Enteral Feeding Calculator

This calculator converts a prescribed caloric goal into a practical enteral (tube feeding) delivery plan: total daily formula volume, the pump rate needed to deliver it over a chosen feeding window, and the protein and free water that volume actually provides. Daily volume is simply the caloric goal divided by the formula's caloric density (standard formulas run about 1.0 kcal/mL, high-calorie or fluid- restricted formulas up to 2.0 kcal/mL or more), and the hourly pump rate divides that volume across however many hours per day the feed runs -- fewer hours (bolus or intermittent feeding) means a faster rate for the same daily total. Protein delivered is read directly from the formula's labeled protein density (grams per liter), since formulas vary widely here -- a standard 40 g/L formula and a high-protein 63 g/L formula deliver very different amounts of protein at the identical volume and calorie count. Fluid needs are estimated with the Holliday-Segar method (100 mL/kg for the first 10 kg of body weight, 50 mL/kg for the next 10 kg, 20 mL/kg for the remainder), a pediatric-derived formula that is still commonly used as a rough adult daily fluid estimate in enteral nutrition planning, though individualized fluid orders (heart failure, renal impairment, fever, ostomy losses) should override it. The method comes from Malcolm Holliday and William Segar's 1957 paper in Pediatrics, "The Maintenance Need for Water in Parenteral Fluid Therapy," which remains the standard reference for this weight-banded fluid estimate nearly seven decades later.

Because most enteral formulas are themselves roughly 80-85% water, the calculator also estimates how much of that fluid requirement the formula itself supplies, and flags the remaining "free water" gap that needs to come from separate water flushes -- a frequently under-recognized source of dehydration in tube-fed patients whose only fluid intake is the formula itself. Water content is NOT fixed across formulas: it falls as caloric density rises, since a denser formula packs more calories (fat, carbohydrate, protein) into the same milliliter and has less room left for water -- roughly 84% water at 1.0 kcal/mL, down to around 70% at 2.0 kcal/mL for concentrated renal or fluid-restricted formulas. Leaving the water-content field at its 82% default while switching to a denser formula understates the free-water deficit, on exactly the concentrated products where under-flushing is the biggest dehydration risk -- always set water content from the specific product's label rather than the default. Always verify a specific product's actual caloric density, protein content, and water content against its label rather than relying on the ranges assumed here, and confirm any calculated rate and free-water plan with the ordering clinician or a registered dietitian before use.