Home › Forums › Feeding Issues › Tube Feeding › Alimentum through an NG anyone?
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May 8, 2007 at 3:59 pm #32637AnonymousInactive
Anyone NG tube feed Alimentum???? We switched from Neosure to Alimentum to help her DGE about a week ago. Ever since we did the switch the Alimentum does not go down her tube!!! I’m going crazy, I have to sit there and keep plunging it. If I just leave it, it takes like 2-3 hours to bolus 60 ccs. At first I thought maybe her tube was clogged. Took it out, put a new one in, and the same thing!!! I was like what in the world is going on here. The Alimentum actually looks thinner than her usual Neosure that goes down fine, sometimes too fast! So today I decided to give her Neosure through the tube to see if it went down fine because I thought the tube was clogged and it went down fine. I dont know what to do because her Pedi. GI told us Alimentum would help her DGE and it seemed to have been helpin a bit, I would like to keep using it but dont know what to do. I mix it to 24 calories. That might be it? But it still looks really runny thats what I dont understand. Plus I’ve mixed Neosure to 24 and 27 and it went down fine. HELP!!!!!!!!
May 8, 2007 at 4:31 pm #32640AnonymousInactivewhat size tube do you have? maybe a bigger (8 french ) might help. also can you flush with water before or after a feed to see if that helps. we did pregestimil 24 calories through kendra ng and it worked ok. i don’t know how thick alimentum will be thorugh the tube. i hope it gets better.
May 8, 2007 at 6:38 pm #32650AnonymousInactiveWe have a 6 french. I do flush water and it still doesnt help. The thing I dont get is that the Alimentun looks thinner! Ugh! I gave up and now I’m just giving her Neosure again, it goes down fine. We will probably need an 8 french tube though. I think the bigger then worst for them though Shes already spitting up like crazy, more than ever today! Every bottle I try and every tube feed comes right back out Yesterday her GI said to wait for a G-tube!! Ahhhhhhhh! She said that since she will be starting speech therapy to wait on the G-tube. I’m like I dont know how much longer I can deal with this NG it’s driving me crazy and poor Cassie too. Thanks Leo I’m so stressed out right now!!
May 8, 2007 at 7:00 pm #32653AnonymousInactiveVanessa,
hang in there swettie yes the 8 french can be worst, but it might work better though. i was demanding a 6 french for kendra and they told me that a 6 french gets clog a lot and i was scared to death to change the tube so i opted for an 8 french. i know it can be hard and cruel, but i would change her tube to the bigger size if you have it and give it a try. That’s just my pinion, but you do what you think is best for cassie. we never had a problem with our tube. also sometimes a diferent kind might work better. some mom told me the yellow one is a pain in the neck, but the clear one with the orange or white end at the end is better (we had the latter one). which one do yo have? (your ped can get some from the local hospital or might hav esome in her office)
also this is from my experince, but kendra is so much happier now with the G-Tube and it was not as hard as i thought. she is adifferent baby. i know you are worried, but the g-tube was the best for kendra. ask me any question you want. i know every child is different. i hated dealing with kendra NG tube.
Hugs honey
May 8, 2007 at 8:24 pm #32664AnonymousInactiveWe have the yellow one. I hate it!!! At the hospital we had the clear one which I liked a lot because u can see when u give meds and u can see if theres still milk in the tube and stuff. When she was discharged they gave us 3 clear ones but we dont have any more. I am going to call her tube provider if they have the clear ones. I am sooooo sick of the tube right now. Shes spitting up like crazzzzzzzzzzzy today. I dont know why, It might be the tube. I just want to take it out so bad. I know she wont eat enough though. She only takes about an ounce sometimes. I was really scared and didnt want the G-tube but now I am at wits end and I want it!! But now her GI says to wait to see if speech therapy works. I dont think I can wait. I might just call her GI and tell her we need to do the G-tube. She will go like 6 hours and still not want to eat. So I know if I take the NG out she will lose weight. When will this ever end???
