The use of blenderized tube feeding (BTF) continues to increase in popularity, among people of all ages, in the United States and across the globe. BTF is the process in which foods and liquids are blended together and given via an enteral feeding tube.
Is homemade blenderized tube feeding effective?
The popularity of homemade blenderized tube feeding (HBTF) continues to increase among enteral nutrition (EN) consumers and healthcare providers alike, citing improved feeding tolerance over standard commercial enteral formulas, among other health outcomes. Within the past 5-10 years, there has been …
What is a blended diet or tube feeding diet?
There is a growing movement to including foods in the tube feeding diet. A blenderized diet, also called a blended diet or BD, is one that includes real food, not just formula. There is quite a range, from mixing jars of baby food purees with formula, all the way to completely blending whole table foods only.
Can you use a nasogastric tube for blenderized food?
Although very uncommon, some people use nasogastric (NG-) tubes in the home setting; using blenderized food is difficult or not possible with small-bore NG-tubes. As with any tube feeding, the person being fed should be seated upright or have their upper body elevated at least 30 degrees to help prevent reflux.
What is tube feeding by syringe?
Tube feeding by syringe involves the infusion of food or formula into the tube by pushing on the plunger of a filled syringe. The plunger can be pushed very slowly or very quickly.
How do you prepare Blenderized feeding?
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What is an advantage disadvantage of Blenderized tube feedings?
Blenderized food may not provide all the vitamins, minerals, fiber, hydration, and calories you need. It is difficult to formulate a well-rounded, calorie-dense diet that can get through your tube. Of equal concern, blenderized food may clog your tube.
What is an advantage of Blenderized tube feedings?
Benefits of blenderized tube feeding Some of the benefits to a blenderized tube feeding include: Exposure to real foods and tastes. The ability to adhere to dietary restrictions or preferences (dairy free, vegetarian, etc.) Possible improvement in gastro-intestinal (GI) symptoms like reflux or constipation.
Who needs Blenderized diet?
When is a Blended Diet Appropriate?When a child is over one year old. Children under age one should still be receiving the bulk of their calories from formula or breastmilk. ... When a child has enough safe foods to make a balanced diet. ... When a child has a G-tube.
Can you put regular food in a feeding tube?
Raw foods can be used, but foods that normally require cooking (such as meats, brown rice, potatoes) should be cooked just as they would if they were being eaten by mouth. Blenders and syringes need to be thoroughly cleaned right after each use.
Can you put pureed food through a feeding tube?
Commercial pureed baby food (stage 2) can be used for variety, consistent nutritional value, and it also avoids the potential complication of clogging the feeding tube. It is convenient especially when traveling, and avoids the need to purchase an expensive heavy-duty blender.
How long can you have a PEG tube?
A PEG tube lasts about 1 year. Replacing the old tube is usually a simple procedure that your healthcare provider can do without surgery or anesthesia.
How do you gain weight on a feeding tube?
If you use the bolus method for tube feeding, the most basic strategy to increase calories is to increase the volume of each bolus meal. Try slowly increasing a meal volume by 30- to 60-mL (1- to 2-ounce) increments. Often, the adult stomach can tolerate a total volume of 240–480 mL per meal.
What is a water bolus?
The bolus method is a type of feeding where a syringe is used to send formula through your feeding tube. The syringe you'll use is called a catheter syringe. A catheter syringe doesn't have a needle. It has a hole with a plunger in it.
Do you feel hungry with a feeding tube?
Will I get hungry? Will I feel full and satisfied? Tube feeding can give the sensation of fullness, the same way you would be affected by eating food. However, when the tube feed is administered continuously in small amounts over the course of a whole day, you may feel less of the sensation of fullness.
What are the five signs of intolerance to a tube feeding?
This can make people feel bloated, have stomach cramps, feel sick or be sick, regurgitate food or drink (where it comes back up into the mouth), become constipated or suffer diarrhoea. These symptoms are described as 'feeding intolerance'.
Can you drink alcohol with a feeding tube?
I know some patients want to enjoy a “cocktail hour” so it's fine to put wine, beer and other alcoholic beverages slightly diluted into your feeding tube. You'll enjoy the benefits of libation and may find yourself more relaxed and sociable.
What is the advantage of gastrostomy from nasogastric tube feeding?
Gastrostomy Tube Feeding Patient comfort with gastrostomies is an advantage over NG tubes. Gastrostomies do not irritate nasal passage, esophagus, or trachea, cause facial skin irritation, nor interfere with breathing. Gastrostomies are stable and more physiologic, allowing continued oral eating.
What are the drawbacks of a feeding tube?
