These instructions are for Children’s Hospital of Philadelphia (CHOP) patients whose feeding tube is held in place by a device that is attached to the nasal tube, known as the Bridle™.

Important information:

• The Bridle nasal tube securement device is a safe and effective way to keep your child’s feeding tube from coming out. The device is inserted by a healthcare provider. A piece of thick string is guided into one nostril, wrapped behind the bone in the back of the nose, guided through the other nostril and then connected to your child’s feeding tube with a plastic clip. This helps to hold the tube in place.
• The Bridle is not painful, however, if your child pulls on their feeding tube and Bridle, they may feel some discomfort. This discomfort usually stops children from pulling on the tube. If your child continues to pull on the tube, the tube will stretch and disconnect before the Bridle can injure the bones in their nose.

Instructions for cleaning the Bridle:

• To clean the Bridle, gently wipe the Bridle strings and clip on the outside of your child’s nose with soap and water as needed.

Instructions for removing the Bridle:

If your child’s feeding tube comes out, follow the steps below to remove the Bridle:

1. Ask a second person to hold your child’s head still.
2. 
   Use blunt-tipped scissors to carefully cut the string as close to the Bridle clip as possible.
3. Then gently pull the tube and the Bridle out of your child’s nose.

If the feeding tube comes out, contact your healthcare provider immediately.  They may direct you to go to the emergency department or return to CHOP to replace the tube.

Instructions for protecting your child’s skin:

• Do not pull the string tight when taping the tube to your child’s face.  
• Leave some slack between the clip and your child’s nose, about the width of 1 finger.  
• If you cannot tape the tube to your child’s cheek because of a rash or other skin injury, you can let the bridle hang freely from their nose.
• If you cannot move the tube to prevent pressure on your child’s skin or the device is causing skin redness, call your healthcare provider.

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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