A bolus is a tube feed that is given like a meal. Typically, a larger amount is given in a short period of time, usually less than 30 minutes. There is often a break of several hours between feeds. Often, a child receives bolus feeds during the day and a continuous feeding at night. Sometimes infants will receive bolus feedings around the clock since this is a normal feeding pattern for newborns.

There are multiple ways to administer bolus feeds:

  • Syringe Push: A 60ml syringe with the plunger in place is used to push the food into the stomach using the plunger of the syringe.
  • Open Syringe: More common is the open syringe method. An open syringe with the plunger removed is filled with formula that flows into the stomach by gravity. When doing a bolus feed via gravity, the higher you hold the syringe above the child, the faster it will flow. To slow the rate of flow, lower the syringe so it is closer to the child’s stomach. If you hold the syringe below the level of the stomach, or if your child arches or coughs, formula may back up into the syringe. Simply raise the syringe to reverse the flow.
  • Gravity Bags: Bolus feedings can also be given using a gravity bag that hangs above the child. Gravity bags have roller clamps on the tubing that can be moved up or down to control the rate of flow. Fifteen drips into the chamber above the roller clamp equals 1ml of formula.
  • Feeding Pump: Some parents give bolus feedings using a feeding pump at a faster rate over a shorter period of time than continuous feeding. These can be scheduled to run automatically using the interval setting on the feeding pump, or you can turn the pump off between feedings.

How to Bolus Feed Using a Pump

Pump Feed and Open Syringe Gravity Feed

Programming the Pump

It can be really easy to use a pump for intermittent feeds. There are two basic ways to do it. The first involves programming just the dose (amount) to be delivered and the rate you want it delivered it. When the feed is done, the pump will beep and can be shut off.

If your child gets more frequent intermittent feedings, you might want to use the Intermittent or Interval Mode, which is available on most pumps. In this case, you set the dose and the rate, but you also select the interval you want the feeds to be given. For example, if you want to give a feeding every 2 hours, you would set the interval to 2 hours. See this tutorial on how to do set the Interval setting using the Infinity pump.

The two most common pumps have interactive tutorials to let you practice how to program the pump. See the Virtual Infinity Pump or the Kangaroo Videos for more assistance.