Skin Issues (around the site of your tube) Unintentional tears in your intestines (perforation) Infection in your abdomen (peritonitis) Problems with the feeding tube such as blockages (obstruction) and involuntary movement (displacement)
What are the complications of a feeding tube?
Risks / Benefits These complications may include: Clogged, damaged or displaced tube. Infection at the tube insertion site. Gastrointestinal problems including constipation, nausea and diarrhea.
Is there an advantage to placing a PEG tube?
Benefits of PEG feeding tubes Benefits include: It is well tolerated (better than nasogastric tubes). Nutritional status is improved. Ease of usage over other methods (nasogastric or oral feeding) reported by carers.
How to use blenderized feeding?
Use of blenderized feeding can range from adding one fruit or vegetable blend daily to a regimen of standard commercial EN formula, to a diet that consists only of blenderized foods. One way to make a balanced meal is to portion out foods in amounts that would otherwise have been eaten by mouth, add liquid, and blenderize. Another way is to blend a specific number of portions each day from the different food groups: carbohydrates (grains and starchy vegetables), protein, vegetable, fruit, dairy (or dairy substitutes), and fats and oils.
How to administer blenderized food?
Blenderized foods can be administered the same ways as regular canned formula—by gravity, bolus, or pump. However, most often they are infused into G-tubes (including PEG-tubes and low-profile devices) slowly with a 60 mL syringe, by using gentle pressure on the syringe plunger (called bolus feeding). All methods work well with tubes of 14 French size or larger. Although very uncommon, some people use nasogastric (NG-) tubes in the home setting; using blenderized food is difficult or not possible with small-bore NG-tubes.
Why is blenderized food important?
Homemade blenderized foods can be less expensive than commercial products, which is an important factor for people whose insurance does not cover EN formulas. Some who are concerned about the environment like blenderized foods because there are fewer cans and cartons to throw out. Many HEN consumers enjoy sharing meals with their families and experiencing the sight and smell of foods while they prepare and use blenderized meals. Epp recalls one of the HEN consumers she has worked with saying, “Blending real food has brought the joy of cooking and eating back into my life.” Epp also mentions that people report improved bowel regularity.
What are the ingredients in EN?
Some have allergy or intolerance to certain ingredients that are present in most standard EN products, such as corn, cow’s milk, or soy proteins. Others desire more variety, and/or healthy, unprocessed natural foods for a diet lower in sugar and with phytonutrients and fibers. Most conventional EN formulas contain corn syrup, maltodextrins, sugar, ...
What is the best blender for liquifying food?
High-speed and commercial-quality blenders such as Vitamix® or Blendtec™ work best for more complete liquification of foods. Foods should be cut into chunks and placed in a blender along with enough liquid to allow blending to a smooth consistency. You may need to strain the blend to remove small chunks or seeds.
What foods can you mix with a tube feeding?
Epp states that brown rice, fruits, vegetables, lentils, toasted breads, and crackers work well for blending, and that olives, white pasta, white rice, breads, muffins, and bagels tend to gum up in the blender. General food safety principles are very important, especially if the person using tube feeding has compromised immune function.
What are some good foods to blend?
Foods that are popular for blending include sweet potatoes, bananas, quinoa, avocado, oats, nut and seed butters, chicken, yogurt, kefir, various grains, and milk (cow’s, soy, almond, coconut, etc). Other liquids include water, broths, and juices. Some foods have more potential to clog tubes, such as string beans, blueberries, and flaxseeds. Eggs can become lumpy if not thoroughly cooked prior to blending. Epp states that brown rice, fruits, vegetables, lentils, toasted breads, and crackers work well for blending, and that olives, white pasta, white rice, breads, muffins, and bagels tend to gum up in the blender.
What is a blenderized tube feed?
Blenderized tube feeding (BTF) is defined as liquefied whole foods that are pureed in a blender, and delivered through a feeding tube. Historically, blended food was used for tube feeding. Over the years, standard, ready to use, commercial formulas have replaced blenderized food to provide nutrition when a patient is unable to eat by mouth.
Why are commercial formulas replaced with blenderized food?
Over the years, standard, ready to use, commercial formulas have replaced blenderized food to provide nutrition when a patient is unable to eat by mouth. Many families are becoming interested in returning to a more natural food source by tube feeding with homemade, blended foods.
What is blended diet for tube feeders?
This can mean avoiding foods like milk or soy, or focusing on foods that are easier to digest. A blended diet exposes a child to digesting real food. We have heard from older tube feeders that they are sometimes able to taste foods that are fed to the stomach.
How is blended food fed?
