Blended Food Recipes For Tube Feeding

One Familys Mission To Disrupt The Feeding Tube Nutrition Market One Blended Meal At A Time

For Real Food Blends co-founders , using a Vitamix blender for family meal preparation was not a lifestyle choice it was a life-saving measure.

After being a somewhat typical breast-fed baby, at six months old, their son, AJ, suffered a 45-minute seizure. After a series of tests, doctors informed the Bombacinos that AJ had brain malformations of his cortical development, he may never walk or talk, and his life would certainly never be normal. The Bombacinos faced this difficult reality as AJs seizures continued. To make things worse, soon after this seizure, he struggled with what was thought to be severe, worsening reflux. A swallow study brought more difficult news: AJ needed a feeding tube for 100 percent of his nutrition immediately.

For three months, the Bombacinos fed AJ traditional commercial formulas through his feeding tube, and for three months, AJ threw up five to 10 times per day, sustained regular seizures, was barely sleeping and experienced formula intolerance side effects like diarrhea, constipation, irritability and failure to thrive. The Bombacinos worked with registered dietitians and gastroenterologists to implement a variety of possible solutions, including a low-protein formula, a high-protein formula, low-fat formulas and even 24-hour feeding but nothing seemed to work.

Thanks to the power and ease of our Vitamix blender, we were able to quickly experiment with different food blends and take back some control.

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Whether You Or Your Loved

Food is always better shared, so I do my best to design recipes and meal plans that are composed of foods that are both enjoyable to eat and convenient to feed by tube.

Staple ingredients for a variety of tube fed breakfasts include- oats, juices, yogurt, eggs, greens, nut butters, toasted bread, fruit, milk, cereal, muffins

Youll be amazed how simple it is to create a balanced blenderized breakfast in no time. Before blending, make sure you set aside a portion for your friends or family who eat by mouth so that everyone can enjoy the meal together.

You can blend your usual breakfast favourites, or try something new. An easy option is pureed oatmeal. Throw in some fruit for extra vitamins and don’t forget the protein. Use milk instead of water as milk is a protein-containing liquid. For a big protein boost, consider adding eggs. A raw egg can be added to the oats when they are still piping hot and it will cook from the heat of the mixture. Then transfer the mixture to the blender, add milk or juice and blend until smooth. Or, you can scramble an egg or two and add them into the cooked oats before blending. For an easy plant-based protein boost, add a tablespoon or two of nut or seed butter. Bonus- nut butter provides healthy fat, an important nutrient to include for a balanced meal.

Choosing And Preparing Food

Blenderizing foods is easier than you might think and many foods can be used. 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.

Foods that are popular for blending include sweet potatoes, bananas, quinoa, avocado, oats, nut and seed butters, chicken, yogurt, kefir, various grains, and milk . 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.

General food safety principles are very important, especially if the person using tube feeding has compromised immune function. As with any food preparation, hand washing is essential, and fresh vegetables and fruits and dried legumes should be carefully cleaned to remove any soil, microorganisms, and other contaminants. Dried legumes should be inspected for small pebbles prior to cooking.

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Commercial Ready To Use Blenderized Tube Feeding Products See Table 3

• Liquid HopeTM. Ready to use organic whole foods. The manufacturer recommends switching to Liquid HopeTM slowly, one meal per day until the transition is complete. The unopened formula is shelf stable for up to 2 years. It has a 3-hour room temperature hold time and unused formula can be refrigerated for 48 hours. The formula can be diluted with water to achieve the desired consistency. Patients can order online . Medicare approved code for this product is B4149 .http://www.functionalformularies.com
• Real Food BlendsTM. Pre-made blenderized meals, available in 3-meal varieties and is shelf stable for 18 months. Unused formula should be refrigerated and used within 24 hours. The quinoa meal is slightly thicker and may require additional fluid to flow easily. Patients can order online approved by CMS HCPCS for code B4149 .
• Compleat©. Formulated with real food ingredients: chicken, peas, carrots, tomatoes, and cranberry juice. Available in 250 mL carton and 1 liter closed system. HCPCS code B4149 . http://www.nestlehealthscience.us/products/compleat

An Introduction To Talking Tube Feeding Blended Diet Recipes

Contributing expert: Cath Fogarty, Specialist Paediatric Dietitian

Nice to meet you

Welcome to this collection of easy cook recipes for a blended diet . My name is Cath and I am a dietitian working with children who require enteral feeds. I also have a background in cooking as I trained and worked as a chef for over 10 years.

Before you get started

Please discuss your decision to start a blended diet with your local dietitian. They are best placed to advise on the suitability of BD for your child. They can also help with suitable BD portion sizes based on your childs nutritional requirements alongside current commercial feeds and will be the best person to assist in terms of reducing any commercial feeds.

Housekeeping

Good food hygiene, preparation and storage is essential.

