For individuals unable to meet their nutritional needs by eating, enteral nutrition, or tube feeding, provides a direct way to supply nourishment. This method delivers a liquid formula to the gastrointestinal tract and is used in many health scenarios. Medical teams select a feeding schedule and delivery method based on a person’s physiological requirements and health status. This ensures each individual receives the correct nutrients in a way their body can best handle.
Defining Bolus Feeding
Bolus feeding involves administering a specific volume of formula into the stomach over a short duration to mimic a standard meal pattern. A typical bolus feed consists of 100 to 300 milliliters of formula delivered in four to six separate sessions throughout the day. This schedule aligns with conventional meal times, which can be psychologically more familiar for the person receiving the feeds.
The formula is delivered using one of two techniques. One method uses a 60-milliliter syringe to gently push the formula through the feeding tube over 15 to 20 minutes. An alternative is the gravity feeding method, where the formula is placed in a bag and hung above the individual, allowing it to flow into the tube over 20 to 60 minutes.
Defining Continuous Feeding
Continuous feeding is a method characterized by the slow and steady infusion of formula over an extended period. This approach utilizes an electronic feeding pump to deliver nutrients at a precise, controlled rate for many hours at a time. A continuous feeding schedule can run for 12, 18, or even 24 hours a day, depending on the individual’s nutritional needs and tolerance. The rate of infusion is set by a clinician and remains constant, providing a steady supply of nutrients to the digestive system.
Key Differences in Administration and Lifestyle
The most immediate difference between the methods is the time commitment and daily schedule. Bolus feeding is intermittent, with distinct feeding times separated by several hours of freedom from any equipment. This structure allows for significant periods where an individual can engage in daily activities without being physically connected to a feeding system.
In contrast, a person on continuous feeds is connected to an electronic pump for most of the day, which influences their daily routine. Equipment for continuous feeding includes the pump and specialized tubing, which can be more complex to manage and requires a power source. Bolus feeding requires only a syringe or a gravity bag, both of which are simple to use and transport.
This difference in equipment directly impacts mobility. While portable backpacks for continuous systems offer some movement, the person remains tethered to the equipment, which can make some activities more challenging. Physiologically, the two methods create different experiences. Bolus feeding fills the stomach with a larger volume at once, creating a sensation of fullness similar to eating a meal. Continuous feeding delivers a low, steady volume that avoids stomach distention and the feeling of being full.
Medical Considerations for Choosing a Method
The choice of feeding method is heavily influenced by a patient’s medical condition and gastrointestinal tolerance. Continuous feeding is often selected for individuals who cannot handle larger volumes of formula at one time. This can include people with delayed gastric emptying, where the stomach empties too slowly, or those with malabsorption issues. The slow, steady rate of infusion helps prevent symptoms like nausea, cramping, and abdominal distention. It is also frequently used for patients at a high risk of aspiration, as the low volume in the stomach reduces the chance of reflux.
Bolus feeding is preferred for individuals who are more medically stable and have a well-functioning gastrointestinal system. Patients who can tolerate the larger volume of formula without discomfort or complications are good candidates for this method. This approach supports greater independence by minimizing the time spent connected to medical equipment.
The decision to use bolus or continuous feeding is made by a healthcare team, including a physician and a registered dietitian. They conduct a thorough assessment of the patient’s gut function, health status, and risk for complications like aspiration. The team also considers the patient’s lifestyle and preferences to ensure the selected feeding plan is safe and effective.