Tube feeding log sheet for families (printable G-tube and PEG record)

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If your parent came home with a feeding tube — a G-tube or a PEG tube — the family inherited a routine that runs on exact details. There's a specific formula, a specific amount or pump rate, set feeding times, and whatever flushes and medicines the plan includes. And there's a care team that needs to know what actually happened at home. When two or three people share the feedings, "did the evening feeding run?" needs a written answer.

This page is a printable tube feeding log: a per-feeding record of what was given and how it went, plus a plan sheet that holds your parent's feeding plan — every line of it copied from your parent's own dietitian, nurse, pharmacist, or care plan.

That copying is the design, so it's worth saying plainly: this log contains no feeding rates, no volumes, no flush amounts, no positioning rules, and no symptom lists of its own. Tube feeding is prescribed for one person at a time, and the right instructions for your parent live with their care team. Every clinical line on the sheet is a blank with a named source. The log holds their plan and records what happened; it never supplies a plan of its own.

This article is educational and is not medical advice. Follow your parent's care plan and the instructions of their dietitian, nurse, pharmacist, and care team for every feeding, and call them with every question. If anything ever seems like an emergency, call 911.

Related resources:

• Caregiver daily log template — the day's overall record; the feeding details stay on this sheet
• Turning schedule for bedbound family care — if your parent also spends most of the day in bed
• Bowel movement and toileting log for elderly care — if the care team also asked you to keep track of bowel movements
• Caring for a parent after a stroke: the first weeks home — if the feeding tube came home after a stroke

On this page:

• Quick answer: what the log records
• Fill in the plan sheet from the care plan
• Tube feeding log (copy and print)
• The per-feeding record
• The tube site: record and report
• Formula and supplies on hand
• Bring the log to every nurse and dietitian contact

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Quick answer: what the log records

For every feeding:

1. What was given — start and end time, and the amount in the plan's units or the pump rate as it was actually set
2. Flush and medicines — the flush marked done, not in the plan, or missed, and each medicine given through the tube on its own line, so a blank never has to be guessed at
3. What you observed — a line of plain words for each feeding
4. Who gave it — initials

Behind all of it sits the plan the feeding was measured against — the plan sheet, copied from the care team and dated, so a feeding given by a sibling on Tuesday and by a paid aide on Wednesday follows the same instructions.

Fill in the plan sheet from the care plan

Fill in the plan sheet once. When the plan changes, start a new plan sheet the same day — with its date, the time it takes effect, and who changed it — and keep the old one with the log. Sit down with the discharge papers, the dietitian's written plan, and — for anything missing — the phone. Copy each of these word for word:

• Your dietitian's formula — the product name exactly as written.
• The amount per feeding from the care plan — and, if the plan uses a pump, the pump rate — each with its units exactly as the plan writes them, plus the feeding method as the plan describes it.
• The feeding times from the care plan.
• The flush instruction from the care team — in their words, including whether flushes are part of your parent's plan at all.
• The positioning instruction from the care team, if they gave one.
• What to do if the tube comes out or won't flush — the care team's instruction, in their words, written down before you ever need it.
• What to do about a missed or partial feeding, and whom to tell — the care team's instruction, in their words.
• The care team's list of what to report, and who to call — the nurse or agency, the dietitian, and the after-hours number.

Medicines get their own section on the plan sheet. Ask the pharmacist to go through your parent's medication list and give you an instruction for each medicine that will go through the tube — including what to do if a dose is missed or can't be given — and write each one down in their words, with the date and who gave it. How a particular medicine should be given through a tube is the pharmacist's call — not something to work out at home.

If a blank is still empty after the paperwork, that blank is a phone call to the nurse, dietitian, or pharmacist — never a search, and never a number borrowed from another sheet. MedlinePlus's nutritional support page is a plain-language backgrounder on tube feeding; your parent's care plan is the one to follow.

Tube feeding log (copy and print)

Fill in the plan sheet once and keep it next to the formula. Then print one day sheet per day, adding rows if the plan has more feedings than the sheet, so the feeding and the record happen together.

TUBE FEEDING PLAN SHEET — fill in once. When the plan changes, start
a new plan sheet the same day and keep this one with the log.

