G-Tube Mechanics

Yes, actually, I am a mechanic who works on g-tubes. They can be funny little things. Mostly they cooperate, which is really good since that is what keeps my daughter nourished and growing!

We give Little Miss bolus feedings, rather than using a pump. It gives us more freedom and takes less time. Plus it mimics eating in that her stomach gradually fills over 20 – 25 minutes and allows her to feel hunger between meals. This practice supports our goal to increase her self-feeding. Currently her self-feeding (otherwise known as eating like other people) is at zero. It waxes and wanes. Drat.

Little Miss receives three meals and one snack per day – timed as much as possible to coincide with the family meals. The protein/veggie recipe is used for the three meals. Fruit/grain recipe is given at snack time.

Feeding a meal starts with the timer. A 60 ml (2 ounce) syringe is given at 3-minute intervals. Each time I hear the buzzer, I reset it for 3 minutes and begin feeding a syringe to Little Miss. I take 20 seconds to empty one syringe. This gives her tummy time to respond to feeding and accommodate the food (rather than cause reflux). It is important to make feeding a relaxed, gentle process.  If rushed, of course vomiting can be the end result! 

Eight of those syringes, for a total of 16 ounces,  is adequate caloric intake for her age, size, activity level, and stomach capacity. (Little Miss is nearly 11 years old, 75 pounds, busy!! and had 10% of her stomach removed during a surgery.)

So, it looks like this:

8:05    1st  2 ounce syringe

8:08   2nd 2 ounce syringe

8:11   3rd  2 ounce syringe

8:14   4th 2 ounce syringe

8:17   5th

8:20   6th

8:23   7th

8:26   final

Snack is the same, just a different food.

Meals are separated by 3 hours.  So if breakfast is at 8:00 a.m., lunch cannot begin until 11:00 a.m. I allow at least 3 hours between the start of one meal and the start of the next meal to allow for digestion.

However, the fruit/grain snack is more quickly digested and I am able to begin her last feeding of the day 2 hours after snack.


4 thoughts on “G-Tube Mechanics

  1. Thanks so much for your blog! I just came across it today and I am thrilled! I have a 4 yr old son who had a g-tube placed in Oct last year, and I have been investigating feeding purees vs. formula, and I think I am finally ready to take that step. 🙂 I am a “need to know all the details before I start” kind of person, and this post is the best guideline I have seen so far on the nitty gritty “how to” of the process, vs what the Dr’s say- “just do a bolus feeding”. (we are currently using the pump) I am excited to start and this post has encouraged me on how to go about it. Thanks!! I will definitely be checking back often.

  2. We have recently transitioned our three year old to a BD. Yesterday was the first day of no formula and no overnight feed! We have been pushing the food in slowly in a 2 oz syringe, because it is too thick for a pump, gravity bag, or gravity via syringe. I was surprised to find out that this practice of pushing it in with the syringe plunger is thought to be dangerous by some people… We talked to his doctor about the change to BD, but it didn’t occur to me to talk to them about the method of feeding, since we regularly push in 2 oz ‘boluses’ of water via syringe. We are adopting him, but the state has custody until it is finalized later this year. This means we are particularly concerned with being accused of some kind of mistreatment, no matter how healthy he looks! Any comments would be appreciated. Thanks!

    • Hi Kelly, God bless you for taking in a child with complex care needs! What a wonderful gift to our society when we recognize the value of all people and invest in any one of the “needy”. Ok, enough soapbox… I don’t think you would ever be accused of mistreatment… That seems crazy but we all know of crazy things. So here is my caution to you… Establish a schedule and method.. Clearly you have already done this. Documenting it will be helpful to you if any questions come up. Because it is easiest for me this way, I record in hashmarks on my calendar each bo,us given. So on any given day there are four sets of 8 or 9 hashmarks on each date. Wherever you feed him, have a clock in your house with a second hand. In this way you can say, “yes, I always watch the second hand as I am pushing in the food, making sure it takes at least 20 seconds.” i would also send a letter to the doctor explaining how you are delivering the feeds, over what timespan and how long you take for each 2 ounce syringe. Ask for his input. If you get approval from him, then you are set to go. I doubt you’ll get it in writing so you might want to request that. Otherwise you can document on your calendar that the doc called on a specific date and approved your methods and schedule. Having a calendar or journal where you document your care of him will show your diligence. Legal entities highly value documentation and that may help you considerably.
      Along that line, I would also document any vomiting, diarrhea and his height/weight statistics. That will be valuable to you as well. I have a journal for each year that keeps track of my daughter’s statistics and anything I deem noteworthy. It included seizures when she had them, medical procedures, school triumphs and challenges, results of tests, etc.

      I hope that helps. I’d love to be kept posted as to how things go!


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