Tube Feeding My Child: What is the Safest Way to Handle the Bag Between Feedings?

Amy Long Carrera, MS, RD, CNSC, CWCMS
Registered Dietitian Nutritionist
01/23/17  9:56 AM PST
tube feeding

Pump-assisted feeding, or interval feeding, is commonly used among children who are on tube feeding. Some children tolerate the controlled rate through the enteral pump better than gravity feeding with a syringe or gravity bag. Interval feeding entails pouring formula into the feeding bag*, running it through the pump for a specified time – usually 30 minutes to an hour – and repeating this procedure after a break of 1 to 3 hours.

With this method, the same bag is used in a 24-hour period. So what do you do with the feeding bag between feeds? What is the safest way to handle the bag between feedings that will result in the least amount of bacteria in the bag?

tube feeding

*The feeding bag is sometimes called a feeding set.

Should you: a) Rinse the feeding bag with water and let it dry until the next use? Or b) Store the bag in the refrigerator, residual formula and all?

A recent study at Children’s Mercy Hospital in Kansas City compared these two options.


  • Researchers filled each feeding bag with 120 milliliters of formula and ran the pump for 30 minutes every 3 hours during a period of 21 hours.
  • Feeding bag #1 was rinsed with sterile water and left on the pump for 3 hours until the next feeding.
  • Feeding bag #2 was placed in a ziplock bag in the refrigerator for 3 hours until the next feeding.
  • Researchers measured bacterial growth in both bags 3 times during the entire 21-hour period: before the first feeding, at 12 hours (after the 5th bolus feeding) and at 21 hours (after the last bolus feeding).


Bacterial growth was slightly lower in the refrigerated bag than in the rinsed bag. Researchers attribute this to the fact that refrigerating the bag required less manipulation than rinsing. For both bags, the growth was for the most part, within acceptable ranges according to U.S. FDA guidelines.


Refrigerating the feeding bag in a ziplock bag is the safest method of handling the bag between feedings, compared to rinsing the set with sterile water.

How to Handle the Feeding Bag Between Feedings:

  1. Wash your hands thoroughly with warm, soapy water for at least 20 seconds.
  2. Remove the feeding bag from the pump.
  3. Put the feeding bag in a clean ziplock bag.
  4. Place the ziplock bag in the refrigerator.
    1. Keep a thermometer inside your refrigerator to make sure the temperature stays at or below 40 degrees Fahrenheit.


Enteral Feeding Set Handling Techniques: A Comparison of Bacterial Growth, Nursing Time, Labor, and Material Costs. Nutrition in Clinical Practice. 2016.

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