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Enteral Feeding at Home

Chad Birt
Written by Chad Birt on Mon Jul 26 2021.
Images of three enteral feeding products

Caring for a loved one who’s unable to chew or swallow their food often requires enteral feeding at home. While administering meals and snacks through a feeding tube might seem daunting, with patience and practice, it’s possible, even if you don’t have a medical background. 

Tube feeding takes a bit of getting used to, but it gets easier over time. If you’re feeling nervous, uncertain, or overwhelmed, this guide is for you! 

Keep reading to learn the answers to the following questions:

How do I prepare for enteral feeding at home?

Before starting enteral feeding at home, it’s important to cover some basic safety precautions, including:

Proper storage. Liquid nutrition is just like solid food in that it can spoil. To reduce the risk of food poisoning, it’s crucial you store the formula exactly as the label prescribes. Keep it in the freezer or the refrigerator, only taking it out in advance of meal or snack times, and always check the expiration date.

Practice good hand hygiene. Before preparing a meal, wash your hands with soap and warm water for at least 20 seconds. If you don’t wash your hands, harmful bacteria can enter the feeding tube or formula, increasing the risk of food-borne illness. 

Avoid cross-contamination. Enteral feeding can take anywhere from 4-12 hours depending on the method used. When preparing a meal, don’t overfill the bag. Only include enough formula to meet your loved one’s nutritional needs. Then, put any formula that’s leftover back into the refrigerator. 

If you underfill your loved one’s feeding bag and it starts running low, replace the bag entirely. Adding fresh or new formula to the existing bag could result in food poisoning.

Does my loved one need to stay in a specific position while tube feeding? 

When tube feeding at home, have your loved one sit upright with their back straight. If they’re bed-ridden or unable to sit up for extended periods, put the head of their bed at a 30-45 degree angle. Practicing proper posture reduces the risk of aspiration, or formula entering the lungs. 

If you’re bolus or gravity feeding, encourage your senior to stay upright for at least an hour after each meal. If they require round-the-clock continuous feeding, keep their head elevated at all times.

What are the types of enteral feeding?

Enteral feeding falls into three categories –– bolus enteral feeding, gravity enteral feeding, and pump enteral feeding. 

The type that will most benefit your loved one depends on their current health, their feeding tolerance (Ie: how well they handle a liquid diet), and their individual nutritional needs.

At first, at home enteral feeding requires some trial and error. If your loved one is comfortable after they finish a meal, continue following their physician’s prescribed dietary plan. If they experience stomach upset or have a tendency to choke, you may need to reevaluate the delivery method. Before making any changes, always consult with your loved one’s medical team first.

What is bolus feeding?

Bolus feeding is a type of enteral nutrition that uses a syringe. At mealtimes, you fill the syringe with the prescribed amount of formula and gradually lift it above your loved one’s stomach. Gravity causes the formula to flow into the syringe, through the feeding tube, and into the digestive system. With bolus feeding, meals typically take 15-20 minutes.

Necessary supplies:

To administer a bolus feeding, you’ll need:

  • Oral syringe or 60 mL catheter tip

  • One cup of room temperature water

  • Formula

How is bolus feeding administered:

  1. Wash your hands with soap and warm water, then shake the bottle of formula and open it.

  2. Flush your loved one’s feeding tube with 30-60 mL of water.

  3. Pull the plunger out of the syringe and connect the syringe to the feeding tube.

  4. Position the syringe upright to prevent the formula from spilling. Then, slowly pour a small amount of formula into the syringe.

  5. Gravity causes the formula to flow into the syringe, through the feeding tube, and into your loved one’s stomach. You can use the syringe’s plunger to speed up the feeding process, but that isn’t always necessary.

  6. Repeat these steps several times, until you’ve administered the prescribed amount of formula.

  7. After the meal, flush your loved one’s feeding tube with water, wash your hands, and clean the syringe. If there’s any formula left over, put it back in the refrigerator.

Additional resources. If you still have questions about bolus feeding, check out these handy guides from Shield Healthcare and Memorial Sloan Kettering Cancer Center.

What is gravity feeding?

Gravity feeding is a type of enteral nutrition that uses a feeding bag without a pump. You hang the feeding bag on an IV pole or wall hook and let gravity do its work. Meals administered with gravity feeding take about an hour to complete. 

