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Dietitians Offer Sample Recipes and Helpful Hints for Blenderized Tube Feeding
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Carol Ireton-Jones, PhD, RDN, LD, CNSC; Karen Martin, MA, RDN, LD, FAND; Vicki Emch, MS, RDN, CNSC; Cynthia Reddick, RD, CNSC; Lisa Epp, RDN, LD, CNSC; Vanessa Carr, MS, RDN, LDN

Note: This information is not meant to replace your physician or dietitian’s recommendations. Before starting a homemade blenderized tube feeding regimen or replacing your current prescribed feeding regimen, talk with your clinician to assure that this is the right choice for you, your specific nutrition goals, your family, and your lifestyle.

 

               There are many types of tube feeding products or formulas. Traditional tube feeding products (examples are Jevity, Ensure, Boost, Peptamen) have all the known vitamins and minerals added to the formula. They may also have special additives, or special characteristics, such as specially broken-down proteins, carbohydrates, and fats for maldigestion, or additional nutrients. Traditional tube feeding formulas are typically packaged in 8 oz containers and provide between 250 and 500 calories per container, depending on the concentration of the formula prescribed.

 

               Blenderized tube feeding (BTF) refers to commercially available products and homemade blends made from real food ingredients blended to a consistency that can be fed through a feeding tube. Examples of commercially available BTFs are Compleat (Nestlé Nutrition), Liquid Hope and Nourish (Functional Formularies), Real Food Blends (Real Food Blends), Core Essentials and Peptide Plus 1.5 (Kate Farms). Note that Real Food Blends is considered a “meal replacement” and is not nutritionally complete; this BTF can be used to complement a commercial or other blenderized formula.

 

               Some people who use tube feeding at home would like to make their own food-based tube feeding. The information that follows will provide some helpful hints and sample recipes for those who do. Always check with your physician and Registered Dietitian Nutritionist (RDN) to make sure that the food-based formula you make meets your clinical needs and can be administered through your feeding tube.

 

Getting Started

               You will need a great blender! High-powered blenders lessen the need to strain the blend. Examples of high-powered blenders are: Ninja (www.ninjakitchen.com); HP3, Total Blender, or equivalent by Blendtec (www.blendtec.com); and Vita-Mix 5000 or equivalent by Vita-Mix (www.vitamix.com). After the formula is blended, you might need a strainer to remove bits and pieces that may clog a tube. A crockpot is helpful for cooking grains, legumes, sweet potatoes, etc.

 

               Practice good food safety habits in preparing the blend. Food safety practices are essential in any food preparation but are particularly important when preparing home BTF. Start with a clean work area, clean hands, and fresh food. Avoid raw or undercooked meats, fish, eggs, or poultry. For more tips, as well as updates on recalls, etc., check out www.foodsafety.gov, www.fightbac.org, or www.cdc.gov/foodsafety. It may take a short while to develop a routine, but preparation time decreases with experience.

 

               Remember that you can combine BTF and commercial tube feeding products. This can ease some of the burden of preparing, cooking, and blending your food every day.

               The table below will help you evaluate the pros and cons of the different types of nutrition. Working with your dietitian and physician, you can choose what works best for you.

 

Nutrition

               How many calories do you need? How much protein? Do you have any limitations of fat, carbohydrate, or volume? How often do you tube feed? What type of nutrition (home BTF, commercial BTF, or traditional formula) is best for you? The USDA resource Choose My Plate (www.choosemyplate.gov/MyPlate-Daily-Checklist) can be used to determine calorie levels and mix of nutrients to assure nutritional adequacy for enteral consumers who enjoy blended foods.

 

               Here are some tips using the example of 1,800 calories per day, with 80 grams (g) of protein:

  • You do not have to get exactly 1,800 calories and 80 g of protein every day! Some days you may not feel as well and will “eat” less, and other days you may be hungry and “eat” more.
  • Many people like to divide their feeding into three “meals” per day and a snack. You can divide it any way that works for you.

