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.