Community› The Bump Message Boards› Special Needs
Special Needs
New Discussion

XP: G Tube Mom's - Help with Bolus Feeds

lstaylor73lstaylor73
in Special Needs

I posted on the Preemie board, but I know some of you here may be able to answer my questions.

We need to start trying bolus feedings.  I have seen this countless times in the NICU for my twins and in the hospital when they had NG tubes before we went to GJ tubes and have even done them myself in the past too.  But it's been a long time and I'm scared to screw this up and don't feel like I know what I'm doing.  We tried yesterday and today and both boys have thrown everything up almost instantly because it goes in so fast and it's so much.  We try to control the flow with the clamp but it doesn't seem to really be meant for that purpose as it's easy to let up just a tiny bit of preassure and then too much flows in too fast.

They are on a pump feed of 50mls /hour so to bolus feed we were told to give them two hours worth at first and see how they do.  Answer:  Miserably.

So please, tell me like a 5 year old, how should I be doing a bolus feed of 100mls into a baby that won't sit still / knocks my hands away and is scared of the bolus tube because he knows he's going to barf?

Also, what is your bolus feeding schedule if you do continuous feedings over night?

Thanks,
Laura

Report Reply to Post

Re: XP: G Tube Mom's - Help with Bolus Feeds

  • erinmserinms member

    Sorry, I don't have a full answer, but here are a few thoughts.

    1.  Are you using a 60cc syringe to bolus feed?  If so, just hold the syringe lower to make it flow in slower.  If you hold it up way high above their heads it will flow in really fast.  If you hold it really low, it should flow in slower.  You should be able to do this with whatever you are bolus feeding with.

     2.  Maybe start with a smaller volume.  I assume they recommended the 2 hours worth as a guideline, but if that is too much then I would try a smaller amount and work your way up.  It would be better to have success with 30cc and build up (build up volume but also confidence and tolerance from the boys!) from there than to feel like it is constantly a miserable process.

    3.  You could try a bolus feed while they are taking a nap.  They will be still and they will be easier to feed.  If they tolerate it then you will probably feel more confident with the bolus feeds they get while they are awake.

    Sorry I don't have the whole answer, but I will try to think of other ideas.  Good luck!

    Report Reply
  • Loading the player...
  • erinmserinms member

    Also, I assume this is a MIC-key button being used to put food into the stomach.  This is not still a GJ tube, right?  If it is the GJ then you should check in with your doctor about the vomiting.

    If it is the MIC-key you could use the right angle extension tube and not the bolus extension tube.  The bolus extension tube flows in really fast and you might have more luck with the right angle tube.

    Report Reply
  • lstaylor73lstaylor73
    imageerinms:

    Also, I assume this is a MIC-key button being used to put food into the stomach.  This is not still a GJ tube, right?  If it is the GJ then you should check in with your doctor about the vomiting.

    If it is the MIC-key you could use the right angle extension tube and not the bolus extension tube.  The bolus extension tube flows in really fast and you might have more luck with the right angle tube.

    Yes, we're finally on the MIC-key G tube now, and hopefully never go back to the GJ's.  Your suggestions have all been fabulous, thank you.  I did not think about the type of bolus tube they gave me and it is too big and stiff and short and I was definitely holding it way too high.

    Report Reply
  • erinmserinms member

    Oh good, I hope it helps.  Toddlers are not the easiest people to try new things on! 

    Report Reply
  • McBonBonMcBonBon
    Could you use the pump for bolus feeds? That's what we do. My son gets 5 110 ml boluses per day, and then a continuous feed of 62 ml/hr during the night. We use the pump for all of his boluses. We run the day bolus feeds at a rate of 125 ml/hr, so the feed goes in in a little under an hour. Any faster than that and he vomits. You may need to run the boluses in slowly at first, and using the pump makes that a lot easier. You can take the bag out of the backpack between feeds and put it in the refrigerator to keep the formula fresh. That's what we do, and it works out ok. If the boys don't tolerate cold feeds, you can run the bag under warm water to warm it up. What kind of volume are you trying to get into them? We feed our son at 8:30 am, 11:30 am, 2:30 pm, 5:30 pm, and 8:30 pm for the boluses, and his continuous feed runs from 10:30 pm to 6:30 am. It is a lot of time connected to the pump, but when he is connected we work on fine motor skills and other quiet activities like reading books. I hope you can find a schedule that works for you. Hugs. 
    Report Reply
  • Pierce3252Pierce3252

    Sorry i know i'm late to the conversation - but I second what pp said about using the right angle extension tube and the smaller syringe up top ( i think the one we use holds 50 ml tops).  We have two sets of tubes and the one actually for the bolus feedings give him WAY too much milk too fast.  We have always used the smaller tube and syringe and it just goes much easier and slower on him. 

     I also second holding it down low - you can slow it almost to a stop by just putting it really low and letting him take it in as he can. 

    We also give him a good toy to distract him because he otherwise wants to grab the tube and the button itself. 

    Also, I was told to prop his head up really good, so his head is not even with the rest of his body, and it does seem to help him not spit it up. 

    Hope this helps - I'm sure it will get easier soon!!!  We don't do continuous feeds at night - we do all bolus all day - up to 7 oz. a time.

    Image and video hosting by TinyPic Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker BabyFetus Ticker
    Report Reply
This discussion has been closed.
Choose Another Board
Search Boards
"
"