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Apr 3, 2024

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Bolus G-Tube Feeding with Syringe by Gravity When children cannot eat enough or receive medication normally through their mouth, a surgeon or pediatric gastroenterologist does a procedure called a gastrostomy. A gastrostomy is the surgical procedure to insert a tube through the abdomen (area that contains the stomach, intestines, liver, and other organs) and into the stomach. The tube or gastrostomy tube is also known as a g-tube .” Children who can handle a feeding at one time can be fed by a bolus feeding. The bolus method is given like a meal and is a type of feeding that uses a syringe to deliver a large amount of milk or a formula through the child’s g-tube. It can take between 20 to 30 minutes to complete. SUPPLIES : Extension set (already in place) Water (warm) 5 or 10 mL syringe with plunger for water flush 60 mL feeding syringe without plunger Formula (remember to rinse the top of the unopened bottle/can) STEPS : 1. After gathering supplies and positioning the child in an upright or sitting position, wash hands thoroughly. 2. Attach the syringe with water to the extension set that is in place by twisting the syringe clockwise. The extension set or extension tubing should be clamped and look like the image to the right. 3. Unclamp the extension tubing and “flush” 5-10 mL of warm water by pushing the plunger down to prevent the g-tube from clogging. Figure 1. (UC Davis Health, n.d.). 4. Clamp the extension tubing and remove the syringe used to flush water. Attach the feeding syringe without a plunger. Figure 2. (Saint Luke’s Health System, n.d.).
5. Pour the prescribed or desired amount of formula/milk into the syringe. Figure 3. (MSKCC, 2023). 6. Unclamp the extension set/tube and allow the formula/milk to flow into the g-tube by gravity (allows force to pull the fluids downwards). Figure 4. (Saint Luke’s Health System, n.d.) NOTE You can adjust the flow rate by lifting the syringe higher or lower. The higher you hold the syringe, the faster the formula/milk flows. If the formula/milk isn’t flowing through the tube, you can gently push using the plunger that comes with the plastic syringe. Continue to add formula/milk before the syringe empties to prevent air from entering the tube and into the stomach. 7. After finishing the prescribed or desired amount of formula/milk, “flush” or add warm water into the feeding syringe to continue to prevent clogging. Figure 5. (Mount Nittany Health, n.d.). 8. When feeding and flushing is finished, clamp the extension tubing. Disconnect and wash the feeding syringe and syringe used for water/flushing. Allow them to air dry. References Mount Nittany Health. (n.d.). [Image of flush after feeding]. Retrieved March 2, 2024, from https://mountnittany.org/wellness-article/gastrostomy-or- gastrojejunum-tube-flushing-the-tube Memorial Sloan Kettering Cancer Center. (2023). [Image of pouring formula/milk into feeding syringe]. Retrieved March 2, 2024, from https://www.mskcc.org/ cancer-care/patient-education/tube-feeding-using-bolus-method Saint Luke’s Health System. (n.d.). [Image of attaching feeding syringe to extension tubing]. Retrieved March 2, 2024, from https://www.saintlukeskc.org/health- library/gastrostomy-feeding-tube-care-flushing Saint Luke’s Health System. (n.d.). {Image of formula/milk flowing into g-tube]. Retrieved March 2, 2024, from https://www.saintlukeskc.org/health-library/ your-childs-gastrostomy-or-gastro-jejunum-tube-syringe-feeding UC Davis Health. (n.d.). [Image of flushing using a syringe with plunger]. Retrieved March 2, 2024, from https://health.ucdavis.edu/children/patient-education/ Introduction-to-Gastrostomy-Tube
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