Sewing Clothes for G-tube Access, Part One: DESIGN

Parents can be amazingly creative. When faced with the challenge of dressing children that eat through g-tubes, they come up with some pretty clever solutions!
Two-piece outfits, such as a shirt and pants or blouse and skirt, tend to give convenient access to the tummy. Most of my daughter’s current wardrobe falls into this two-piece category. It also is a standard way for dressing boys.
But there are times that two-piece outfits just don’t work. Babies and toddlers wear onesies or one-piece pajama sleepers (actually, plenty of older kids do too!). They wear overalls or jumpsuits, especially when learning to crawl or playing often on the floor, because the one-piece outfits are comfortable during all that busy activity. Dresses, whether special occasion or otherwise, are one piece by their very design.
Let’s face it…there’s just something a little less than delicate about crawling up through layers of petticoats and skirts to hook up your daughter’s g-tube. And if she wears a feeding pump in a backpack, tubing that dangles from a skirt hem is just asking for an accident.
Or what about little boys? Boys can be a little less complicated (did I really say less complicated??) because their clothing tends to come as two-piece outfits. And most overalls allow relatively easy side access (many of the commercial overalls my daughters wore were GREAT for g-tube access). Even boys, though, sometimes wear clothes that don’t offer much access to the stomach.
So, what do we do?
There are some clever commercial solutions: Tummy Tunnels, Grab-a-Scab fabric stickers (read a brilliant post on this at Adaptions 4 Kidz), both of which are ironed on to create a “patch” with an opening for g-tube access. These can be applied to off-the-rack clothing, require no sewing, and come in cute styles. But they are a little conspicuous, can be a bit juvenile for older kids, and only work on flat areas of fabric.
If you sew or know of someone who does, a world of creative possibilities for g-tube access unfolds. You can create functional openings that are tailored-and-classy, cute decorative focal points (without even hinting at the presence of a g-tube), or completely hidden. These options are available to work with many children’s sewing patterns, whether on areas of flat fabric or on gathers and pleats. The possibilities are endless!
Let’s get started…
First choose your pattern. We’ll talk about three styles:
1) “Blank canvas.” These styles offer a smooth, flat area of fabric over the g-tube area. Sample “blank canvas” styles include some overalls or coveralls, A-line dresses or jumpers (using American terminology here) and many sleepers:

One last great feature of “blank canvas” designs—most any garment in this category, whether purchased or sewn at home, can be retrofitted with a g-tube access enclosure after it is made!
2) Flat seamline. These styles provide a seam near the g-tube where two flat pieces of fabric join. Examples of these “flat seam” patterns are princess-seam dresses, some tailored dresses, and some overalls and coveralls:

3) Gathered seamline. For this style of pattern, gathered fabric is sewn to a flat panel at a seam near the g-tube. It requires a slightly different method for creating an opening than the flat seamline. Many dresses feature full gathered skirts attached to a smooth-fitted top section; girls’ jumpsuits are also often constructed this way:

Second, choose the opening style. What look do you want? Something sporty? Something cute? Something inconspicuous?
Keep in mind that pocket flaps can be tailored, sporty, cut in cute shapes, or create interest with fun buttons.
Appliqués can be part of a cute design (i.e.: the flowerpot below a fun flower, the boat below a sail) or made from shaped lace (purchased in the bridal section of the fabric store or stitched out with your home embroidery machine, if you are so fortunate). They can even be designed to look like a working pocket!
Sashes (and cummerbunds, for your little ring bearer) are wide bands of fabric, very often gathered, that lift up to reveal a secret opening. Overlays also lift up, and can be designed as plain panels or as false vest or jacket fronts.
Next, sketch your options.  If you are artistic, grab a pencil and paper and start drawing away! You might find good inspiration from a pattern catalog. There are lots of online options if you want some ideas ( has catalogs for all the major pattern companies, or go directly to the manufacturer websites).
If you prefer, you can also print out the line drawings found with patterns by larger commercial pattern makers. Use these blanks to sketch out your options.
Keep in mind the placement of your child’s g-tube when you plan the location of the opening. Some people like the opening right over the top of the g-tube. Other people like openings offset to the side or below, finding that it reduces the chance for accidentally catching. These are your creations—feel free to design them in a way that works for your child.
As you sketch your ideas, remember to keep balance and proportion in your design. You need room to maneuver the tubing, so plan a wide enough opening for your fingers, but don’t overwhelm your small child with a giant appliqué. Remember that many tailored designs are symmetrical, so you will want a second mock pocket flap on the right side to balance out the functional flap on the left.

Last, familiarize yourself with the sewing steps for the pattern style and g-tube access treatment you’ve chosen.  We’ll go over these sewing steps in the next few parts of this tutorial. I’ll post the second part today, where we go over the steps for applying pocket flaps and appliqués to a blank canvas. See you back here in a little while!
 Happy sketching!


marythemom said...

I found this post while searching for ways to accommodate my mother's PEG/ g-tube. They must be a little different from children's, because my mom has a tube permanently attached requiring accommodations.

I did find some accommodations that had worked for me when designing nursing tops for myself, but maybe wouldn't work as well for active babies/ children.

If you have any suggestions, I'd love to hear them.

Rose-Marie said...

Mary, your adaptation of the wrap dress is brilliant! Your mother is so fortunate to have your creativity on her side. Not only does the wrap dress provide access to the tube, but would be easy to put on and be very comfortable as well. I love what you have done and hope other readers will head over to your blog to see what you have sewn.

The way you are thinking, applying the principles from tops for breastfeeding, is clearly the right direction for the larger PEG "hardware. These do take a larger opening than a gastrostomy button, and the nursing openings provide that. Could you apply the same concept, just lower, in a dress with princess seaming?

I don't know what method your mother uses for feeding, but we have found that fanny-pack, worn to the front, not only holds the feeding pump where it is easily reached, but provides some coverage for discretion, too.

I'll keep noodling about what other styles might lend themselves to being adapted for a PEG tube. In the meantime, I've bookmarked your site to make it easy to come back with those thoughts. Keep up the great work--what you are doing is very important. I'm so glad you are posting so others can apply your adaptations.

marythemom said...

Thanks for the comments! If you want to post a comment on my blog linking back to yours that would be great.

My mom uses "gravity" feeding. Which means she attaches the tube (that's permanently attached to her stomach) to a syringe which she then fills with Ensure type drinks (and water, Miralax and meds...). She has a cool wooden stand that she hangs the syringe from (letting gravity do the work) since she and her husband don't have the hand strength needed to push the plunger on a syringe.

As for the tube itself she keeps it in the flat velcro pouch on an elastic band like what's pictured at the top of my blog post. To get out the tube, she has to be able to easily access and open the velcro pouch which she wears under her clothes. To sleep, she tapes the tube to her stomach so it doesn't get pulled if she twists during the night.