Methods on this page:By push
NOTE: For ease of reading the rest of the text, the word (nutritional) “formula” also includes “breast milk”, “fortified breast milk” or “infant formula”.
The formula is given to your child through the enteral route to provide nutrients and calories to meet their nutritional needs.
- We suggest administration methods (by push, gravity and feeding pump) that can be used as a guide; discuss with your healthcare team the specific method and equipment recommended for your child.
- Do not administer the formula if you are not sure that the button is in the right place after making the usual checks.
- Check and follow the manufacturer’s or your healthcare team’s instructions for preparation and storage of the formula.
- Discard expired formula or return them to the pharmacy.
- Always administer the formula at the temperature your child tolerates, as recommended by your healthcare team.
- Never add new substances to the formula without consulting your healthcare team.
- Always follow the flow rate (or rate of administration) prescribed for your child. Changes in formula volume or delivery time may require an adjustment of the gravity flow rate or reprogramming of the pump to your child’s tolerance. Check with your healthcare team to determine what adjustments are necessary.
- Follow the recommended storage time for formula in the feeding bag to avoid contamination and potential development of an infection in your child.
- Never increase the speed of formula administration (eg, To “catch up” after a delayed start to feeds) unless recommended by your healthcare team.
- The amount and type of water used for irrigation (eg, tap water or cooled boiled water) depends on the type of tube and the child (e.g., age, health condition, etc.). Always follow the guidelines of your healthcare team.
- Assess the need to be have a second person available during the procedure to keep your child in a safe position (eg, if your child is young and/or moving).
- Ensure your child’s comfort during care by using different positioning and distraction techniques that suit your child best.
- Good hand washing is essential before and after performing this care.
- The formula is given as a bolus (intermittently) or continuously, depending on the specific recommendations of your healthcare team.
- Bolus administration allows the child to receive certain amounts of formula several times a day, with breaks in-between feeding sessions. Each feeding session typically lasts approximately 30 to 60 minutes.
- Continuous administration allows the child to receive small amounts of formula continuously throughout the day or night without interruption (for eg, over 8 to 24 hours a day).
- Breast milk, fortified breast milk, infant formula or prepared nutritional formula
- Water at room temperature in a container
- Oral/enteral syringe (for irrigation)
- Extension set
- Oral/enteral feeding syringe from 30 to 60 ml
- Container for formula
- Gravity feeding bag with tubing and roller clamp
- Hook or IV pole
- Feeding bag with tubing for pump
- Enteral feeding pump
- Hook or IV pole
Refer to your healthcare team:
- if the material used or the sequence of steps taught at home is different from what is described in the method of care,
- to review the functioning of the enteral feeding pump used for your child.
Depending on your child’s age and condition, always encourage your child’s autonomy in carrying out the method of care.
The steps of the methods of care are illustrated by a Mic-Key® gastrostomy button.
The steps of the “By pump” method of care are illustrated by a Kangaroo Joey pump ™.