May 8, 2007 at 8:27 pm #32666AnonymousInactiveDoes Kendra have DGE?? Cassie has it bad. She spits up 3-4 hours after a feed. I think for DGE babies they do J tubes… but I’m not sure???? I dont really know much about J-tubes other than they go straight into the bowels.
May 8, 2007 at 9:04 pm #32670AnonymousInactiveVanessa,
kendra does not have DGE, but she was on reglan b/c she spit up so much and wasn’t gaining very much wt. the reglan helped, but its side effects outwighted the benefits for kendra. we tried bechanecol but it din’t help her. the other motility drug we wanted to try was eromythin (sp?), but the ped would not agreed with it at all. then we switched to alimentum and the spit up improved a lot.
I think you are right they do Jtubes with babie swith DGE b/c of the vomiting, but i don’t know very much about it. one thing for sure i would not delayed with the other type of tube. our speech therapist told us that it was hard for the baby to improve with teh NG tube b/c it can makes reflux worst and the oral aversion too. the reflux b/c the NG tube keeps the Lower sphicenter (sp?) slighly opens and the oral adversion b/c they can feel the tube going down their throat.
i don’t want to stress you out more, but i was in your shoes.I was desperate and knew i needed to make a decision to improve kendra’s quality of life and the G-tube was the right one for us (i hope it stays good too). talk to you GI carefully about which tube is best for Cassie, you don’t want to make things worst.
The tube we had was a 8 french clear one 15″ long with the white end.
May 8, 2007 at 9:22 pm #32677AnonymousInactiveVanessa,
I’m so sorry for all you and Cassie are going through. I feel so bad, because I know how you’re feeling! It’s like your describing Bryce when he had his NG tube. He has DGE too, and was just constantly spitting up after tube-feeds. You shouldn’t have to get a j-tube…. at least Bryce didn’t. The thing that helped Bryce’s spitting up more than anything was the Erythromycin. The NG tube made his spitting up worse, but even with the g-tube he still spit up tons until he was on a good dose of the Erythromycin.Anyway, hang in there! I know how hard it is, but eventually you will figure out the right combination of things and Cassie will begin to thrive.
Oh.. and sorry, I don’t have any advice on the formula. We were using fortified breastmilk with Bryce’s NG tube, so it didn’t ever get clogged like that. I sure hope you can find a solution for that! It must be so frustrating.
May 9, 2007 at 1:17 pm #32715AnonymousInactiveHUGS to you!!
well i have no idea about teh Neosure but the Alimentum is usually not that runny… because it is broken down, it actually sticks together more than a regular formula, so i could see why it is not flowing easily. Now, you are doing gravity feeds with teh NG? The 6fr was fine for us and we loved the Viasys, but i know different people put in different things. If you are doing gravity feeds with the neosure, how long does a feeding take? You can replicate that with a syringe. I have done purees down a 6fr tube… just have to push it through and make it runny… but def thicker than alimentum.
How long has she had the NG tube? Do you think the boluses are too big/too long? Babies take a LONG time to adjust to tubes because the stomach is getting no warning from the brain that food is coming (ie if there is food in the mouth, the brain signals down to the stomach to prepare itself for digestion etc).
So you have not had a speech eval at all? I can see where the doctors are coming from saying to wait… and i really hated that NG tube. If in your heart you know that things are not going to improve quiclkly, the Gtube is def the way to go. Yes, it is hard at the beginning but it really beats the NG!
As per DGE – has she been tested? Matthew spit up and threw up way after feedings for a long time and he did not have DGE — just reflux. We always managed to maintain a healthy weight just by feeding slowly, continous feeds when we could overnight, slower rate etc…But we did try to increase his motility with motilium (rarely available in the US). I am surprised she has DGE and it is not being treated. Most doctors do reglan — yes, you hear a lot of scary things about it but it is something that truly can work for DGE. Erythromycin is just a low dose antibiotic – the only thing i have heard about it is that it can cause Cdiff in some babies… is that why your ped did not want to do it? I mean, there are so many babies in profylactic (spelling) antibiotics… you should ask him why he said no.
