Health Care Plans for Students with G-Tubes
All contents of this resource were created for informational purposes only and are not intended to be a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your physician, therapist, or other qualified health providers with any questions or concerns you may have.
When a child has a G-tube, support must extend beyond the home. Schools are legally required to provide accommodations so a child can safely attend and participate in school. These supports must be clearly written into the IEP, 504 Plan, or Individualized Health Plan (IHP)—not left to verbal understanding or informal agreements.
Clear documentation ensures that G-tube care and blenderized diets are treated as medical necessities, protects school staff who must follow written plans, and helps prevent delays, confusion, or emergencies during the school day.
This article will cover:
- Legal basis for accommodations
- What to include in the IEP or health plan
- Feeding and nutrition supports
- Medications administered via G-tube
- Emergency G-tube plan
- Required emergency supplies
- Staff training requirements
- Sensory and behavioral accommodations
- Transportation considerations
- Field trips and special events
- What happens if the G-tube comes out
- Supporting Independence
- Legal and advocacy considerations for parents
G-tube care is a medical necessity, not a preference. School staff are only permitted to follow written plans and medical orders. Therefore, clear documentation protects your child, school staff, and families by preventing delays, confusion, or emergencies.
Legal basis for accommodations
Support for G-tube care and blenderized diets may fall under:
- IDEA (Individuals with Disabilities Education Act)
- Section 504 of the Rehabilitation Act
- Americans with Disabilities Act (ADA)
These laws require schools to provide reasonable accommodations when medical needs affect a child’s access to education. Schools cannot deny enrollment or participation due to a feeding tube or medical feeding needs.
What to include in the school IEP or health plan
Feeding and nutrition supports
The health plan should clearly outline:
- Feeding schedule (bolus or continuous)
- Location for feeds (classroom, nurse’s office, or another safe, agreed-upon space)
- Who is responsible for administering feeds
- Time accommodations for feeds without academic or attendance penalty
- Explicit access to blenderized food or approved formulas brought from home
- Food storage accommodations (refrigeration, labeling, handling)
- Written acknowledgment that blenderized diets approved by a medical provider are medically necessary, not optional
- Clarification that food from home is not subject to cafeteria or allergy policy restrictions
Blenderized diets should be treated the same as formula-based tube feeds when medically prescribed or approved.
Medications administered via G-tube
If medications are given during the school day, the plan should include:
- Medication schedule and responsibility
- Instructions for administering medications via G-tube
- Required flushing before and after medications
- Storage and documentation procedures
Emergency G-tube plan
A detailed emergency plan must be written and accessible to all relevant staff. It should include:
- Step-by-step instructions for what to do if the tube comes out
- Location of the emergency G-tube kit while at school
- Names and roles of staff trained in G-tube care
- Parent/guardian contact information
- Clear guidance on when to call parents versus when to call EMS
- Alignment with written physician orders on file with the school
Required emergency supplies
Most families only have one or two sterile backup G-tube buttons, so planning is essential. Emergency kits should include:
- Backup g-tube (correct size)
- Extension sets
- Sterile syringes
- Small bottle of sterile or distilled water
- For cleaning the stoma
- For filling the g-tube balloon if needed
- Water-based lubricant (e.g., KY jelly)
- Gauze and gloves
- Extra sterile cotton pads or dressings
Because backup tubes are limited, the emergency g-tube kit should be kept in a backpack or go-bag that stays with the child across settings, including school, daycare, therapy, field trips, and community outings.
Staff training requirements
The written plan should clearly state:
- Which staff members are trained in G-tube care
- Who is trained and permitted to replace the tube if it comes out
- Who may administer feeds and medications
- That substitute staff must have access to written instructions
Do not assume training carries over year to year. Request annual updates and documentation of staff training.
Sensory and behavioral accommodations
For children with sensory sensitivities or behavioral challenges, the plan should include:
- Adaptive clothing allowances (onesies, tube covers, protective garments)
- Extra supervision during higher-risk times (transitions, bathroom, recess)
- Permission for comfort items or visual supports
- A calm, predictable routine around feeds
- Privacy accommodations when appropriate
Transportation considerations
If your child rides the bus:
- Bus staff should know who to contact in an emergency
- Feeding schedules should not conflict with transportation times
- Emergency kits should travel with the child if needed
Field trips and special events
The plan should address:
- Planning for feeds during field trips or special events
- Ensuring trained staff are present
- Permission for a parent or caregiver to attend if necessary
- Confirmation that emergency supplies travel with the child
What happens if the G-tube comes out
Not every school or setting has staff trained to replace a G-tube. A clear plan must be written into the IEP or health plan. Appropriate options include:
- Call the parent or caregiver to come immediately
- If a parent cannot arrive quickly, call EMS to place the tube safely
- Follow written medical instructions from the child’s physician
Replacing the tube quickly helps prevent the stoma from closing, but this is not typically a life-or-death emergency. Staying calm and following the written plan is key.
Supporting independence (when appropriate)
For older children or adolescents, plans may include:
- Gradual participation in care tasks, as developmentally appropriate
- Support for self-advocacy
- Privacy and dignity considerations
Legal and advocacy considerations for parents
Schools cannot refuse enrollment due to a G-tube. Additionally, they must provide reasonable accommodations. Oftentimes, firm, informed advocacy is necessary. A written plan will protect everyone involved.
If resistance occurs:
- Request a meeting with the school nurse and administrator
- Ask for decisions and refusals in writing
- Bring medical orders and documentation
- Involve an advocate if needed
Conclusion
A well-written IEP or health plan turns fear into preparedness. By planning ahead, keeping emergency supplies with their child, and clearly defining roles and responsibilities, families help ensure their child is safe, supported, and able to fully participate in school.