• Ensure clean work surfaces throughout.
• Always wash your hands thoroughly before cooking, after handling raw meat and frequently during food preparation.
• Once cooled and if not using immediately, store cooked blends in an airtight container in the fridge or freezer and label and date. Freezing instructions are provided for each recipe.
• Use blends stored in the fridge within 24-48 hours.
• Clean all equipment used including the blender, chopping boards etc after use.
• Discard any leftovers of fresh or defrosted blends.

Designed for you

Ingredients

A note on portions

Unless stated otherwise, each recipe is a single adult portion.

Batch cooking

Blending, liquid and preventing tube blockages

Enjoy!

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Use Of Blenderized Tube Feeding

BTF is defined as the use of blended foods and liquids given directly via the feeding tube. Historically, these types of enteral formulas have been called blended diet, blenderized feeding,blended formula,or homemade blended formula. The practice of incorporating BTF into a feeding regimen could be a combination of a commercial formula and commercial pureed baby food, or three meals a day of homemade blenderized foods supplemented by nocturnal feeding of a commercial formula, or complete feedings using homemade BTF made from recipes, and many variations in between. The introduction of ready to use BTF in the marketplace has also provided HEN patients with an option over commercial enteral formulas. Regardless of how a patient uses BTF, it is essential to identify a commercial enteral formula for emergency situations, or when traveling when refrigeration is not available.7

There is little published research available to support the efficacy of BTF that translate into any type of beneficial outcomes of this feeding technique. There are numerous anecdotal reports from patients, caregivers, and medical professionals of positive experiences that have been shared through informal patient questionnaires, feeding support groups on the internet, social media, professional discussions and clinical experiences.5-9

I Currently Have A Nutrition App What Makes This One Better

There are many other nutrition apps, yet they all lack key components people in the tube feeding community need. This app has what we need for our unique health conditions. For example, it has fully customizable, child and adult nutritional profiles. It can help calculate how many calories a day you need at a certain age, and how much water per day. Not only that, this app is made to be more affordable. This app has it all!

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Welcome To Growing Independent Eaters A Woman

Our founders have lived the feeding-tube journey themselves, and we understand the need for passionate experts to support families through their questions, concerns, fears, and ultimate triumphs. Our goal is to provide parents of tube-fed children a path towards joyful, relaxed oral eating while providing the support their families need throughout the process: whether you’re just beginning, in the middle or near the end of a wean, we are here to help you succeed.

Tips For Food Safety And Preparation With Btf:

• Have a minimum of two nonporous cutting boards on handone for raw meat, fish, and poultry, and the other for fresh fruits and vegetables. The advantage of plastic or glass is they can be run through the dishwasher.
• Replace a cutting board if it becomes nicked, chipped, cracked, or broken.
• Keep your blender clean by following manufacturers instructions carefully.
• Home blended formula is good for up to 48 hours in the refrigerator.
• If you have made a big recipe you can freeze it in canning jars, or glass or plastic containers. Remember to fill containers two-thirds full as the contents will expand once frozen. Ice cube trays are a useful way to freeze your food blend in small convenient portions.
• Never place frozen food on your countertop or in hot water to defrost. The outside of the food blend will thaw out and reach a warmer, unsafe temperature sooner than the inside. This will leave time for bacteria to grow.
• Do not leave home BTF out of the refrigerator for greater than 2 hours.
• You may want to have a back-up formula available for those days when you are not feeling well or need to travel, or cannot blend for other reasons.
• If you are trying to eat orally but cannot finish your meal, throw the leftovers in the blender as an addition to your regular recipe.
• Determine how much your blender makes before starting a recipe. For example, your blender may make 4 to 4 ½ cups at a time.

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How I Blend Now

I dont freeze much. I typically blend enough for 2 days at a time , and then blend again on the evening of the 2nd day. Ill make 2-4 recipes and repeat those for the 2 days.

I usually do a fruit oatmeal based recipe for breakfast, alternating what fruits I use depending on what I have/whats in season. For the mid-morning feed, I do scrambled eggs and toast, or an egg omelette, or more of a lunch recipe like a sandwich and milk, soup, etc. For the late-afternoon and dinner feeds, I usually do more dinner-type food .

I store the blends in 500ml glass Mason jars, about 400ml worth which is enough to feed both boys .

Now that Ive got the hang of what works for our family, its easy and fun to blend meals for them! Not always easy to fit in the time to cook the items in the first place , but Im making it work.

Do you do a blended diet? Whats your style or go-to recipes?

When To Consider Blenderized Tube Feeding

Table 1 outlines the prerequisites before seriously considering the use of BTF. Ideally, a clinician must first determine if a patient is a good candidate for BTF. However, a tube-fed patient may already have transitioned to either partial or full homemade BTF regimen before a referral is made. Working with a dietitian is essential to ensure that the homemade diet is adequate and whether the current homemade BTF recipe plan needs modification. The best candidate is a patient and/or caregiver who made the decision to try this feeding option, and is willing to commit their time and effort for instruction and preparation of BTF. A patient who is having tolerance issues or allergy to a commercial enteral formula may also be a candidate after discussion with the medical team and dietitian.