Person: ____________________  Plan dated: __________  By: _______
In effect from (date and time): __________________
Tube type (as the care team wrote it): __________________________

THE CARE PLAN (copy exactly from the dietitian, nurse, or discharge
papers — call for anything missing; never fill these from memory or
the internet)

  Your dietitian's formula (as written): _________________________
  Amount per feeding from the care plan (with its units): ________
  Pump rate from the care plan, if it uses a pump (with its units):
  ________________________________________________________________
  Feeding method (as the plan states it): ________________________
  Feeding times from the care plan: ______________________________
  Flush instruction from the care team (or "not in plan"): _______
  Positioning instruction from the care team: ____________________
  If the tube comes out or won't flush, the care team said:
  ________________________________________________________________
  Missed or partial feedings — what the care team said to do, and
  whom to tell: __________________________________________________
  The care team's list of what to report (copy it):
  ________________________________________________________________
  Who to call: _______________  Phone: __________  After hours: ___

MEDICINES THROUGH THE TUBE (one entry per medicine — the
pharmacist's or prescriber's instructions, in their words)

  Medicine (as on the list): _____________________________________
  How to give it through the tube: _______________________________
  If a dose is missed or can't be given: _________________________
  Source + date: ________________  Pharmacist / phone: ___________

  Medicine (as on the list): _____________________________________
  How to give it through the tube: _______________________________
  If a dose is missed or can't be given: _________________________
  Source + date: ________________  Pharmacist / phone: ___________

  Medicine (as on the list): _____________________________________
  How to give it through the tube: _______________________________
  If a dose is missed or can't be given: _________________________
  Source + date: ________________  Pharmacist / phone: ___________

TUBE FEEDING LOG — DAY SHEET

Person: ____________________  Date: __________
Care plan followed today (the plan sheet's date): __________
If the plan changed today: new plan from (time) ______, dated ______

FEEDING RECORD (fill in as it happens — not from memory at night)

  Start   End     Amount given    Rate set    Flush    Initials
                  (plan's units)  (if pump)
  _____   _____   _____________   _________   ______   ________
  _____   _____   _____________   _________   ______   ________
  _____   _____   _____________   _________   ______   ________
  _____   _____   _____________   _________   ______   ________
  _____   _____   _____________   _________   ______   ________
  _____   _____   _____________   _________   ______   ________

  Flush key:  D = done   NP = not in the plan   M = missed
  ? = not sure (find out, then fill it in)

NOTES BY FEEDING (start time → what you saw, in plain words;
anything stopped or changed, and why)

  _____ → ________________________________________________________
  _____ → ________________________________________________________
  _____ → ________________________________________________________
  _____ → ________________________________________________________
  _____ → ________________________________________________________
  _____ → ________________________________________________________

MEDICINES GIVEN THROUGH THE TUBE TODAY (one line per medicine
due — each given per the plan sheet's instruction)

  Time    Medicine (as on the list)     Given?   Initials
  _____   ___________________________   ______   ________
  _____   ___________________________   ______   ________
  _____   ___________________________   ______   ________
  _____   ___________________________   ______   ________
  _____   ___________________________   ______   ________

  Given? key:  D = given per the instruction   M = missed
  ? = not sure (find out, then fill it in)

  Missed, partial, or changed feedings or medicines today (record
  exactly — what to do is the care team's call: see the plan
  sheet's instructions for feedings and for each medicine; if a
  blank is empty, call before changing anything):
  ________________________________________________________________

TUBE SITE (record and report — describe what you see; check it
against the report list on the plan sheet; the care team says what
it means)

  Time: ______  What you noticed at the site or the tube (plain
  words): ________________________________________________________
  On the report list?  Y / N / not sure   Reported to: __________
  What they said: ________________________________________________

QUESTIONS FOR THE NURSE, DIETITIAN, OR PHARMACIST (bring this strip)
  - ______________________________________________________________
  - ______________________________________________________________

FORMULA AND SUPPLIES ON HAND

Supplier: ____________________  Phone: _____________________
Reorder owner (who watches the count): ______________________
Coverage confirmed with (supplier / plan, and the date): ____

  Item (as named on the order)    On hand   Reorder at   Ordered
  _____________________________   _______   __________   _______
  _____________________________   _______   __________   _______
  _____________________________   _______   __________   _______
  _____________________________   _______   __________   _______

  If what arrives doesn't match the order, note it here and call the
  supplier. Using a different formula is the dietitian's decision —
  what they decided, and when: _________________________________

The per-feeding record

A shared feeding routine rewards boring consistency, and its enemy is the question "did anyone run the 2pm feeding?" The row for each feeding exists so that question always has a written answer, especially when family members alternate days or a paid caregiver covers part of the week.

