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Bolus versus continuous feeding regimens post gastrostomy tube placement in children

Steven Bruch1, Taylor Paige2, Karly Saez2

  • 1C. S. Mott Children's Hospital, Section of Pediatric Surgery, 1540 E. Hospital Drive, SPC 4211, Ann Arbor, MI, USA 48109.

Journal of Pediatric Surgery
|October 7, 2020
PubMed

Insights

For children receiving gastrostomy tubes, starting initial feeds via bolus or continuous methods does not significantly impact feeding tolerance or complications within the first month.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Nutrition
  • Medical Device Management

Background:

  • Gastrostomy tube placement is common in pediatric care.
  • Varied feeding regimens exist for initiating nutrition post-placement.
  • Optimal initial feeding strategy requires clarification.

Purpose of the Study:

  • To compare the efficacy of bolus versus continuous feeding methods for initial post-gastrostomy tube feeds in children.
  • To assess feeding tolerance and gastrostomy tube-related complications based on initial feeding method.

Main Methods:

  • A prospective randomized trial was conducted.
  • Pediatric patients were randomized to receive either bolus or continuous feeding.
  • Data on feeding tolerance and complications were collected for four weeks.

Main Results:

  • Demographics were comparable between the bolus and continuous feeding groups.
  • While initial feeding modifications were more frequent in the bolus group within two weeks, overall time to goal feeds was similar.
  • Gastrostomy tube leakage was higher in the bolus group during the second week, but other outcomes were similar.

Conclusions:

  • The method of initial feeding (bolus vs. continuous) after gastrostomy tube placement does not significantly affect feeding tolerance.
  • Clinically insignificant differences were observed, with no major impact on gastrostomy tube complications in the first month.
Abstract

Keywords:
Feeding methodsFeeding toleranceGastrostomy complicationsGastrostomy tube placement

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