The pump for Paul’s tube feeding was delivered today. It will enable him to carefully regulate the rate of feedings, and to take in some calories very slowly overnight, if the wants. A home health care nurse will be coming by tomorrow to show us how to use it.
Paul ordered the new formula today. It is a low-osmolality, or near isotonic formula. Paul found a very interesting bit of information today on tube feeding formulas from – imagine that – the University of Washington Medical Center. It’s from their extensive on-line resource on nutrition for pre-term infants (who apparently sometimes need tube feeding). This is not information that we’ve received from anyone at UWMC. They say:
The osmolality of a formula has a direct influence on the gastrointestinal (GI) side effects that occur with enteral feeding. Osmolality refers to the concentration of osmotically-active particles per liter solution of formula, expressed as mOsm/L. The osmolality of a formula is affected by the concentration of amino acids, carbohydrates, and electrolytes. Formula with a higher osmolality than that of normal body fluids produces an osmotic effect in the stomach and small intestine; this hyperosmolality draws water into the GI tract to dilute the concentration of the formula.
An influx of water into the GI tract may cause diarrhea, nausea, cramping, and distention. Isotonic formulas are designed to alleviate these problems. The osmolality of full-strength isotonic formulas is similar to the osmolality of normal body fluids, approximately 300 mOsm/L.
Hmmm… the problems related to hyperosmolality sound familiar. Perhaps that’s the problem. The osmolality of the spacefood is a whopping 950, more than three times that of normal body fluids, so it could be sucking lots of water into Paul’s GI tract. Here’s hoping the new stuff, with an osmolality of 350, will work a whole lot better for Paul.