%) have dysphagia early on, which raises the risk of poor intake and chest infections if feeding isn’t managed well.
How to Start RT Feedings
Starting at home should be slow, simple, and supervised:
- Prescription & plan
Your doctor and dietitian confirm the need, set calories/protein/fluids, and choose the formula and schedule (small “bolus” portions or a slow pump). - Insertion & confirmation
A trained clinician places the tube. An X-ray is the safety baseline to confirm the correct position before the first feed or medicine. - Home setup
You’ll receive: formula, a large syringe (60 mL), clean water for flushing, tape, and (if prescribed) a feeding pump. You’ll also get a written timetable. - Caregiver teaching
A nurse shows hand-washing, how to keep your parent upright, how to check the tube mark on the nose, how to flush with water before/after feeds and medicines, and which warning signs need help. - First-week review
During the initial days, the nurses or dietitians observe coughing during feeds, nausea, loose motions or constipation, or pain and make necessary changes in the rate or formula.
RT Feeding Uses
The technique is usually prescribed by physicians to those cases where the person:
- Can no longer safely swallow due to conditions like stroke, Parkinson’s, dementia or other neurological conditions
- Have been undergoing chemotherapy for head and neck cancer, which makes it painful to eat/difficult.
- Needs short-term support after surgery, or
- It is not meeting nutrition needs by mouth for a while.
These are the standard short-term indications for an NG/Ryle’s tube.
Studies show malnutrition in older adults around 18%, with almost half at risk, which is why timely, guided nutrition support matters during illness.
Caring for RT Feeding at Home
The daily care deals with the prevention of choking (aspiration), infections, and tube obstructions. The following steps are included in some of the most frequently used hospital leaflets and community guidelines:
- Keep the body upright, the patient should sit in an upright position during feeding and 30-45
- minutes after feeding to minimise reflux/aspiration.
- Flush with water, instruct the nurse to empty the tube before and after feeds and when taking every medicine; this keeps the tube clean.
- Hygiene. Wash hands, clean/dry the nostril and the tape area, and observe the centimetre mark on the tube to determine whether or not it has moved.
- Medicines. Request the doctor/pharmacist about all the medications that can be crushed or changed to a liquid; not all pills are safe to crush.
- Red flags: get help fast. Coughing/choking during feeds, difficulty in breathing, vomiting, fever, the tube appears shorter/longer than previously, blood or continuous diarrhoea/constipation. Stop the feed and call your nurse/doctor.
X-ray is the gold standard for initial checks, but even X-rays can be misread. That’s why teams use clear protocols and teach families exactly when and how to re-check tube position.
Techniques of RT feed
Clinically, RT feeds are delivered in a few simple, doctor-prescribed ways. Your nurse will teach the exact method for home:
1) Bolus via syringe (gravity push)
- Measured feed given in portions using a large syringe (plunger off).
- Simple and quick; may cause more tummy symptoms in some people if given too fast.
2) Gravity bag method
- Feed flows from a hanging bag through tubing by gravity into the tube.
- Handy at home; keep the person upright and control flow with the roller clamp.
3) Pump-assisted feeding (continuous or intermittent)
- An electric pump delivers feed at a fixed rate (mL/hour).
- Useful when slower, steadier delivery is safer or better tolerated (e.g., reflux risk).
Choosing a technique (doctor/nurse-led):
- Bolus/gravity: fewer devices, more flexibility; may increase GI symptoms if too rapid.
- Pump/continuous: gentler on the stomach; reduces GI symptoms for some, but limits mobility during feeds. Always follow the prescribed rate.
Safety reminders for every method
- Sit upright during feeds and for 30–60 minutes after.
- Flush with clean water before/after feeds and each medicine.
- Check tube position as taught before each feed/med.
- Stop and call your nurse/doctor if coughing, breathing trouble, vomiting, or pain occurs.
RT feeding procedure
Hospitals follow a simple, step-by-step process:
- Measure the length needed for your parent.
- Insert the soft tube through the nostril into the stomach (with lubricant and gentle technique).
- Confirm the position for the first time by X-ray; later by pH and other checks as taught.
- Secure the tube with tape and write down the centimetre mark at the nose.
- Start feeding as per the plan (bolus or pump), with regular flushing and comfort checks.
Simple checklist you can print
- Doctor’s plan and diet chart in one folder
- The feeding schedule is stuck near the bed
- Position: upright now with 30–60 minutes after
- Flush before/after feeds and each medicine
- Record: amount given, time, any symptoms
- Emergency phone numbers on the wall
Conclusion
RT Feeding is a manageable way that maintains nutrition and medicines in check as one heals. Carry out according to the plan of the doctor, make sure that they are in an upright position during and after each feed, empty the tube at regular intervals, and respond to the warning signs. The little, continuous steps are more important than the perfectness. The thing is, when you do not know, stop the feed and call your nurse or your doctor.
FAQs
What are RT feeds?
RT Feeding (Ryle’s tube) is a technique used to give nutrition, water, and some medicines through a soft nose-to-stomach tube when swallowing isn’t safe or enough, usually short-term.
What is the RT procedure in nursing?
Nurses measure and insert the tube, confirm first placement by X-ray, secure it, teach checks and flushing, and start feeds as prescribed.
How to give feed through Ryle’s tube?
Sit upright, verify tube position as taught, flush with clean water, give prescribed feed slowly by syringe or pump, flush again, observe, and record.
What are the risks of RT feeding?
Possible issues include irritation, blockage, nausea, vomiting, diarrhoea, or aspiration. Reduce risk by confirming position, upright posture, slow rate, and regular flushing.
