During bolus enteral feeding via a gastrostomy tube, which position is best for administration to minimize aspiration risk?

• A. Prone
• B. Fowler's
• C. Sims'
• D. Supine

Answer: (B)

Preventing aspiration during bolus enteral feeding relies on positioning that reduces reflux and keeps gastric contents away from the airway. Elevating the head of the bed to Fowler's position (about 30 to 45 degrees) creates an angle that helps keep stomach contents lower than the esophagus and uses gravity to minimize backflow during and after the bolus. This protective angle is why Fowler's is the best choice for administration. In contrast, lying supine allows reflux to move toward the esophagus and airway; prone position places the airway in a more vulnerable relation to the stomach contents; and a side-lying (Sims’) position does not provide the same protective angle and can complicate feeding flow and tube stability. Keeping the head of the bed elevated during and after the feeding is a common practice to maintain this protective effect.