A highly placed NG tube exposes the newborn to a risk of milk aspiration because of instillation of feedings into the esophagus. The current practice of a three-point measurement (bridge of nose to ear lobe to xiphoid) can result in variable placement by different caretakers. Unlike graphs available for endotracheal tube or umbilical catheter insertions, no standardized graph exists that verifies the correct NG tube insertion distance. We hypothesized that a correlation exists between body length (BL) and appropriate NG tube depth. This was evaluated by relating the cm mark of NG insertion to correct tip location on X-ray. Appropriate insertion was defined by tube placement in the fundus; radiographs were reviewed by a single observer. The figure illustrates the relationship between BL and correct depth of NG insertion in 17 patients (1-5 measurements) with 40 different x-rays at various times during hospitalization. These initial data indicate a correlation between a wide range of BL and appropriate NG tube depth of insertion. This graph may provide a useful tool in assessing appropriate placement of NG tubes in newborns and may improve care by decreasing the risk of milk aspiration.

figure 1