Ask the RD: What Kind of Water Should I Put Down My Feeding Tube?

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist
09/27/13  9:45 PM PST

Regular flushing of your feeding tube with water will help prevent clogging. Flush your tube before and after each use to keep it clear of formula and medications. Putting water down your tube also helps you meet your hydration needs. Inadequate fluid intake may lead to constipation or dehydration. So – water in my feeding tube? Yes please! The type of water you use depends on your level of health and your personal preferences.

Tap water, or the water from your sink, meets the Environmental Protection Agency regulations for drinking water and is consistent with the World Health Organization’s guidelines for water safety. This type of water is safe to use for most tube-fed patients.

Use this type of water when:

  • You have a gastrostomy tube and are otherwise healthy

Purified water has been treated to meet the standards of the U.S. Pharmacopeia for purified water. It is essentially free of chemicals and may be free of bacteria if it undergoes a disinfection process, such as distillation, reverse osmosis, ozone or ultraviolet light. Not all bottled water is purified or sterile. Read the label on bottled water to see if it has been treated with one of these methods.

Use this type of water when:

  • You are mixing powdered formula
  • You are diluting medications
  • Your immune system is weakened due to acute or chronic illness
  • You have a jejunostomy tube

If you are unsure, ask your healthcare provider which type of water you should use and how much you need each day. Always use safe handling practices when preparing your tube feeding.

This article is is tended for educational use only and does not replace the advice of a medical professional. If you have any questions or concerns regarding your feeding regimen, contact your healthcare provider.

For more information, see related articles and feeding tube resources here:

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    1. Thank you for your question, Laurie! Tap or bottled water is recommended to maintain hydration or to keep your gastrostomy tube from becoming clogged. Distilled water can be used for this purpose as well but is not necessary and has not been shown to be any more beneficial than tap or bottled water.

  1. My stepfather used demonized water in my nephew ‘s pej to inflate the balloon instead of sterile water is this ok? Please

  2. My son has a J tube and we put water in the bag with his feeds. Our city water just changed as it is hard so I can’t boil and use it any more as there is always a film on to. Should I be using bottled water or distilled water to be sure it is safe for him? Thanks

    1. Hi Kathy, thanks for your question!
      Tap water is usually recommended, as it’s regulated more than bottled water. If you don’t feel comfortable using the water that comes from your tap, try using sterile or purified water. You can usually find it near the baby formula, as it’s used to prepare powdered formulas. This would be safer than regular bottled water for putting down the jtube.

  3. When attempting to dissolve certain medications it helps if the water is hot, what’s to hot a nd can if burn the organs of the digestive track at all? What’s to hot?

    1. Thank you for your question! When using water to dilute or dissolve medications for your feeding tube, it should not be hot and does not necessarily need to be warm. If you are unable to dissolve the medication in water that feels warm to the touch (try testing it on your wrist, like one would to test water for a baby’s bottle), ask your doctor or pharmacist is there is another form of the medication that would dissolve more easily.

  4. I thought people should avoid using distilled water for flushing since the distillation process removes minerals from water, making it hypotonic, or at least with a lower osmolarity (osmolality??) than tap or purified/spring/bottled water

    1. Hi Karen. That’s an excellent question! I hope you find this answer helpful.

      From Shield HealthCare RD, Stephani:
      When patients are in the hospital, staff usually will only use distilled or sterile water per their hospital protocols. However, certain brands of bottled water are actually distilled. Distilled, purified, and filtered water are all going to have a lower osmolarity than tap water because more of the natural minerals have been removed. If the water for flushing needs to be sterile, it is ok to use distilled, purified, and filtered water.

      Please note: Before changing your feeding tube process, including the type of water you use, please speak to your doctor.

    1. Hi Stephanie. That’s a good question. Always make sure to follow the gtube hydration/flush directions you received from your doctor. If you are not tolerating your treatment plan or feel it needs to be adjusted always talk to your doctor or medical team before making changes.

  5. Hi,my 29year old brother just recently had a G-tube inserted and his feeding instructions say to flush his tube with 60ml water (30×2)
    with every feed and he has 4 feeds per day. With that he’s experiencing constant constipation which is said to be one of the side effects of the G-tube but I’ve recently noticed that he has a dry mouth and is restless and I fear he might be dehydrated. Is it safe to give him more water to hydrate him and help alleviate the constipation?

    1. Hi Pagel,
      It sounds like your brother is exhibiting some signs and symptoms of dehydration. I cannot give you an exact quantity of formula that he may need as I am not familiar with his medical history, but I can tell you that an average amount of water an adult needs is about an ounce per kg of body weight. Please call his primary care physician for more specific recommendations. Good luck,

    1. Hi Scillisa. Thank you for the question! Yes, you can put water in a feeding bag, but if using a pump you may get an alarm message as the sensors can’t “read” the water.

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