Example 1: 1,800 calories divided into four meals, each containing 450 calories

Example 2: 1,800 calories divided into three meals, each containing 500 calories, and one snack of 300 calories

 

Tips:

  • You can weigh meat and other ingredients on a food scale.
  • Cool cooked eggs before blending (warm blends best).
  • Fruits with small seeds are difficult to blend.
  • Oatmeal can be ground to powder before it is cooked to make it smoother when blended.
  • For vegetables, rotate carrots, green beans, broccoli, asparagus, kale, etc. Cool them before blending.

Tips for Food Safety and Preparation with BTF:         

  • Have a minimum of two nonporous cutting boards on hand—one 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 manufacturer’s 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.

 

Tips for Feeding with BTF:

  • The recommended method for BTF is bolus feeding with a syringe.
  • Since home blended and commercial BTFs have a thicker consistency, it is recommended to have 14 French or larger feeding tube to prevent tube clogs.
  • When starting on BTF, it is best to start slowly and transition over a few days. Begin with ½ of your standard tube feeding formula and ½ of BTF. Continue this for a few days. If you have not had any tolerance issues, then continue with ¼ and ¾ combination, and finally graduate to 100% homemade BTF.
  • Homemade BTF may be better tolerated if you have gastric (into your stomach) feeding tubes and have no problems digesting and absorbing intact protein and fat.
  • If you are being fed into your jejunum (through a J-tube or G-J tube), you will need a feeding pump. Use the pump to infuse the BTF SLOWLY. Tube feeding pumps are not designed to push thicker mixtures through the mechanical rotor of the pump and through the tubing (feeding bags) that works with the pumps. Additionally, home BTF should only be outside the refrigerator for 2 hours, which limits the amount of time they should be hanging in a feeding bag.
  • Homemade BTFs are usually more concentrated and contain less water than commercially prepared formulas, so it is important you consume additional water either by mouth or via syringe flushes (before and after tube feedings) for hydration. Since homemade BTFs are thicker, giving some extra water flushes before and after feedings and at various other times in the day will help prevent clogging in your tube and keep you from becoming dehydrated.
  • When blending, remember that well-cooked, warm foods (not hot) blend more easily.
  • To thin a blend, you can use juice, water, broth, milk, or peppermint or ginger tea.
  • Don’t throw away the liquid from cooked vegetables as this nutrient-rich fluid can be used to adjust the desired thickness of the blend.
  • For extra calories, add oils, Karo syrup, dates, heavy cream, and protein powder.
  • If one of your recipes comes out too thin, try adding cooked pasta, cooked potatoes, avocados, or banana to thicken the blend. A nice benefit of a thicker blend is that it can help decrease gagging and reflux symptoms after feeds.
  • You may need more calories when using BTF compared to commercial products. If you are having difficulty getting adequate calories, these high-calorie foods blend well: nuts and nut butters, oils (coconut oil, vegetable oils, MCT oil), avocado, dried fruit.
  • When adding in MCT oil, start with a small amount and gradually increase over multiple days. Adding too much too fast may cause stomach upset.

Additional Resources

This article was inspired by Carol Wilson who has become a home blenderized tube feeding expert by default. When I met with her, she was working hard to assure her husband received the nutrition he needed. It hasn’t been easy, but she has “conquered” the BTF and has been a wonderful resource for me. Carol has provided the sample recipes . Thank you, Carol!

 

 
 

LifelineLetter, September/October 2017

 

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2/13/2020
Delmar NY Tube Feeding/TPN Support Group for Patients & Caregivers

This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.

 

Updated in 2015 with a generous grant from Shire, Inc. 

 

This website was updated in 2015 with a generous grant from Shire, Inc. This website is an educational resource. It is not intended to provide medical advice or recommend a course of treatment. You should discuss all issues, ideas, suggestions, etc. with your clinician prior to use. Clinicians in a relevant field have reviewed the medical information; however, the Oley Foundation does not guarantee the accuracy of the information presented, and is not liable if information is incorrect or incomplete. If you have questions please contact Oley staff.
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