Tube Feeding: How to Bolus Feed/Syringe Feed

Bolus feeding is a type of feeding method using a syringe to deliver formula through your feeding tube. It may also be called syringe or gravity feeding because holding up the syringe allows formula to flow down using gravity. Most people take a bolus or a “meal” of formula about every three hours or so. This allows you to have more freedom in between feedings. A feeding will usually take up to 20 minutes.

You can also watch a video with our registered dietitian showing how to bolus feed:

To bolus feed, you will need:

• 60-milliliter (mL) catheter tip or oral syringe
• Cup of room-temperature water
• Formula

How to Bolus/Syringe Feed:

1. Wash your hands.
2. If you have a low profile feeding tube, prime the extension tubing to remove any air before attaching it to the feeding tube. Priming the tubing helps prevent air from entering your stomach and causing discomfort.
   1. Clamp the extension set.
      1. Remove the plunger from the syringe and attach the syringe to the extension tubing.
3. Pour about 15 mL of formula into the syringe.
   1. Unclamp the extension set, allowing the formula to flow just to the end of the tubing and clamp the extension set.
   2. Attach the extension set to the feeding tube.
4. If you have a regular gastrostomy tube, flush your tube with water.
   1. Remove the plunger from the syringe.
   2. Attach the syringe to your feeding tube
   3. Pour 10-15 mL of water into the syringe and let it flow through your tube.
5. Clean off the outside of your formula container with a clean towel and open it.
6. Hold up the tube and syringe with one hand.
7. Slowly pour formula into the syringe with your other hand. Allow it to flow by gravity into your stomach. It should take around 15 minutes to deliver 8 ounces of formula.
8. Feed more slowly or more quickly depending on your tolerance.
   • You can make the formula flow faster by raising the syringe higher in relation to your stomach or by using the plunger push the formula through.
   • You can make the formula flow more slowly by lowering the syringe in relation to your stomach or by taking only ¼ or ½ of the can at a time with a minute or two in between.
9. Flush your feeding tube with the amount of water recommended.
10. Close the feeding port and disconnect the extension tubing (if applicable).
11. Wash your hands.
12. Wash and air-dry all equipment and supplies.
13. Refrigerate any leftover formula and use within 24 hours.

Bolus Feeding Tips:

• To prevent infection, always wash your hands before handling the feeding tube,  supplies and your skin.
• You should have better tolerance if you are sitting up during your feedings and for at least 30 minutes afterward.
• Cold formula may upset your stomach, so take it out of the fridge a few minutes before a feeding.
• You may need to slow down the formula if you start to feel nauseous or too full during the feeding.
• You may also need to feed more slowly if you experience stomach upset or loose bowel movements immediately after your feedings.
• Tap water is safe to use for most people. Ask your doctor if you need to use purified water.

For more information, see related articles and resources here:

• How to Use Your Child’s J-tube (Jejunostomy Tube)
• How to Clean ENFit Extension Sets
• Recorded Webinar: The Complete Nurse’s Guide to Tube Feeding
• Shield HealthCare’s Enteral Videos
• Tube Feeding My Child: What is the Safest Way to Handle the Bag Between Feedings?

Click here to watch the video: