Bolus versus continuous feeding regimens post gastrostomy tube placement in children*

Background/purpose: Owing to the frequency of gastrostomy tube placement in children and the numerous regimens used to start feeds after placement we attempted to see if it matters if the initial feeds after a gastrostomy tube placement are provided in a bolus or continuous manner. Methods: Using a prospective randomized trial, children were randomized to initial bolus or continuous chimney feeding after gastrostomy tube placement. Feeding tolerance and complications related to the gastrostomy tube were collected for 4 weeks after placement. Results: Demographics were similar in the two groups. Times to goal feeds were similar in both groups, but in the first two weeks more feeding modifications were required in the bolus group. Other than the rate of leakage during the second week after placement which occurred more in the bolus group, all other clinical outcomes were similar in the two groups. Conclusions: Other than minor, clinically insignificant differences noted above, the method of initial feeding after a gastrostomy tube placement does not affect feeding tolerance or gastrostomy tube complication in the first month after placement. Level of evidence: Therapeutic, level II. (c) 2020 Elsevier Inc. All rights reserved.

Automated summary

A randomized trial showed that the initial feeding method (bolus or continuous) after gastrostomy tube placement had little effect on feeding tolerance and complications in children. Apart from minor differences in the first two weeks, the clinical outcomes were similar in both groups.