A Family Caregiver's Guide To Bolus Feeding
Up to half a million Americans get their primary nutrition through a feeding tube, known sometimes as enteral nutrition or enteral feeding. There are several ways to administer liquid nutrition, but one of the most common is the bolus method. This method uses a catheter syringe to push food into a feeding tube.
If you or your loved one have a feeding tube, it’s essential you know how to administer snacks and meals safely. Rushing the process or skipping necessary steps can increase the risk of side effects, including diarrhea, nausea, and bloating.
Below is an easy-to-follow guide on how to properly perform bolus feeding.
What You’ll Need
To complete a bolus feeding, you need the following:
Formula or blended food (in the amount prescribed by your loved one’s doctor or healthcare professional)
Tube feeding system (e.g., catheter, clamp, and syringes)
A clean washcloth or roll of paper towels
A container of water
A 60 milliliter (mL) catheter tip or ENFit syringe
A button adaptor (if your loved one has a button catheter instead of a tube catheter)
“If you make your own tube-feeding formula by blending food, it’s best to get a high-powered blender,” said Jennifer Akimoto, a registered dietitian, tube-feeding expert, and the founder of the blending dietitian. “Your food needs to be very smooth so that you don’t risk blocking the feeding tube.”
How To Perform Bolus Feeding
Step 1: Wash Your Hands and Put On Gloves
After gathering the necessary supplies, wash your hands for at least 20 seconds with antibacterial soap and warm water. Then, dry your hands thoroughly and put on a pair of disposable gloves.
Step 2: Check the Liquid Nutrition’s Label and Expiration Date
Look at the label on the formula or blended food and check its seal and expiration date. This small but crucial step can help prevent food poisoning and other gastrointestinal issues.
Step 3: Flush The Feeding Tube with Water
Flush the feeding tube with at least 60 milliliters of water. Water flushes helps lubricate the tube, reducing the risk of clogs and blockages.
Step 4: Connect the Feeding Tube to the Gastrostomy Port
Connect the feeding tube (catheter) to the gastrostomy (G) port in your or your loved one’s stomach.
Step 5: Fill the Syringe with Formula
Fill the syringe with the prescribed amount of formula and close the feeding tube clamp.
Step 6: Connect the Syringe to the Feeding Tube
Put the end of the syringe into the feeding tube. Before administering the meal, ensure there’s a solid connection so the food doesn’t leak or squirt out.
Caregiver Tip
This is where medical tape comes in handy. Wrapping the connection between the catheter and syringe helps prevent leakage and makes mealtimes less messy.
Step 7: Administer the Bolus Feeding
Slowly push down on the syringe, delivering the liquid nutrition into your or your loved one’s stomach. It typically takes about 8 minutes to administer 15 ounces of liquid formula, but the length of mealtimes might vary, depending on tolerance and food type.
Step 8: Close the G Port and Remove the Feeding Tube
After you or your loved one finish administering the liquid nutrition, close the G port and remove the feeding tube. Then, wash all the components, including the feeding tube, clamp, and syringe, and let them air dry.
Commonly Asked Questions
1) Can my loved one lie down after bolus feeding?
After administering bolus feeding, ensure your loved one stays seated for at least 30 minutes. Lying down too quickly after a meal increases the risk of digestive issues, such as bloating, nausea, and diarrhea.
2) How long does bolus feeding take?
Administering a meal with bolus feeding typically takes 20-35 minutes. Don’t rush the process! Giving liquid nutrition too quickly increases the risk of gastrointestinal issues and aspiration (choking).
3) How often should I perform bolus feeding?
Most caregivers perform bolus feeding every 4-6 hours, but the exact schedule depends on your loved one’s general health and nutritional needs. If you have questions, your loved one’s doctor or healthcare professional can tell you how often to administer meals and water.
Takeaways
If you or your loved one rely on tube feeding, it’s important to make sure you’re meeting the necessary nutritional requirements. Working with a registered dietician can help you stay on track.
“Bolus feeding is often a completely new concept to people and it can be overwhelming when you are getting started,” Akimoto said. “Be sure to ask lots of questions and advocate for your needs. Tube feeding formulas, schedules, and delivery methods are never set in stone. They are meant to be tried and adjusted based on tolerance, needs, lifestyle, and medical status.”
Need Help?
Our Caregiving Specialists regularly assist caregivers with feeding-related questions. If you have questions about equipment, formulas, or the bolus feeding process, call (800) 696-CARE or email support@carewell.com, and we’d be happy to help.
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Chad Birt is a freelance medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.
Chad Birt is a freelance medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.