Teaching guidelines on G-tube and Monarch® gastrostomy tube in association with practical teaching by a professional

Paediatric guidelines (in development)
NHS Lothian

Objectives

To enable you:

  1. To give feed safely through a G-Tube or Monarch® gastrostomy tube.
  2. To give medication safely through a G-Tube or Monarch® gastrostomy tube.
  3. To care for a G-Tube or Monarch® gastrostomy tube following the manufacturer guidelines.
  4. To safely change a G-Tube.
  5. To recognise and manage complications.

Scope

Purpose of this document:

To aid with the instruction of parents/carers of a child/young person with a G-Tube or Monarch® gastrostomy tube, to ensure they can safely care for and use a G-Tube or Monarch® gastrostomy tube.

To provide guidance for staff to ensure consistent and safe approach when caring for a child/young person with a G-Tube or Monarch® gastrostomy tube.

To aid with the instruction of non-health care professionals, to ensure they can safely care for and use a G-Tube or Monarch® gastrostomy tube.

Audience

Who should use this guideline?

All those involved in the instruction and care of children/young people requiring a G-Tube or Monarch® gastrostomy tube.

To whom this guideline applies: All those involved in the care of children/young people requiring a G-Tube or Monarch® gastrostomy tube.

Editorial Information

Last reviewed: 22/06/2025

Next review date: 30/06/2028

Reviewer name(s): Catherine Paxton, Caroline Clark, Natalie Carter.

References

Braegger C et al. Practical approach to paediatric enteral nutrition: A comment by the ESPGHAN committee on nutrition. Journal of Pediatric Gastroenterology and Nutrition 2010;51(1):110-12

https://avanos.co.uk/wp-content/uploads/2022/01/HC209-02-UK_COPY-05147-MIC-Patient-Booklet-2021.pdf

(Accessed 22.6.25)

NHS, Quality Improvement Scotland (2007). Best Practice Statement, Caring for Children and Young People in the Community Receiving Enteral Tube Feeding. (Not now directly accessible online)

NHS Lothian, (2013). Lothian Enteral Tube Feeding, Best Practice Statement for Adults and Children. https://policyonline.nhslothian.scot/wp-content/uploads/2023/03/Enteral%20Tube%20Feeding%20Best%20Practice.pdf (Accessed 22.6.25)

NPSA (2010), Rapid Response Report NPSA/2010/RRR010: Early detection of complications after gastrostomy. Summarised in BMJ 2010. https://www.bmj.com/content/340/bmj.c2160 (Accessed 22.6.25)