Blended tube feeding - three new presentations separate myths from facts
Last year I met Amanda, the parent of an 11-year-old girl with cerebral palsy who was entirely tube fed. But her daughter had failed to thrive on commercial tube feeds - she vomited, had severe, painful reflux and was constipated.
After some googling, Amanda discovered that blending her own food might be an alternative to commercial feeds - but while her daughter’s hospital was sympathetic, its policy meant it couldn’t provide any support for trialling a blended diet.
Amanda’s story made me consider the role of dietitians in supporting clients who’d like the option of a home-prepared blended diet.
Amanda went on to have better luck with a nutritionist who, although unfamiliar with blended diets, was willing to help plan blended meals - and within a few weeks of having home prepared food, her daughter’s gastrointestinal symptoms resolved. She gained weight, her skin colour changed from pale to pink and she was much happier.
Our modern commercial tube feeds have been instrumental in the survival of our enterally fed clients - and have come a long way from the first tube feeds created in hospital kitchens, using combinations of pureed and strained foods, powdered milk, raw egg and added vitamins and minerals.
But now some of our long term clients and their carers want a choice. They’re asking questions. Can carers prepare blended food themselves? Is it safe and can it provide all the right nutrients? The answer is yes, yes, yes! But many dietitians, including me, lack the confidence and practical skills to help with blended tube feeds.
To learn more, I contacted Dr Sarah Durnan, a Specialist Paediatric Dietitian in the UK who works clinically with children who are enterally fed, and is doing post-Doctoral research on the use of blended diets in enteral feeding. She is lead author of the 2019 British Dietetic Association (BDA) Policy Statement: The Use of Blended Diet with Enteral Feeding Tubes, and the BDA Practice Toolkit to be published later this year.
She was happy to help but when her presentation went on hold last year due to COVID 19 , I spoke with Lina Breik, APD whose private practice, Tube Dietitian specialises in enteral feeding. According to Lina, more and more people are asking about blended home prepared foods - and they all come up against the same problem: hospital policies that prohibit supporting the use of blended foods.
To find out more about blended tube feeds, Lina contacted Canadian dietitian Claire Kariya, who’s been supporting blended tube feeding with clients for over 15 years. Lina and Claire have both agreed to present on this topic for Education in Nutrition - and with the UK’s Covid-19 crisis easing, Sarah has been able to help us too.
We now have a series of three presentations on blended tube feeding. These will give us understanding and confidence in the management of blended tube feeding.
- The first is Dr Sarah Durnan looking at why blended diets are becoming popular as an option for tube-fed children and young people, and how to create a blended diet meal plan with parents and carers.
- Lina Breik and Claire Kariya will present from an adult client perspective looking at client suitability, some of the common myths around blended diets, then provide us with some very practical guidelines around creating nutritious blended meals.
- Lina and Claire will also each present a case study to highlight their decision-making and troubleshooting with these clients.