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  NOTE: I wish I knew the source of this article so I could give proper credit. I did not write this article, but have used this procedure many times. I thought you might find it helpful in a crisis situation!
 
Puppy Tube Feeding

Tube feeding is the safest way to feed newborn puppies, orphan puppies, or a sickly puppy that needs to be supplemented. Eye dropper feeding is the worst method, and bottle feeding, which many people rely on, is very time consuming when having to hand raise a litter of puppies. It can take hours, and you essentially will not get any sleep. Anyone can tube feed! Most people think they will put the tube in the lungs (trachea or windpipe), and kill the puppy. The tubes natural route would be to the esophagus. It is near impossible to put a tube into the lungs. My vet told me this a very long time ago, and I have since read the same in books. I have also found it to be true from experience.

No one likes to tube feed, but we do it out of necessity, since it is the safest, and fastest way to feed puppies, and know how much nourishment they are getting. I suggest to anyone that does not know how to tube feed, have your Vet show you how, or have an experienced breeder show you. Then with them watching you, insert the tube yourself.  Once you learn how, it will be the only way you feed newborns from then on.  Try this with just the tube, no formula, just to learn.   Any danger involved with tube feeding healthy infant puppies, lies in the possibility of emptying the tube too quickly when the distal end is located in the esophagus, instead of in the stomach. If this happens, the esophagus may fill and overflow at the larynx, spilling over in the trachea. Two safeguards, which prevent this from happening, are; inserting the tube completely, so that it empties into the stomach and NOT depressing the plunger so forcefully that the tube dispenses the formula at maximum speed. You must always dispense the fluid SLOWLY.

When you are ready to tube feed your litter, be sure to have everything ready.  For a Westie you would use a #8 French tube.  It is 15” long and is marked 8" from the distal end. Of course you need to measure each puppy before feeding, so as to know how far down the tube will have to go when feeding. You will measure the puppy by stretching out the puppy and measuring from the tip of the nose to the end of the ribcage (or navel). You can then mark the tube with a piece of tape, or a magic marker. I just use a magic marker. On measuring the whole litter, you will find a puppy might be a little shorter or a little longer, but they are usually within the marked area. The puppies measurements will change as they grow so just use your common sense and your eyes; as they grow, you will put the tube further down. Always insert the tube as far as it will go, with out force of course. (You can use other tubing, such as a catheter, which you can get from your Vet, if you are unable to get a #8 Fr. Tube.)

I always feed my puppies on a grooming table (or kitchen table), which I cover with a towel and then lay a paper towel down on top, and lay my tube, syringe, and formula which is lukewarm and placed in a small cup, down on the paper towel. I then fill the syringe with the amount of formula I am feeding that puppy.  I do not over-feed a newborn puppy, but feed them every two hours for the first day or two, then I will feed every 3-4 hours depending on how they are thriving.  I start with 2 cc's for a 4-5 ounce puppy, and gradually increase to 3-4cc's as I think it's needed. I DO NOT want to see any milk coming out the nose or mouth when I pull the tube out. If there is, it means the puppy has been overfed, it doesn't mean it's dangerous, but I would rather not take the chance.  If you have to tube feed after two weeks, I might look into getting a larger tube. I usually only tube feed until I can get the puppies nursing properly.  Now you have everything ready to tube feed.  Be sure everything is properly disinfected and clean, rinse well before filling with formula.

1. Draw the formula up into the syringe.   I always draw an extra cc for the tube.  So if you were feeding 2cc's, draw up 3 cc's. Attach the tube to the syringe and then depress the plunger slowly until a drop or two of fluid comes out the end of the tube. You are now ready to insert the tube into the puppy's mouth

2. Lay the puppy down on the towel and holding his head with your left hand (if you’re right-handed, vice versa if left handed), dip the tube in the formula to help slide the tube down easier,  I also leave a drop on the end of the tube and the puppy will eagerly suck the tube down as you thread it in.  I use my index finger and thumb to go around his head to the corners of his mouth.  I squeeze gently to get the puppy to open his mouth, while I tip the head slightly upward, I then insert the tube and drop the drop of milk on his tongue and I repeat; the puppy will usually suck the tube right down.  Guide the tube over the tongue towards the back of the throat, and it should slide right down to the mark that you previously made. Never force the tube down.  It should slide down easily.  If it does not, then pull it back a little and try again.  If the puppy chokes or coughs, withdraw the tube and start over again.  Don't insert too slowly or the puppy may gag.  The tube should be inserted efficiently using short quick strokes, but no force.  It really takes very little time to get the feel of tube feeding.