Necessary supplies:

To administer gravity feeding, you’ll need:

  • Formula

  • A gravity feeding bag

  • A cup

  • A wall hook or IV pole

  • Water

  • An or 60 mL catheter tip

  • A clean cloth or a paper towel

How is gravity feeding administered:

  1. Wash your hands with soap and warm water, then shake the bottle of formula and open it.

  2. Flush your loved one’s feeding tube with 30-60 mL of water.

  3. Close the roller clamp on the feeding bag, and fill it with the prescribed amount of formula.

  4. Close the feeding bag and hang it at least 18 inches above your loved one’s stomach. If stomach upset occurs with these feeds, it can be advised to open the clamp only halfway to slow the rate that the feed is infusing and reevaluate.

  5. Remove the cover on the tubing attached to the feeding bag. Hold the tube over the sink and open the roller clamp. Let the formula drain to the end of the tube and then close the clamp.

  6. Connect the end of the gravity bag to your loved one’s feeding tube. Open the clamp to adjust the flow of the formula.

  7. After the meal is finished, wash your hands. Then, rinse out the feeding bag and its tubing with warm water. To reduce the risk of bacterial contamination, use a new feeding bag each day.

  8. Flush your loved one’s feeding tube with 30-60 mL of water.

Additional resources. If you still have questions about gravity feeding, check out these handy guides from Shield Healthcare and Memorial Sloan Kettering Cancer Center.

What is pump feeding?

Pump feeding is a type of enteral nutrition that uses a feeding bag with a pump. The pump releases a specific amount of formula at a predetermined rate, allowing for easier digestion. Meals administered by pump feeding typically take several hours.

Necessary supplies:

To administer pump feeding, you’ll need:

  • Formula

  • An electronic feeding pump

  • A pump feeding bag

  • A cup

  • Water

  • A 60 mL catheter tip or an ENFit syringe

  • A wall hook or IV pole

How is pump feeding administered:

  1. Wash your hands with warm water and soap. Remove the formula from the fridge, shake the bottle, and open it.

  2. Flush your loved one’s feeding tube with 30-60 mL of water.

  3. To reduce the risk of food poisoning, fill the feeding bag with just enough formula for a 12-hour feeding. If you’re using powder formula, only fill the bag enough for a four-hour feeding.

  4. Turn on the electronic feeding pump.

  5. Insert the tubing attached to the feeding bag into the feeding pump. Then, remove the cover at the end of the tube attached to the feeding bag.

  6. Refer to the pump’s instruction manual for “priming” directions. Priming the pump causes the formula to flow to the end of the tubing.

  7. If you have a programmable pump, input the prescribed “volume to be delivered” (VTBD)

  8. Set the prescribed infusion rate on the electronic feeding pump.

  9. Connect the adapter on the feeding bag to your loved one’s feeding tube and begin the meal.

  10. After the meal is finished, turn off the pump, and rinse out the feeding bag with lukewarm water. Replace your loved one’s feeding bag every 24 hours.

  11. Flush your loved one’s feeding tube with 30-60 mL of water.

Additional resources. If you still have questions about pump feeding, check out these handy guides from Feeding Tube Awareness and Memorial Sloan Kettering Cancer Center.

Enteral Feeding – FAQ

What is home enteral nutrition?

Home enteral nutrition refers to tube feeding. Instead of being administered at a hospital, it’s done in the comfort of your own residence. Specifically, enteral nutrition helps people get the vitamins, minerals, and nutrients they need if they aren’t able to bite, chew, and swallow normally. 

Home enteral nutrition is administered using a syringe or feeding bag, through a feeding tube, and directly into the stomach or intestines. 

Can tube feeding be done at home?

Yes. Thanks to modern tools and technologies, it’s relatively easy to administer tube feeding at home. The process can be challenging at first and takes a bit of practice.

To protect your loved one’s health and reduce the risk of complications, adhere to all safety precautions. Thoroughly wash your hands before and after each meal; flush the feeding tube before and after meals to prevent clogs and bacteria buildup, and regularly inspect the skin around the feeding tube for signs of irritation or infection. 

How is enteral feeding administered?

The way enteral feeding is administered depends on the type prescribed. Click the links below to access step-by-step instructions.

  1. Bolus feeding

  2. Gravity feeding

  3. Pump feeding

How long can you live with a feeding tube in your stomach?

Living with a feeding tube isn’t a death sentence. It only makes it easier for your loved one to consume the vitamins, minerals, and nutrients they need to thrive. In some cases, a feeding tube is only temporary. Other times, it’s required long-term. No matter the length of time your loved one needs a feeding tube, it’s possible for them to live a long and healthy life.

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Chad Birt
Chad Birt

Chad Birt is a freelance B2B and B2C medical writer who resides in Astoria, Oregon. When he isn't behind a keyboard, you can find him hiking, camping, or birdwatching with his wife Ella and their two dogs, Diane and Thoreau.