Parents will have been informed of the day when the pump needs to be refilled. The beeping is a reminder. The visit for refilling the pump is brief, taking up to 15 minutes. The clinician cleans the skin around the pump and inserts a needle through the skin to inject new drug into the pump reservoir. Very few children have problems with this procedure.
Some clinicians use a topical anesthetic on the rare occasion when it is necessary.
During these visits, team members will check on the child's muscle tightness and talk with parents about their observations on the child's progress. Depending on these observations, the baclofen-injection dose may be altered. The pump could be programmed to automatically deliver different dosages at different times of the day. If, for example, the child's muscles seem tighter after sleeping, the dose may be increased for several hours before the child wakes up. It is technically possible to adjust the pump several times during the day, though currently such frequent adjustments are not made.