Which Enteral Feeding Method is Best?

Enteral nutrition involves feeding a person through a tube that delivers nutrition directly to the stomach (gastrostomy) or small intestine (jejunostomy).  This method is often necessary for individuals who cannot eat orally due to medical conditions such as throat or mouth cancers, cerebral palsy, neurodegenerative diseases that affect swallowing, and more.

Since each person’s needs, abilities, and preferences are unique, there is no “one-size-fits-all” approach when it comes to enteral feeding. The method chosen will depend on factors like the individual’s tolerance, their support system, and their daily schedule. Below, we’ll explore the main methods of enteral feeding, outlining their benefits and drawbacks.

This method uses an enteral pump to deliver nutrition. The formula is placed in a bag (or comes in a pre-packaged closed bag/container) and connected to the pump. The pump is programmed to control the rate (speed) and volume of formula delivered. Feeding can be continuous throughout the day or night, or delivered in “boluses” (larger amounts) multiple times a day, mimicking mealtimes.

Pros:

• Provides accurate, controlled quantities of formula.
• Generally better tolerated than gravity or syringe systems.
• Can be programmed to include water flushes at specific volumes and intervals, helping with hydration.

Cons:

• Requires some technical knowledge to operate, though many pumps are intuitive and easy to use.
• Can be expensive, and some insurance plans or provincial programs may not cover the cost.

In this method, the formula is poured in a bag that is directly connected to the feeding tube. The formula drips through gravity, with a small “roller clamp” used to adjust the flow speed. The patient can regulate the speed of feeding, but it is less precise than the pump system.

Pros:

• Requires minimal equipment.
• Allows the patient to regulate feeding speed during the process.

Cons:

• The flow rate is not as precise as with a pump, which may lead to discomfort or intolerance (e.g., nausea or vomiting) if the formula flows too quickly.
• Requires daily cleaning with soapy water to maintain hygiene.
• More prone to bacterial contamination compared to closed-bag systems.

This method involves manually administering formula into the feeding tube using a syringe. This method tends to work best for patients who can tolerate larger volumes of formula at a faster rate.

Pros:

• Minimal equipment is required, making it more flexible for people with busy schedules.
• Allows for easy adjustment of feeding based on the individual’s needs.

Cons:

• May be poorly tolerated by some patients, especially if the formula is delivered too quickly.
• The manual nature of this method can lead to repetitive strain injuries like tendinitis over time.

Conclusion

Each enteral feeding method has its own advantages and challenges, and the “best” method will depend on the individual’s specific needs, tolerance, and lifestyle. Working closely with a healthcare provider and a registered dietitian is crucial to selecting the right system, ensuring comfort, and maintaining nutritional goals. No matter the method chosen, it is important to prioritize both the accuracy of the feeding process and the comfort of the patient.

Visit our Tube Feeding page to discover more.

Disclaimer: this blog provides general information and should not be used to diagnose or treat a person.  The information listed above does not replace the professional advice of a healthcare provider.  It is recommended to seek professional advice tailored to your needs.

References

1. “Patient Education: Enteral (tube) feeding (The Basics)”. UpToDate, 2025

2.”My Tube Feeding”, mytubefeeding.ca, Nestle Health Science, 2025

3.”Kangaroo OMNI Enteral Feeding Pump”. Cardinal Health, 2025