Gavage Feeding-Continuous or Bolus?

It is a very well done in-vitro study published in 2010, yet has many practical implications.
Abstract

Substantial losses of nutrients may occur during tube (gavage) feeding of

fortified human milk. Our objective was to compare the losses of key macronutrients and

minerals based on method of fortification and gavage feeding method. We used clinically

available gavage feeding systems and measured pre- and post-feeding (end-point) nutrient

content of calcium (Ca), phosphorus (Phos), protein, and fat. Comparisons were made

between continuous, gravity bolus, and 30-minute infusion pump feeding systems, as well

as human milk fortified with donor human milk-based and bovine milk-based human milk

fortifier using an in vitro model. Feeding method was significantly associated with fat and

Ca losses, with increased losses in continuous feeds. Fat losses in continuous feeds were

substantial, with 40 ± 3 % of initial fat lost during the feeding process. After correction for

feeding method, human milk fortified with donor milk-based fortifier was associated with

significantly less loss of Ca (8 ± 4% vs. 28 ± 4%, p< 0.001), Phos (3 ± 4% vs. 24 ± 4%,

p < 0.001), and fat (17 ± 2% vs. 25 ± 2%, p = 0.001) than human milk fortified with a

bovine milk-based fortifier (Mean ± SEM).

Continuous Feedings of Fortified Human Milk Lead to Nutrient Losses of Fat, Calcium and Phosphorous.

Nutrients 2010, 2, 230-240; doi:10.3390/nu2030240Stefanie P. Rogers 1, Penni D. Hicks 2, Maria Hamzo 2, Lauren E. Veit 3 and Steven A. Abrams