There are a number of tube feeding schedules to think about if your child is on the feeding tube. Once the decision to tube feed your child is made, the type of tube feeding schedule needs to be determined.
Some children will need to be fed small amounts each hour throughout the course of the day. Others may benefit from nighttime feeds only so they are only attached to the feeding tube while they are sleeping. Still others are put on more or a normalized schedule, where larger amounts of formula are given at set times throughout the day, mimicking a meal schedule of a child who eats by mouth.
The article below lists the pros and cons of each tube feeding schedule to help you determine, with the help of your physician, the best schedule for your child.
Continuous feeds: A continuous feed is one that is delivered slowly over a set number of hours, usually between 12 and 24. This is the most common way feeds are initiated when a child first gets a feeding tube, and then feeds can be manipulated based on tolerance. The goal is usually to condense the hours as tolerated.
Pros to continuous feeds include:
• Better tolerance, especially for children with reflux and delayed gastric emptying or excessive gagging.
• Nighttime feeds can be given while the child is asleep, allowing waking hours to be spent concentrating on eating by mouth and not being attached to the feeding tube.
Cons to continuous feeds:
• Does not replicate eating a full meal.
• Difficult to establish hunger because child is constantly being fed.
• If feeds are longer than 12 hours there is less freedom to move around and play because the child is constantly attached to the pump.
Bolus Feeds: Provide large amounts of formula over short periods of time.
Pros to bolus feeds include:
• Replicates normal eating patterns
• Freedom to play, go out and move around.
• Feeds can be given via gravity or over 15-60 minutes by pump.
• They expand the stomach, preparing the child for when he is ready to eat by mouth.
Cons to bolus feeds include:
• Greater chance of diarrhea, vomiting or abdominal distention.
• Greater risk of reflux
Ultimately, the decision of what the type of schedule to put your child on will depend on a variety of factors including:
• Your child’s tolerance to feeds.
• Your schedule and ability to feed at given times or on a specific schedule.
• Your child’s medical issues.
Many times the right schedule takes time and effort to plan and is a work of trial and error. A combination of night time feeds and bolus feeds during the day is often a good compromise if your child is unable to tolerate large volumes but does not like being attached to the tube constantly. Click here for more information on manipulating tube feeds. By working with your child’s doctor and dietitian, you will be able to find the best formula and tube feeding schedule for him. The ideal schedule and formula will allow your child to:
• Tolerate tube feeds without any signs of distress
• Grow appropriately
• Be fed at times that fit his schedule
• Continue to eat by mouth if able.
Although the process might be a long one, you will eventually find a schedule that your child can tolerate while having the best quality of life possible.
If you feel your child's tube feeding schedule could be condensed or changed to make life easier and your child happier, make an appointment with us. We will work with you to ensure your child's tube feeding schedule is comfortable for him and provides the most freedom possible.