These instructions are for Children’s Hospital of Philadelphia (CHOP) patients with a feeding tube that use a Farrell Valve™ system to decrease bloating, or air in the stomach, during tube feeds.

Important information:

Some children have trouble with tube feedings because extra air in the stomach causes bloating. The Farrell Valve System can help your child to “burp” while being tube fed. This should help your child handle the feeding without vomiting or bloating.

You can view the steps for setting up the Farrell Valve System here.

Instructions for setting up a Farrell Valve System:

1. Clean hands with soap and water or hand sanitizer.
2. Set up your child’s feeding bag as you have been taught.
3. Hang the Farrell bag on the pole. It needs to hang at the same height as the feeding bag.
4. Close the white clamp that is on the Farrell line above the “Y” port.
5. Open the blue clamp that is below the “Y” port.
6. Insert the end of the feeding tubing into the “Y” port on the Farrell line.
7. Prime the section of the Farrell line that is below the “Y” port, with formula.
8. Insert the Farrell line connector into the feeding tube.
   
   When using the Farrell valve with a low-profile balloon G tube while feeding, use the right-angle extension set and connect the Farrell valve system directly to the feeding port of the extension set.
   
   When using the Farrell valve with a low-profile, non-balloon G tube, connect the decompression tubing to G tube. This will open the valve in the button and allow it to be vented. Do not use the right-angle feeding extension set with the Farrell valve. Connect the Farrell valve to the decompression tubing.
9. Open the clamps on the Farrell line.
10. The Farrell “Y” port should hang 4 to 7 inches below your child’s belly button. This will allow gas to escape while the formula flows into your child.
11. Begin to infuse the formula. Formula will move up and down in the Farrell line while the feed infuses.
12. To stop using the Farrell Valve, close the white and blue clamps on the Farrell line.
13. Change the Farrell set-up when you change the formula bag and tubing.

Instructions for checking for blockage in the line:

When using the Farrell valve, the feeding pump will not alarm if there is a blockage in a line. If there is a blockage, formula will continue to flow up into and fill the Farrell bag. Pay attention to the level of formula in the Farrell bag. If your tubing is blocked, unclog it as you were taught.

Instructions for giving medicine through a G tube with a Farrell valve:

If the medicine cannot be given with formula:

1. Close the blue clamp.
2. Stop the feeding pump.
3. Give the medicine through the medicine port of the tube as you were taught.

If the medicine can be given with formula:

1. Close the white clamp for 30 minutes so that the medicine does not go up the Farrell line.
2. Open the blue clamp
3. Turn on the feeding pump.

Call your healthcare team with any questions or concerns or if:

• The formula backs up into the Farrell bag and will not go down the feeding tube.
• Your child continues to gag or vomit.
• Your child complains of or seems to have stomach pain.

If you have any questions about your child’s health, please contact your child’s healthcare provider. This document is intended only to provide general educational information and is not intended as medical advice or treatment. Please consult with your healthcare provider prior to use, as some of this information may need to be adapted for your child’s specific needs. It is the responsibility of your healthcare provider to advise you on the appropriate use of this information. If you/your child are not already a CHOP patient, this document does not create a doctor-patient relationship between you/your child and CHOP. CHOP is not responsible for any outcomes you/your child might experience from your use of this document. This document is provided "AS IS", WITHOUT WARRANTIES OR CONDITIONS OF ANY KIND, express or implied. If this document refers to any drugs or medical devices, it is the responsibility of your healthcare provider to check the FDA status prior to use. If this document includes references to drug dosing, please do not rely on this document. Your healthcare provider should check the package insert for each drug before use. Hyperlinks used within this document may not be translated into other languages.

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