What is the initiation plan for intermittent tube feeding?

• A. Start at 120 ml every 4 hours, and increase 60 ml every 8-12 hours to goal.
• B. Start at 25 ml every hour for 24 hours.
• C. Start at 50 ml every 6 hours.
• D. Start at 300 ml every 4 hours.

Answer: (A)

Intermittent tube feeding is given as measured boluses at set times, not a continuous drip. The best initiation plan starts with a moderate amount that the stomach can comfortably tolerate, then progresses gradually while you monitor tolerance. Beginning with 120 ml every 4 hours provides a meaningful intake distributed through the day and allows you to assess how the patient tolerates each feed. Increasing by 60 ml every 8–12 hours offers small, controlled steps toward the goal, reducing the risk of intolerance such as fullness, nausea, vomiting, or high gastric residuals while you approach the target volume.

Other approaches either start with too small a volume or too large a volume, or deliver feeds too infrequently or too often, increasing the chances of underfeeding or intolerance.