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Is A Blenderized Diet Right For Your Child

There are many factors to consider when deciding if a blenderized diet is the right choice for your CP child.

Pros:

• Diet can be customized for taste and nutritional need
• May be more cost effective then commercial formulas
• May be better tolerated then commercial formulas
• Can be customized to include a food group rich in any nutrients found lacking

Cons:

• May not provide all vitamin, mineral, fiber, hydration and caloric needs
• Requires close monitoring and supervision by a dietician or nutritionist
• More time consuming than commercial diets

Blenderized Tube Feeding: Suggested Guidelines To Clinicians

Blenderized tube feeding has been gaining momentum among patients despite the availability of commercially prepared and nutritionally complete enteral formulas. This article will review perspectives and provide clinicians with basic guidelines for planning and implementing blenderized enteral feedings when our patients request this feeding option.

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What Is A Blenderized Tube Feeding

Instead of using a formula, theres an option to blend whole foods in a blender and use that instead.

My rotation in private practice allowed me to learn so much about this option, and I even got to develop a recipe to give to her daughter!

There are definitely some pros and cons when it comes to choosing blenderized tube feeding:

What Is Blenderized Tube Feeding

Blenderized tube feeding refers to foods and liquids that are blended and pushed through a feeding tube. This is an alternative to using packaged enteral formulas to feed your child.

The use of BTF has become increasingly popular in recent years. One major reason parents choose to use blended tube feeding is for increased control over what is going into their childs body. The problem is that without proper planning, you risk not achieving complete nutrition for your child.

With the full support of our team and a dietitian at your side, transitioning to homemade blended tube recipes can be a safe, fulfilling way to feed your child.

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Getting Started With A Homemade Blenderized Tube Feeding

• Evaluate the patients medical history, success with current feeding regimen , food tolerances, lifestyle/ethnic/religious preferences, ability to obtain individual ingredients and tools needed for preparing a homemade BTF.
• Discuss with medical team and determine if patient is ready to start the transition. Most patients transition slowly and use a commercial formula for part of nutrient requirements.
• Determine goals for calories, protein, fluids, and vitamin, mineral, and electrolyte supplementation.
• Develop a meal plan and starter recipe. The following tools can be used as starting point to create a meal plan based on caloric goals:
• USDA Choose My Platehttp://www.choosemyplate.gov/supertracker-tools/supertracker.htmlThe supertracker feature provides individualized worksheets where a profile can be created to calculate and track a menu plan. A sample 1000 calorie meal plan will include:
• Grains: 3 servings
• Protein : 2 servings
• Milk or milk substitute:2 servings
• Fats: 3 servings

How I Transitioned My G

I knew from the beginning of our tubie journey that if the boys were still being tube fed by 12 months old , then I was going to blend them real food. This is how I did it!

Before I start, I should add that I am not a doctor, dietician, etc and what works for my kids may not work for yours, or be appropriate for certain medical conditions, or whatever. So, dont take this as medical advice.

Now that those disclaimers are out of the way

As the boys approached 12 months corrected age, I became antsy to figure out how I was going to switch them to real food, since it was apparent oral eating was not going to magically happen by then. We had been in feeding therapy for 9 months at that point with zero progress, though thats a topic Ill write about another time. Without going into details, our eating team we saw regularly was/is a huge source of anxiety and stress for me, doesnt act in the best interests of my children, and honestly made me so angry many times for various things, including pushing these tube formulas on me without being able to answer what the ingredients are, why real food would not be better, how to get started with real food blending, or literally any logical reason why they shouldnt have real food.

ANYWAY. This isnt about my anxieties around feeding therapy, though I could write a novel on that!

I was determined to feed the boys real food after they hit 12 months corrected, just as most people do with their typical kids .

Theyll LET ME KNOW.

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How I Switched Them To Blended

OK, so now getting to the actual point of the post. Here is step by step how I did it. Of course this may not work exactly the same for your child/children, but I hope it at least helps serve as a place to start researching blended diets, the benefits, and how easy it is once you get past that initial switching period!

First, I did a lot of research for HOW to blend. It sounds silly. Just throw food into a blender and hit blend, right? NO MY FRIEND. NO. You need to know the best kind of blender to get , what kinds of things dont blend well , troubleshooting blends that are too thick/thin, how to get it to run through your pump, etc.

Here are my favourite places to research:

Crunchy Tubie Mama she writes a lot about Nestle, Abbott and writes the truth about their products. Also provides great tips to get started blending and coaching services. I hired her to help transition the boys over and it was really helpful!

Blenderized RN Veronica has a YouTube channel and . The Facebook group is SO VALUABLE. Everyone is helpful and I learned so much about blending from there. You NEED to be in there!

After getting familiar with blending, I played around trying to make recipes to meet their calorie and macro goals OBSESSIVELY . Then, I got fed up with that bullshit and bought the recipe book from Natural Tube Feeding instead. LIFE SAVER.

Then I entered what I will now refer to as the 2 Weeks of Hell.