When a child has a G-tube. A blended diet is typically fed to the stomach, via G-tube. Because blended diets are often thicker than traditional formulas, NG-tubes may be too narrow for the food to be delivered. J-tubes are placed further into the intestines and blended food may be difficult to absorb there. While there have been cases of feeding a blended diet to the intestines, it is just beginning to be studied by the medical community. Proteins are broken down in the stomach and duodenum, and must be sufficiently broken down to prepare them for absorption. There isn’t any medical literature at this time looking at whether commercial blenders sufficiently break down proteins well enough to prepare for absorption in the intestines.
What is a blended diet?
A blenderized diet, also called a blended diet or BD, is one that includes real food, not just formula. There is quite a range, from mixing jars of baby food purees with formula, all the way to completely blending whole table foods only. You should consult a dietitian and your doctor before moving your child to a blenderized diet.
When should a child start eating a blenderized diet?
When a child is over one year old. Children under age one should still be receiving the bulk of their calories from formula or breastmilk. A blenderized diet isn’t recommended before one year because that is about the time when orally-eating children would transition to a diet that is mostly solid table foods.
How to keep blender cool?
Wash your counters, and wash your blender. Do the things you would normally do in keeping your food preparation areas clean. Moreover, it is important to keep perishable foods cool once they are blended. Blends need to be refrigerated and kept cool with heavy duty ice packs on-the-go or overnight.
Can tube feeders taste food?
We have heard from older tube feeders that they are sometimes able to taste foods that are fed to the stomach. A number of parents report that children who move to a blenderized diet show greater interest in eating orally. It may be an alternative when there are issues with getting formula covered by insurance.
Does feeding food normalize tube feeding?
Some parents feel that feeding food “normalizes” the tube feeding experience.
Is blender tube feeding good?
While there are many different tube feeding approaches, the option of blenderized tube feeding is becoming increasingly popular. With blenderized tube feeding, you can have fresh homemade meals, and experience health benefits such as better tube feeding tolerance and bowel regularity.
Would I benefit from a blended diet?
If you feel that you or your tube fed loved one may benefit from a blended diet, talk to your health care team . Remember that it’s not unusual for clinicians to have limited experience with blenderized tube feeding and may be hesitant for you to try it. When having these conversations, be sure to express how important it is to you that the option of blenderized tube feeding is explored. Indicate that you are willing to prepare blended food, even though this will require more time and effort. To help reduce concerns of nutritional inadequacy, be open to progressing slowly towards a blended diet. You could suggest starting out by adding just a few tablespoons of blended food to your usual formula. Most clinicians would be agreeable with this cautious approach. Over time, with the support and advice of your health care team, you could incorporate more and more blended food into your diet. Another approach is to use a nutritionally complete commercial blenderized tube feeding product, rather than homemade blended meals. This way, your nutrient intake will be more easily monitored by your health care team. There’s no question that everyone deserves a tube feeding plan that aligns with their personal preferences and health goals. Whether you eat by mouth or by tube, it’s natural to want to make your own choices about what food you consume. Blenderized tube feeding offers a unique opportunity to have a truly personalized diet. The possibilities are endless.
Do Blended Diets Cause Blockages in Feeding Tubes?
If you look closely, you will see a blockage in this feeding tube. Don't worry, the cause of this blockage was not blended food, it was crushed Tylenol that clumped together in the tube.
Blenderized Tube Feeding Research Breakthrough
I mentioned a recent study that showed that there were no tube blockages with the use of blenderized tube feeding over a two year period. What I didn’t mention above is that this was my study.
Study Design and Findings
We then proceeded to design a study where we would review the medical records of all the ALS clinic patients who had used blended food for tube feeding at home over a two year period.
Why Were There No Feeding Tube Blockages?
It’s important to keep in mind that all the subjects in this study were adults and therefore their feeding tubes were fairly large. Their tube sizes ranged from 14 to 24 French, with most people having a 20 French sized tube.
Another Reason Why Blockages Are Rare With Blends
A final consideration as to the rationale for the absence of feeding tube occlusion in my study is that most subjects received education from a registered dietitian on how to properly prepare blended meals. Generally this would include advice on what texture and viscosity to aim for and how to strain blends if needed.
How long can you freeze BTF?
While some caregivers choose to blend each meal separately, it may prove less laborious and methodical to prepare 1 day's worth of BTF split into several bolus feedings. Once greater confidence is achieved, batches for several weeks may be prepared, frozen, and stored in air-tight glass containers in a large freezer space later thawed for use. For optimal nutrient retention, freezer temperature should be 0°F or lower with storage time ideally not exceeding 3 months ( 23 ).
What foods blend easily?
Foods that blend easily include cooked cereals, quinoa, avocado, most fruits and vegetables, fresh meats, nut butters, eggs, and milk and should be chosen according to individualized needs and cooked to safe minimum temperatures ( 21 ).
