Enteral feeding at home, explained without the jargon
PEG and NG tubes, pumps versus gravity, hygiene and how supplies arrive — a calm, dietitian-led overview for families and carers. Educational only; your NHS home enteral nutrition team leads every decision.
What "enteral feeding" actually means
Enteral feeding (often called tube feeding) delivers liquid nutrition straight into the stomach or small bowel when eating and drinking by mouth isn't safe or isn't enough. It is not the same as a drip into a vein. The two routes you'll hear about most are:
- NG (nasogastric) — a fine tube passed through the nose into the stomach, usually for shorter-term support.
- PEG (percutaneous endoscopic gastrostomy) — a tube placed directly into the stomach through the tummy wall during a short endoscopy procedure, used for longer-term feeding. Related types include RIG and gastrostomy 'button' devices.
At home, an NHS home enteral nutrition (HEN) team — led by a specialist dietitian and often supported by community nurses and a homecare company — sets the feeding plan, trains the family, and reviews it over time. This page is a map of the moving parts, not a substitute for that team.
Pump vs gravity vs bolus: how the feed is given
Your dietitian chooses the method based on the tube, the feed, tolerance and lifestyle — not the other way round. Here's how the common approaches compare.
| Method | How it works | Best for | Watch for |
|---|---|---|---|
| Pump feeding | An electronic pump delivers feed at a set, slow rate over hours; can run overnight or in a backpack | Continuous or overnight feeding; sensitive stomachs; precise control | Mains/battery and alarms; a giving set to manage; pump care and cleaning |
| Gravity feeding | Feed flows from a hung bag by gravity, rate adjusted with a roller clamp | Simpler routine without a pump; daytime feeds | Less precise rate; needs a stand and a steady hand on the clamp |
| Bolus feeding | Set volumes given by syringe over ~10–20 minutes, several times a day | Discreet, low-kit, mealtime-style routine; mobility | Tolerance of larger volumes; time across 4–6 daily 'meals' |
General comparison for orientation only. Your HEN team prescribes the method, rate and volume.
Pump or no pump? An honest snapshot
- Pumps give a precise, steady rate that's gentler on a sensitive gut
- Overnight pump feeding can free up the day
- Bolus and gravity need far less equipment and no power
- Pumps mean alarms, charging, and an extra device to clean and carry
- Gravity is less precise — the rate drifts as the bag empties
- Bolus can feel like a lot of 'meals' to fit into a day
A typical day, start to finish
Routines vary by plan, but most home feeds follow the same shape. Always follow the written plan your dietitian gives you.
Wash hands and set up
Wash hands thoroughly with soap and warm water and dry them; gather the prescribed feed, syringe or giving set, and water for flushing. Family carers in their own home don't need gloves and aprons.
Check the feed and tube
Check the feed is the right one, in date and at room temperature, and confirm the tube position exactly as your team trained you before anything goes in.
Flush before feeding
Flush the tube with the prescribed amount of cooled boiled or fresh tap water (as advised) to confirm it's clear.
Give the feed
Run the pump, gravity bag or bolus at the prescribed rate and volume, sitting upright or propped up to reduce reflux.
Flush again and tidy up
Flush after the feed and after any medicines, then clean reusable items. A hung feed and giving set are used for up to 24 hours, then replaced.
Record and reorder
Note volumes, any tummy upset and stock levels, so your next homecare delivery and dietitian review stay on track.
What good home support looks like
You're not choosing a product here — you're checking the support around it. Use this to know what 'set up properly' should include.
A named dietitian and plan
A written feeding plan (feed, rate, volume, flush amounts) and a specialist dietitian you can reach, who reviews you regularly.
Hands-on training, signed off
You and any carers should be trained and recorded as competent before discharge — not handed a leaflet and waved off.
A clear ordering route
Most feed and ancillaries are delivered by a homecare company, often around every 28 days, with a coordinator to call — not your local pharmacy.
Hygiene built in
Simple, repeatable hand-washing and storage steps; feeds kept cool (roughly 5–24°C), out of sunlight, and used within the stated hang time.
A who-to-call list
Numbers for the HEN team, the homecare nurse line and out-of-hours, plus what to do if the tube blocks or comes out.
Spare kit and a back-up
A buffer of feed and giving sets in case of delivery delays, and a known fallback if a pump fails.
This guide is educational and general. Every feed type, rate, volume, flush and hygiene step must come from your NHS home enteral nutrition team — typically a specialist dietitian, with community nursing and a homecare provider. Never change a feed, rate or routine on your own. For anything new — a blocked or displaced tube, vomiting, breathlessness during feeding, or signs of infection around a PEG site — contact your HEN team or homecare nurse line, and in an emergency call 999. For broader guidance, the NHS, NICE and BAPEN publish patient and carer resources.
Common questions from families
Is a PEG permanent?
Not necessarily. Some people use a PEG long-term, others while they recover. NG tubes are usually shorter-term. Your team reviews whether feeding by mouth can resume, partly or fully, over time.
Who delivers the feed and equipment?
In most parts of the UK a homecare company delivers feed, giving sets and ancillaries direct to your door, often on a roughly 28-day cycle, with a coordinator you can phone. Prescriptions usually route through that homecare pharmacy rather than your local one.
How long can a feed hang before it's unsafe?
Infection-prevention guidance commonly allows a ready-to-hang feed and its giving set to stay connected at room temperature for up to 24 hours, after which both are replaced. Follow the exact times your team gives you, as decanted feeds have shorter limits.
Do family carers need gloves and aprons at home?
Generally no — guidance is that family members caring for someone in their own home don't need gloves and aprons for routine feeding, but thorough hand-washing before handling feed and equipment is essential. Paid carers and staff follow their own PPE rules.
Can someone still be active on a pump?
Often, yes. Many pumps fit in a small backpack so people can move around or go out, and overnight feeding can keep daytimes free. What's suitable depends entirely on the plan your dietitian sets.
Feeling more confident, one guide at a time
Home enteral feeding can feel daunting at first — but with the right plan and a team behind you, it becomes routine. Explore more plain-language home-care and nutrition guides, and keep your NHS dietitian as your first port of call.