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Monday, April 9, 2012

Zevex Infinity Interval Setting

Alternate title: How to do bolus feeds (or slow intermittent feeds) with the Zevex EnteraLite Infinity Pump

Alternate title #2: How to make your life easier and get a teensy bit more sleep!

I suppose I should explain why you'd want to use the interval setting. When Raya was younger, we were in a pretty desperate struggle to stop her incessant vomiting. Part of our treatment plan was a very strict feeding schedule. Maybe if Raya had been my only child and I hadn't had ANY other responsibilities but taking care of her, I could have mustered the discipline to get up every time the alarm went off to turn the pump on or off, refill it, etc. but that wasn't the case. I was exhausted and I've never been that good at getting up when my alarm goes off anyway. There were times when she needed to be fed for 3 hours at a time every 4 hours, which meant that I would stay up late to turn on her first feed of the night, wake up 3 hours later to turn it off, wake up an hour later to turn it back on, and repeat. If I'd been able to use the interval setting then, I could have saved myself from having to do that all night long because the pump would have simply paused between feedings and then resumed when it was time for the next feed.

 (note: We had the Kangaroo Joey until she was 7 months old and she couldn't tolerate cold formula until she was older than that so I never did this with the Joey pump. It CAN be done though. For instructions on how to use the Intermittent Feed setting on the Kangaroo Joey pump, click here. Instructions are on pg 13-16 of the manual.)

Thank heavens she's not on that crazy schedule anymore but the interval setting is still a beautiful thing because now we are able to use it to deliver her bolus feeds. A lot of people use syringes to do bolus feeds but that's just something that has never worked for us. With the pump, we're able to give her a 240ml bolus feed in 25 minutes using the maximum feed rate on the pump. I use the interval setting so that when I put her in bed for a nap, I don't have to risk waking her up to start her next feed on schedule because the pump just starts it for me.
This is also a lifesaver when we're out & about because the pump feeds her without me having to drag out syringes, bottles of formula, towels, and try not to make a mess or cause a scene. We went to the zoo this weekend and I knew we'd be there long enough for her to get 2 feeds so I filled up the pump bag, threw in an ice pack, and didn't have to worry about it. It's a great solution for an on-the-go toddler. The pump is also a lot better at delivering the feed at a constant rate than I am. :) The bottom line is that it takes a lot of the human error out of keeping Raya on her feed schedule as long as I've programmed everything correctly and put in enough formula. :)

Without further ado, here's how to use the Feed Interval setting on the Zevex pump.

1. Set the desired feed volume (amount):
Raya's bolus feeds are 240ml, so that's the amount I program in. (she's come a LONG way from the days of 22 hour a day continuous feeds!!)

2. Set the desired feed rate:

Since we use the pump for bolus feeds (large amount in short time) we use the maximum feed rate of 600ml/hour.

3. Push "FEED INT" button and enter in the amount of time between the START of each feed
This can be a little confusing. The amount of time you program into the FEED INT setting is the amount of time you want from the start of one feed to the start of the next. In this case, we used 2 hours and 50 minutes.
This brings me to an important detail. The time on the interval setting goes in hours and minutes. If you want an interval of 3 1/2 hours, you put in 3.30hr, NOT 3.5hr. It's written as a decimal but that's not how it really works. Each .10=10 minutes.

4. Make sure you have enough formula in the
pump bag for all of the feeds and then push "RUN/PAUSE" to start the first feed
Here you can see that 2.5ml has been fed and the "run" indicator is going. Also note that the words "Feed Interval" appear in the corner. If they're not there, then the Feed Interval setting hasn't been activated.
After a full "dose" has been delivered, the pump will stay on but pause for the amount of time programmed. The screen will flash "NEXT DOSE" and then the amount of time remaining until the start of the next feed. The pump will keep cycling until the bag is empty.
In this case, after the first dose finished, there was 2 hours and 25 minutes left until the start of the next dose which means it took 25 minutes for the first dose to run. Make sense??

Okay, hopefully that made sense but I'll give a couple more examples just in case. (As a side note, when I was sitting in my 3rd grade classroom struggling to get a grasp on how to do story problems, I hadn't the slightest inkling that I might someday actually be USING that knowledge to figure out how to get a machine to deliver accurate dosages of special formula to my child! Life's funny, isn't it? :)

Example 1: When Raya was younger, we did slow feeds of 180ml delivered at a rate of 60ml/hour every 4 hours. To program this into the pump, you would enter the dose as 180ml, the rate as 60ml/hour, and then the feed interval would be 4.00hr. The pump would run until the 180ml had been delivered, pause for 1 hour, and then start the next feed.

Example 2: A couple weeks ago Raya had a fever of 104.3 and I didn't dare give her formula because I didn't want to make her vomit. I also didn't want her to get dehydrated though, so I put about 500ml of Pedialyte into the pump bag and programmed the pump to give her doses of 100ml at a rate of 50ml/hour with a 30 minute break in between. Since the dose took 2 hours to deliver and I wanted a 30 minute break in between doses, I set the interval to 2.30 (2 1/2 hours).

I hope someone finds this useful! :)

*Note: In 2013, MOOG released a statement cautioning against using the Interval setting or the INF DOSE setting for any individuals who are sensitive to volume. The statement reported that there is a risk that the pump may continue to run and could pump air into the stomach or intestine when using those settings. That being said, as long as we have removed ALL air from the pump bag prior to starting the pump, we have never had a problem with air running into Raya's stomach. If there is no air in the bag, there's no air available to be pumped into her stomach even if the pump does continue to run.

3 comments:

  1. This post has been so extremely helpful. Thank you for taking the time to write it! I

    ReplyDelete
  2. How do you stop the interval setting when you no longer want to use it and go back to the regular way?

    ReplyDelete

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