What labs are needed for BTF?
Laboratory work-up involving basic labs such as comprehensive metabolic panel and complete blood count is recommended at baseline. If the patient is on proton-pump inhibitor therapy, consider ordering magnesium as these drugs have been shown to impact absorption, depleting serum levels. Phosphorus and 25-hydroxyvitamin D labs provide insight into overall bone health, which may be compromised if a patient is wheelchair-bound or taking a corticosteroid. Pre-albumin provides context to a patient's overall nutrition status, and if malnutrition is suspected, the gastroenterologist may consider obtaining serum zinc and a triene/tetraene ratio to evaluate for essential fatty acid deficiency. These labs may be repeated at designated intervals based on the patient's clinical response and the provider's clinical judgement.
Does BTF help with weight loss?
In another study that surveyed 125 children, no weight loss was observed in 90% on a BTF regimen compared to 66% on a standard enteral formula ( 5 ). In addition to improved GI symptoms and weight maintenance, a final cardinal benefit of BTF is the opportunity to comply with the updated 2015 Dietary Guidelines recommendations by providing a nutrition source with less added sugar than a standard commercial formula, many of which feature sugar and corn maltodextrin as main ingredients on the nutrition label ( 4,16 ). By avoiding these food additives, it is postulated that a patient's overall immune system may be more resilient as recent studies have found parallels between maltodextrin and suppressed intestinal antibacterial defenses, making cells more susceptible to Salmonella and other harmful bacteria ( 17 ).
How to provide tube feeding?
Syringe feeding is the most inexpensive way to provide tube feeding because feeding bags aren’t required and you do not need a pump. Pumps are very expensive to buy and the cost of the disposable pump feeding bags or gravity bags adds up to a lot of money over time. For syringe feeding, all you need is a syringe, and syringes are cheap. Syringes can be washed and reused over and over again, so their cost per use can potentially be very low, particularly if you use a long-lasting syringe, such as an O-ring syringe (more on O-ring syringes later in this post).
How to feed a tube?
All you have to do is draw up blended food into the syringe and then attach it to the feeding tube and slowly infuse it by pressing down the plunger. The other way to administer tube feeding by syringe is the “funnel method” where you remove the plunger from the syringe and attach it to the feeding tube and then slowly pour thin fluid or water into the syringe. This method doesn’t work with thick blends and some people find that even thin fluids don’t necessarily flow down their tube. So, the funnel method may be worth a try, but keep the plunger handy and revert to the plunger push method if needed.
Who Is A Candidate For Syringe Feeding?
When a person is able to tolerate bolus feeding (meals vs continuous infusions) delivered by pump or gravity , they usually tolerate syringe feeding too. Tube feeding by syringe involves the infusion of food or formula into the tube by pushing on the plunger of a filled syringe. The plunger can be pushed very slowly or very quickly. I advise that aiming to take about 10 seconds to push the contents of a full 60 mL syringe into the feeding tube is an appropriate rate for most people. With syringe feeding, food or formula passes quite quickly into the tube compared to the other feeding methods. I’ve seen adults syringe feed as much as 600 ml of formula in as little as 15 minutes. It sounds ridiculously fast, and it is, but if you think about how much an adult can comfortably eat in one sitting, it's not as surprising.
How many syringes should I use for feeding my baby?
Some people find this process very tedious, particularly if they need to consume a lot of food or formula in order to meet their nutrition needs, For example, if a parent needs to feed their child about 600 mL of blended food each day, that's about 10 full 60 mL syringes, plus the water flushes before and after each feed. That's not too bad and wouldn't be terribly time consuming. However, if you are an adult who needs 3000 mL of food each day, that's 50 full 60 mL syringes! 50 times drawing food up into the syringe and attaching it to the feeding tube and pressing the plunger. I consider this a big potential drawback of syringe feeding, but there are some ways to get around this.
How to administer tube feeding with a syringe?
The other way to administer tube feeding by syringe is the “funnel method” where you remove the plunger from the syringe and attach it to the feeding tube and then slowly pour thin fluid or water into the syringe.
What are syringes used for?
In the hospital, inexpensive plastic syringes are used for tube feeding medication administration, water flushes and sometimes administration of tube feeding. These syringes are thrown out, in the garbage, every day. In the home setting, syringes can be reused.
What are the three methods of tube feeding?
There are 3 methods of tube feeding blended food: pump, gravity and syringe. I've already written a blog post all about pump infusion of blended food, so take a look at that if you’re interested. In this post I’ll be going over syringe feeding in detail, including why syringe feeding is a good option for tube feeding blended meals.
