We’ve maxed out the rate on the feeding pump… What do we do now????
The feeding pump we use is the Entralite Infinity Blue by Moog (formerly Zevex) and, for the most part, it has met our needs. When Henry first started eating with his g-tube, he needed the slow steady pace the pump provided. Any attempts we made to do “quick snacks” only resulted in him throwing up. I was determined to feed him over no more than a 30 minute period, when possible… as everything I read said that if a child was to transition to eating orally, he would need be able to eat in a 20 to 30 minute period. If it took longer, then the digestive system might not be physically capable of digesting food well enough for oral eating. So… each time we increased the amount of food Henry ate, we also increased the rate.
I could see it coming… soon enough Henry would be eating enough to max out the pump’s rate. The Infinity model has a maximum rate of 600 ml/hour. Meaning that once Henry was eating 300 mls of food at a meal, he would be at the pump’s maximum rate. Anymore food and it would take longer than 30 minutes to feed him. Not only did this not support our long term goal of transitioning Henry to eating my mouth… but anyone with toddlers can appreciate what it’s like trying to get a 2 1/2 year old to stay at the table for longer than half an hour!
Henry’s actually been eating upwards of 300 mls of food per meal for several months… typically fluctuating between 270mls – 350ml. And trying to engage… entertain… persuade… him to stay at the table that long is nearly impossible. At times he would happily “eat” at the table with us, while other times we would finish our meal and he would finish eating while reading stories, listening to music, or playing. We didn’t mind… Amina, our Occupational therapist, has always stressed that he need not be in his chair the whole time… it was actually better not to force him to stay, but to end “mealtime” at the table once he was finished exploring his foods.
Having said this… the longer it takes to feed him the more challenges we have. At times we were close to 45 minutes for him to finish his food. No quick lunches and off to the park for us…
Lately the issue is coming up more often for a couple of reasons. First, we just don’t want Henry’s meals to be the central part of any of our day. Mealtime is important, but it’s not the only thing we do (and certainly not more important than play time!). Secondly, as Henry eats more, the time is only going to get longer.
The second issue was becoming increasingly important…
- We kept thinking that Henry needed to be consuming more calories in a day. He is so active now and was often running out of energy and getting grumpy. But when we would try to feed him more, he’d say “all done… no more food”. We wondered if this was because he was full of just because he was tired of eating. But we honoured what he wanted and would finish the meal.
- We are still feeding him at night after he’s gone to sleep. This is challenging as it means he wets through multiple diapers overnight (which results in all of us being up many times) and he digests food slowly at night so his tummy would hurt (trying going straight to bed after a full turkey dinner and see how you feel!).
We needed to find a way to feed him more food in a less time. When we asked his dietician for advice, she recommended continuing with the 30 meals during the day and making up the extra calories at night… exactly the opposite of what we wanted!
So… why does the pump have a maximum rate so slow? Because the majority of users never reach that rate. And those who do transition to using a syringe for feeding instead. We’ve tried using a syringe before with limited success. Henry had challenges with the faster pace, and the pump was just easier to use. But now we determined to try again… syringe feeding here we come!