Two habits make the record trustworthy. Fill it in when the feeding happens, not from memory at bedtime. And record what was actually given, not what the plan says — if a feeding was stopped early or a flush was missed, the row says so. The key on the sheet exists so a blank never has to be guessed at: "not in the plan" and "missed" are different facts, and the care team needs to know which. A partial feeding isn't a family failure; it's information for the care team. What to do about it — including whether to make anything up — is the care team's call, and if the plan doesn't cover it, the call comes before any change.

The tube site: record and report

The site rows are for anything you notice around the tube or about the tube itself between nurse visits. For each observation, the job is two steps:

• Record: what you saw, where, and when, in plain words. "Skin around the tube looked redder than at yesterday's morning feeding" is a report a nurse can act on; "it looked irritated" is harder to use.
• Report: check the care team's list on the plan sheet and call the number there per that list. If you're not sure whether what you're seeing is on the list, call and ask. If anything ever seems like an emergency, call 911.

This page doesn't describe what the site should look like, and it doesn't teach site care. Cleaning around the tube, giving flushes, and anything else the plan asks the family to do are hands-on skills your parent's nurse should teach — ask them to teach whoever will be doing them at home. If no one has, call the nurse and ask.

Formula and supplies on hand

The supply block is logistics, and it prevents the most avoidable feeding-day problem: running out.

• Copy each item exactly as named on the order — the formula especially. A different product isn't a substitute unless the dietitian says it is.
• Count on arrival, not on empty, and pick a reorder point that leaves room for shipping delays.
• Name one reorder owner, so the count never falls between family members.
• Confirm coverage before the first reorder. Medicare's prosthetic device coverage page lists enteral and parenteral nutrition among the examples Part B covers when a doctor orders them; what applies to your parent is a question for the supplier and their plan.

Bring the log to every nurse and dietitian contact

The log gives the dietitian and nurse a written record of what actually happened at home: the feeding rows answer "is the plan being given as written?", the notes put plain words on how feedings are going, and the site rows put dates on anything the nurse should see. Bring the sheets — or photos of them — to every visit, and keep them handy for phone calls. When the plan changes, start a new plan sheet the same day and keep the old one with the log, so every day sheet still shows which plan it followed and nobody feeds from yesterday's instructions. If the change comes partway through a day, note the time on that day's sheet.

Frequently Asked Questions

What should a tube feeding log record?

Two things for every feeding. What was given: the start and end time, the amount (in the units the plan uses) or the pump rate as it was actually set, and — only where the plan includes them — whether the flush and any medicines through the tube were done. And what you observed, in plain words. The plan itself goes on the log's plan sheet, copied from your parent's dietitian, nurse, and pharmacist, so everyone who gives a feeding works from the same instructions.

Why doesn't this log list feeding rates, volumes, or flush amounts?

Because they're prescribed for your parent specifically. The dietitian and care team set the formula, the amount, the timing, and the flush for one person, and they change them as the plan changes — a number printed on a generic sheet is exactly the kind of guidance a family shouldn't borrow. The plan sheet has a blank for each one, with its source next to it. If a blank is empty, that's a question for the dietitian or nurse, not a guess.

What if a feeding is missed, stopped early, or doesn't match the plan?

Write it down exactly — what was given, what wasn't, and why. What to do about a missed or partial feeding, including whether to make any of it up and whom to tell, is the care team's call: the plan sheet has a blank for their instruction. If that blank is empty, call the number on the plan sheet before changing anything.

What should we do if something about the tube or a feeding seems off?

Record what you saw, when, and what was happening, then check it against the care team's list of what to report and call the number on the plan sheet. The plan sheet also has a blank for what the care team said to do if the tube comes out or won't flush — get that answer written down, in their words, before you ever need it. If you're not sure whether something is on the list, call and ask. If anything ever seems like an emergency, call 911.

Related Planning Steps

• Roll each day's summary into the caregiver daily log instead of copying every feeding twice.
• If your parent is also in bed most of the day, keep the turning schedule chart at the bedside.
• Keep every medicine — including the ones that go through the tube — on the master medication list.
• If the tube came home after a stroke, the first weeks home after a stroke guide covers the rest of that recovery.