3. When you feel that the tube is inserted far enough, hold the syringe perpendicular as you depress the plunger. This insures that air is only in the upper portion of the syringe, away from the tube. Depress the plunger smoothly and slowly. I always hold the tube with my fingers around the puppy's mouth, so the tube does not slip out any while depressing the fluid.  If the tube should slip out some, stop and insert it back down into the stomach.  Puppies are always moving around, so this can happen.  I usually hold the puppies head up with my left hand, and with my index finger and thumb, hold the tube at the mouth once it is in the stomach, so it can't slip out any.  You must work swiftly and surely, so that the puppy doesn't have the time to back away from the tube, thus pulling on the tube.

4. After depressing the formula into the puppy's stomach, I pinch off the tube with my right index finger and thumb, and swiftly pull the tube out. Remember the tube still has 1 cc of fluid in it. I feel doing it this way, reduces any chance of getting any air into the stomach. I always make sure the puppies have relieved themselves before I feed them too.

5. Now you are ready to tube feed the next puppy.  I usually keep the formula in a small plastic baby/dog nursing bottle or baby food jar, sitting in a bowl of hot water, and just pour out enough for the next feeding in a cup.  This way the formula stays warm while I am busy feeding a litter of puppies. I do not like to keep re-heating formula. Always test the formula on your wrist to be sure it is lukewarm, before feeding the puppies.

6. Be sure to clean the tubes each time you use them.  If you have to use the same tube on another puppy, rinse with very hot water first. I read that one should not use hot water on tubing/syringes, but I have had no problem with it so far. I have also boiled the tube and syringe for a moment, then remove from water quickly as it does soften the tube, however the tube will come back into shape. I fill the syringe with the hot water and run it through the tube, to be sure the tube is disinfected thoroughly. Just be sure the syringe works properly after boiling. You can also use a mild Clorox solution, but be sure to rinse thoroughly.

This may sound like a lot to do, but once you learn how, you will wonder why you never did it before.  Remember that a newborn puppy is the easiest to tube feed.  Once they open their eyes, it is much harder to do.  You can make your own formula, or use ready made ones.

Amount to feed: I am not going to give amounts of formula per weight of puppy, as I think the charts are way too much for a toy breed; however, I have heard of people feeding that much with no problem.

I would rather go by my common sense, and I feed according to how full my puppy's stomach looks. The charts say feed 3-7 ounce puppy 1 cc per ounce of weight every three hours. Well I think a 3 ounce puppy getting 3 cc's is a little much, and would be overfed, however, that is my personal opinion.  I would start a 3-ounce puppy out with 1 cc; gradually increasing to 2 cc's every two hours. I would then increase the formula as I saw fit, depending on how the puppy is growing.   Any medication needed, can be given mixed in with the formula when tube feeding.  The puppy's stomach should look full, after tube feeding, just like they do when nursing properly.

It took me a long time to feel comfortable with tube feeding, and I lost a lot of sleep over the years because of not tube feeding.  It is the safest, easiest, and quickest way to feed hungry puppies.  Don't be afraid to try it!  Actually, what takes the longest is heating the formula, and preparing the tube for feeding.  Feeding a whole litter takes a matter of minutes.  If tube feeding because the dam has no milk yet (due to a c-section), I will tube feed an appropriate amount, then let them nurse a little from the bottle. Just so they will not get lazy and lose their sucking reflex, I only do this during the day.

A tube can also help with a puppy that has colic. I have put a tube into the stomach with nothing on the end of it, to help to release air/gas in the stomach. I have saved newborns life with this method.  I use infant Mylicon drops for colic.  This is something that anyone who breeds dogs should keep on hand.  You can get it at any drugstore. Some drugstores have their own brand, which is less expensive, and it can be found under gas remedies.  Nursing puppies also get colic at times; if this happens, give the dam a dropper full of the medicine. Give a newborn puppy only a drop or two every few hours, until you're sure the colic has subsided. One to two is for a newborn only a few days old; increase as needed.  This has been a lifesaver for me.

Speaking of colic, when bottle feeding this can be a problem.  Some puppies suck so vigorously they take in a lot of air.

Check out this video on tube feeding puppies: