Methods of delivery

Enteral feedings are delivered by several different methods. Continuous infusion must be used when duodenal or jejunal feedings are administered. For gastric feedings, bolus or intermittent feedings could be administered instead of continuous feedings. Each method has advantages and disadvantages.

In many hospitals, EN is delivered most commonly as a continuous infusion over 24 hours at a constant rate regulated by an infusion pump. A variation of continuous infusion is cyclic feeding, in which a constant rate is maintained by a pump over a certain number of hours daily. This method of administration is used commonly in long-term care or home settings. Often EN is administered overnight, giving the patient

"freedom" from the infusion pump during the day, although this may not be practical for patients with high nutritional needs because it may be difficult to increase the rate of feedings while trying to maintain GI tolerance with limited infusions.

Intermittent feedings are used commonly in long-term care or home settings due to easier administration. Patients frequently are started with continuous feedings, transitioned to intermittent feedings given several times a day over about 30 to 45 minutes for each feeding, and eventually changed to bolus feedings, where feeding is administered several times a day over less than 10 minutes per feeding. An advantage of intermittent feedings is that they may be administered by gravity flow adjusted with a roller clamp, although some institutions may use an infusion pump. Bolus feedings preclude the need for an infusion set or pump and can be administered using a 60-mL syringe, although, again, in some circumstances an infusion set and pump may be used. Intermittent and bolus feedings often are given in amounts of 240 to 480 mL per feeding, corresponding to one to two cans (8 oz each) of formula.

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