Yes, the Jtube can be a solution — but it is not something they will put in as easily as a Gtube. It is helpful for babies that do not gain weight because they are not handling the volume well and therefore vomitting. but a Jtube is VERY different to the Gtube. Because the J tube is going straight into your duodenum, the rate at which you do the feedings is MUCH SLOWER than the Gtube. See the Stomach expands to accomodate all of the food… then the intestines absorb food very slowly… they cannot handle volume or hight rates…. which means a majority of babies are on continous feeds for many hours every day, some of them have to be on it for 24 hours to get the volume through. Just FYI.
Sorry about all the questiosn – i don;t come around often enough so have not read much about your baby!!
May 9, 2007 at 4:46 pm #32732AnonymousInactiveThais – Shes had an NG tube since she was born. She was a preemie. Shes had one ever since. I dont know If that is what is causing her spitting up to be this bad for the past 2 days. I mean it’s bad!! I’m wondering if it is the NG. Shes had it forever though. I think the older they get the worst it is though. I dont know thats my theory. I get it about the Alimentum it does look like more sticky, but it looks more runny. I might be going crazy or something LOL! That formula will just not go down at all!!!! The neosure usually takes about 30 mins for 100 cc’s. Which is what we give her every 3-4 hours or 24 calorie/ounce. As for the Alimentum it takes 2-3 hours and thats with me plunging it every once in a while!!! I was so sick of it that I just started Neosure again.
Heather – I asked her GI about Erythromycin and she kinda thought I was crazy or something She said Reglan was best for her. So shes on 0.9mls 4x a day. It seems too high so I give her 0.7
Leo – Ya I now know how you felt when u wanted the G-tube. I want it now really bad!!! I dont think I can wait for speech therapy. I know I should be optimistic, but I dont think speech therapy will help so fast… and I cant go for more another 2 weeks with this NG!
May 9, 2007 at 5:39 pm #32737AnonymousInactiveIt’s too bad they won’t let you try the Erythromycin. Bryce was on Reglan for a very short time when he was first diagnosed with reflux, and it didn’t work nearly as well as the erythro. There are a lot of people who have good luck with Reglan though. Does it seem to help Cassie at all?
May 9, 2007 at 6:23 pm #32739AnonymousInactiveI dont think so I think maybe her feeds are too fast and she might need a continous pump. I give her 100ccs every 3 hours. With DGE I think that is too much for her. But her Ped wants a certain amount of calories in her per day. Goshhhh!!! Maybe we could do less volume for calories. Shes just spitting up so much these days!!! I think the NG is really gettin to her now that shes gettin older.
May 9, 2007 at 6:24 pm #32740AnonymousInactiveI meant less volume with more calories sorry 🙂
May 9, 2007 at 6:42 pm #32741AnonymousInactiveYou’re right, that could be one reason she’s spitting up so much. Maybe she just can’t handle that much at once with her DGE. I don’t think Bryce was drinking that much at a time at 6 months. In fact, he can only handle 150 cc at a time now.
What we do with Bryce is we do the continuous pump at night while he’s asleep, then bolus feeds during the day (every 3 hours). That is the only way we can get enough calories down him. In my opinion, if you want to teach her to eat, it would be best to keep her on scheduled bolus feeds rather than continuous during the day. If you don’t want to try the continuous feeds, maybe you could increase the calories, like you said…. maybe up to 27 calories/oz and see how she does? Anyway, those are just some ideas.
I know it’s frustrating because your supposed to get so many calories down them, but then they turn around and spit it all up anyway. So in the end you’d probably keep more down if you fed them less.
May 9, 2007 at 6:44 pm #32743AnonymousInactiveOh – and I’ve also heard that it’s not a good idea to have the NG tube for more than a couple of months or they do start having problems. Bryce had his for 4 months and that was probably longer than it should have been. You always just keep hoping that they’ll get off the tube and won’t have to resort to the g-tube.
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