We see a lot of questions from parents about continuous feeding and really wanting to avoid it at all costs. When you start tube feeding, no one wishes for continuous feeding. But, if your child needs it, it is actually a lot easier than you may think. You can try other techniques like switching formulas, trying a blended diet, or feeding slower to maintain bolus feeding. But, more often than not, changing feed schedules to continuous feeding can help tolerance, especially in children with motility issues. You adapt, just like you did to tube feeding.

Continuous daytime feeding is made much easier with a small, portable feeding pump and backpack. Even if your child is not able to wear the backpack, it is handy for carrying and hanging (with a carabineer clip) on strollers, park swings, and grocery carts. In the home, it can be clipped to high chairs.

Parents have also put backpacks on toy shopping carts, plant carts, or other inventions with wheels, so that the backpack can either be pushed or followed by the child.

With a small portable pump and backpack, even toddlers can wear their own backpacks.

You do need to secure extension sets and tubing more securely with continuous daytime feeding. Try taping the extension set to your child’s tummy or pinning it to her diaper, shirt back, or underwear, especially if your child has a GJ-tube so it doesn’t spin. If there is a possibility that your child could move away from the backpack and drag it, you may want to consider a heavy duty tape like durapore to secure the tubing to clothing. It will leave some sticky residue, but it can withstand dragging a backpack and not pull the tubing at the tube site. The 24-inch extension sets work best in this situation. Any extra tubing can be coiled and tucked into the backpack.

If possible, schedule feeds so your child is not tube feeding during the most active times of the day. This gives the child a break from wearing the backpack, or you a break from following the child around with the backpack.

For information on continuous feeding at school, see Feeding at School.

Frequently Asked Questions

Active children really need a backpack for the pump and food bag. Even if your child is not able to wear the backpack, it is handy for carrying and hanging (with a carabineer clip) on strollers, park swings, and grocery carts.

Try taping the extension set to your child’s tummy or pinning it to her diaper, shirt back, or underwear, especially if your child has a GJ-tube so it doesn’t spin. The 24-inch extension tubes work best in this situation. Any extra tubing can be coiled and tucked into the backpack.

If possible, schedule feeds so your child is not eating during the most active times of the day. This gives the child a break from wearing the backpack, and you a break from following the child around with the backpack.

  • A change of clothes for your child, and maybe yourself.
  • An extra button kit. You never know when it might get pulled out.
  • Medical tape. It comes in handy for your child and a number of on-the-go emergencies. One momma taped up her car bumper!
  • Syringes. Larger ones (60 mL) are good for flushing and entertaining your child. Smaller ones (10, 5, 3 mL) are helpful for giving meds.
  • Venting supplies. A bolus tube and syringe for venting.
If you were not given a backpack already, check with your DME supplier to find out if your insurance will cover one. The Moog Infinity Enterlite pump has two backpack options appropriate for children: the Super Mini (holds 500 mL bags) or the Mini (holds 500 or 1200 mL bags). The Super Mini is the right size for a toddler or small child. The Kangaroo Joey also has bags designed specifically for it.

If your insurance doesn’t cover one of these backpacks, you can modify a child’s backpack, a lunch cooler, or purchase a parent-made backpack. Click here to view backpacks in Useful Products.

You can feed on-the-go, no matter where you are or where you are going.

You can pack it with ice packs for the overnight feed and leave it hanging for 8-10 hours, or pack it with ice for day trips.

You don’t have to attach the feeding pump to the IV pole. You can just hang the backpack up.

Your child can continue to be an active kid.

It is possible to orally feed while doing continuous feeds. Kids on continuous feeds, however, often are not very hungry because they are being fed continuously. Sometimes a slight reduction in tube feeds, either by reducing the length of the continuous feed by an hour or two, or reducing the amount fed, will help a child feel hungry. Oral feeds should be kept small at first. If oral feeds are being tolerated well, your child may be ready to try some bolus tube feeds during the day as well.
If your child is showing signs of readiness, such as excellent tolerance of G-tube feeds or the ability to eat a bit orally during the day, it may be time to try going back to bolus feeds. Of course, ask your doctor first.

First, you can try to condense daytime feeds a bit. For example, if your child normally is fed 8 hours during the day and 12 hours at night, try doing 8 hour-long feeds during the day instead, with 30 minutes between feeds. You can program the pump using the interval setting, so it should not feel any different than continuous feeds. Slowly, over a period of weeks, speed the feedings up until they only take 20 or 30 minutes.

You can also split the daytime feeds into 3 to 4 “meals” that are initially given very slowly, over two or more hours. Gradually, over a period of weeks, speed up the rate of each meal until the feed is completed in 20 or 30 minutes.

The most common cause of failure is being too aggressive by speeding up the feedings too quickly. Expect the transition to take weeks to months.

You can start by getting your child used to wearing the backpack empty. Then you can start to add some weight to it by adding some small toys. Next, you can include the pump alone. Finally, you can add the feeding set with formula. You may want to start with just a couple of hours’ worth of formula, rather than several hours until your child gets used to the additional weight.