Thank you for taking part in the quiz poll last week. We just want to share a bit about PEG feeding before getting to the outcome at the end of this article, if you want to jump straight to there click here.
Lwanele is exclusively fed through a gastronomy tube, also know as Mic-key or Percutaneous Endoscopic Gastronomy (PEG) feeding tube. He got this done in May 2018 after we almost lost him due to aspiration pneumonia which was earlier misdiagnosed as bronchopneumonia.
About Percutaneous Endoscopic Gastrostomy (PEG) Feeding
There are two types of PEG feeds. Continuous feeding (where the use of a feeding pump is required) and Bolus feeding where one is fed/eats a full meal at some specific intervals.
Lwanele is on Bolus feeding. Bolus feeding is mostly given using a catheter syringe and rarely using a pump. Bolus feeding is done into the stomach but not into the jejunum (the jejunum is the middle segment of the small intestine found between the duodenum and the ileum).
Fitted mickey with extension tube. All food, liquids and medication go through this port. The patient does not take anything through the mouth.
In Lwanele’s case we are always guided by his dietitian on how much of what food/liquid to give him and how often. He eats 5 meals a day 3 hourly. All his food is finely blended, then mixed with Pediasure (a supplementary formula), then fed through a PEG.
Lwanele’s diet is as wholesome as yours. The meals include a protein, carbohydrate, vegetables and of late, fruit. Talk of chicken, sweet potato, pumpkin/carrots/butternut, peanut butter, mealie-porridge and maltabela porridge, avocados, bananas, apples and paw-paws. All the good food you love to eat as well. Just just he doesn’t bother tasting it, straight to the core of the matter.
What You Need for Each Meal
- The pureed meal
- 40ml pre-boiled water for flushing after feed
- Catheter syringe (50/60ml)
- Bolus extension feeding tube
Typical Meal Steps
- Wash your hands thoroughly with soap and water.
- Prepare, puree and strain the meal as per the menu guide.
- Open the feeding port cap on the G tube.
- Connect the bolus extension feeding tube to the catheter syringe.
- With the tube clamp closed pour the puree into feeding tube.
- Bleed out all air from the bolus extension to prevent gas collecting in the tummy.
- Connect the bolus extension tube to the peg.
- Hold the syringe upright raising or lowering it as needed, the flow is per gravity.
- Let the food go, pausing after every 10mls for a few minutes. This should pace the 200ml + meal to feed in at least 30 minutes.
- After the feeding, flush the extension tubing with water. This ensures the PEG’s interior stays clean at the same time keeping him hydrated.
- Disconnect, wash and sterilize the feeding apparatus to be ready for the next meal in three hours.
Scared Of PEG Feeding?
For God has not given us a spirit of fear, but of power and of love and of a sound mind. – 2 Timothy 1:7 (NKJV)
In conclusion, and now directed to anyone caring for somebody with feeding difficulties, don’t listen to fear-mongering rumours. PEG feeding is not complicated, it’s just different. It’s not scary its fancy. Your case will always be different from Lwanele’s and you will feed as per your doctor’s instructions. Lwanele grew from an underweight and malnourished little body to a slightly-above graph healthy weight that has supported the development of his lungs and other organs. It will work out well for you.
- Do not fear tube feeding. Your child has to eat. It’s actually good for early development of your child as he/she will get proper nourishment.
- Before you start the journey you may feel scared but rest assured, as time goes on and when you remember why you have to do it, you will learn how to maintain the PEG and even how to replace it yourself without rushing to the casualty
- It’s not the end of the road but the beginning of nourishment. Don’t listen to rumours, discuss with your doctor and go for nourishment.
Lwanele’s Birthday Cake Quiz
About the Birthday Cake Quiz last week … unfortunately Lwanele did not get to eat his birthday cake as he is exclusively tube-fed and his dietitian wouldn’t allow us to blend cake for him.
It was his second birthday in hospital, maybe if he was home we would have made a plan :-).
Praying that he has his next birthday out of hospital, and that he can have his cake and eat it too.
60% of those who took part in the poll are as naughty as we are, seems they wanted us to puree the cake and feed it via PEG. 29% polled that we didn’t share cake with Lwanele, mean as they are, they were right. Such friends.
In the comment space below, you can tell us what you want us to share about.