Bolus feeding procedure

Paediatric guidelines (in development)
NHS Lothian

Items required for the procedure

  • 60ml enteral syringe
  • Feed as directed by a dietician
  • Cooled boiled water for flushing

Remember good food hygiene
Feed and equipment must be prepared on a clean surface
NB. G-tube does not have a clamp so ignore about unclamping/ clamping the tube.

The Procedure

  1. Ensure everything you need has been collected and is near to hand.
  2. Inform the child/young person that you are now going to start the feed.
  3. Position the child/young person in a sitting position. If this is not possible their head should be elevated by at least one pillow. For babies, place the pillow underneath the top of the mattress.
  4. Wash and dry hands thoroughly.
  5. Open the cover on the feeding port and attach barrel of 60ml enteral syringe to it. Ensure clamp is closed, pour recommended amount of cooled boiled water into barrel.
  6. Flush the gastrostomy tube by unclamping the clamp and allowing recommended amount of cooled boiled water to flow in.
  7. Once the flush is complete close the clamp.
  8. Pour feed into syringe barrel and unclamp.NB Do not use the plunger to push the water or feed. If it is going in too fast lower the syringe, if it is too slow then raise the syringe. The average time it should take for the feed to run through is 15-20 minutes.

    For the first 5 days following insertion of the gastrostomy tube if the child/young person experiences pain on feeding, fresh bleeding, or leakage of feed around the tube feeds should be stopped and you should call for advice (please refer to Contact Points for details).

    If the child/young person starts coughing or vomiting during the feed, then stop, and restart once they have settled. If they continue coughing or vomiting, then call for advice (please refer to Contact Points for details).
  9. Once the feed is completed flush the gastrostomy tube with the recommended amount of cooled boiled water. Once complete, close clamp and replace feeding port cover.
  10. Wash and store extension set and reusable enteral syringe as per manufacturer’s instructions.
  11. Wash and dry hands thoroughly.

Unused feed should be stored in a fridge and discarded after 24hrs