This is a blog for my daughter Scarlett. She was born with a complex congenital heart defect known as Tetralogy of Fallot with Pulmonary Atresia. She is my little hero.

Thursday, October 22, 2009

Bolus Feeding

Scarlett was sent home on a feeding tube and on oxygen. Her right nostril has two little tubes coming out of it (or going into it?). One is the nasal-gastric [ng] feeding tube and the other is her oxygen nasal cannula.

After her first surgery, she was also sent home on a feeding tube. We had to tube feed her for about 6-7 weeks post-op back in February, March, April. So we (Todd & I) are very familiar with the insertion of ng tubes, and using stethescopes for checking placement.  There are two ways you can feed a baby on an ng tube. Bolus feeding or Continuous feedings.

Bolus feeding means that you (the parent) hold a 2 ounce oral syringe and 'hand-pump' the milk into the ng tube at a rate that you think a baby would normally drink a bottle. Continuous feeding means that the child is tethered to a machine (ours was called a kangaroo Joey) that you can electronically program to pump (dispense) milk at a rate you determine ...i.e. 30mls per hour, 35mls per hour, 60mls per hour, etc..

The first time we were sent home on a feeding tube we used the kangaroo Joey (aka 'the pump') to feed Scarlett what she didn't drink by mouth. Meaning, if she was supposed to eat 3 ounces during a feed and she only drank 1 ounce, then we put he other 2 ounces in a bag connected to the pump and turned the pump on., etc. It was kind of pain. We found that Bolus feeds were waaaaaay easier, faster, cleaner and more convenient.

So this time around, we didn't even order the feeding pump from Apria. We're just going to do 100% bolus feeds.  We're old pros now, ya know...

I just woke up to pump (hence my 3am-4am blog post time) and to give Scarlett her 3am dose of Avitan (they're weaning her off of it slowly in a 4 day program). I got out my handy dandy yellow stethescope, checked for placement [shoot a puff of air through the ng tube and listen to her tummy for the woosh of air], and then down the tube, I put her meds and 3 ounces of the milk I just pumped. I did offer her a 2 ounce bottle at the same time, but she only drank 1 ounce. Her strength and endurance to eat/drink isn't quite there yet, but I'm not worried, it'll come around eventually.

I just think to myself... this too shall pass.  The feeding tube isn't half as bad as the oxygen cannula & tank, because with the feeding tube, I can still move her around wherever I want, but being connected to that gosh darn oxygen tank is a major nuisance.  In fact, when we were leaving the hospital, I just pushed Scarlett away in her stroller and completely forgot about the O2 tank and it totally fell over and made a pretty loud noise.... and I was like "D'oh!", I forgot she was tethered to that thing!

I'll end this post by saying that heartmoms whose kiddos are on long-term feeding tubes or oxygen (u know who u are)... Heaven Bless you.


  1. Thank you so much for explaining the NG tube better. I am scared of having to check and change it, but also realize that Hope will probably need one for a little while. I also want to thank you for describing the differences between the bolus and continuous feeds. I think I will do the bolus feeds as does sound easier. It is so great that you are keeping up your blog and sharing such great information...especially for us new heart moms that are scared and nervous and don't really know what to expect or what to ask.

    I am so glad Scarlett is doing so well and that you are home. I will continue to pray that she increases her feeds and gets off the oxygen soon.

  2. Way to go Nurse Melodie. Last week you said you thought she would go Wednesday!!! Go Scarlett. I bet she is off both by the time you go to work.