Commercially produced complete nutritional formulas (CFs) are commonly delivered to children requiring enteral nutrition via gastrostomy. However, a cultural shift toward consuming a more natural diet consisting of whole foods has caused the use of blenderized tube feeds (BTFs) to grow in popularity among parents and carers in recent years. There are advantages and disadvantages of both BTF and CF use. There is evidence that suggests that BTFs can significantly improve tube-feeding tolerance and reduce gastrointestinal symptoms associated with tube feeding, such as gagging, retching, and constipation, thereby resulting in an improved quality of life (QoL) for enterally fed children and their caregivers. BTFs have also been implicated in increasing the diversity of the gut microbiota in enterally fed children. However, concerns have been raised that BTFs may be inferior to CFs in energy and nutrition sufficiency. Issues such as microbial contamination, tube blockages, and difficulties in preparation and administration may also complicate the use of BTFs. Additionally, like CFs, BTFs can vary significantly in nutrition composition, and dietitian involvement with BTF use is crucial. The current literature on the clinical outcomes of BTF use is limited, and further research is needed before recommendations can be made on BTF use in children. A literature review was conducted to compare clinical outcomes between BTFs and CFs and evaluate the feasibility of BTF use in children.

Exploring Clinical Outcomes and Feasibility of Blended Tube Feeds in Children.

Objective: To analyze scientific evidence on the use of blenderized tube feeding in children regarding nutritional composition, family satisfaction, and health outcomes. Data source: Survey was conducted in the PubMed, Scopus, Embase, and Virtual Health Library (VHL) databases using the following search terms: blenderized tube feeding OR blended tube feeding OR homemade OR pureed AND enteral nutrition AND enteral tube. The methodological quality of the selected articles was evaluated using the Critical Appraisal Skill Programme and Hierarchical Classification of Evidence. Data synthesis: After analysis, 11 articles were included in the present review. Most studies demonstrated improvements in health outcomes and greater family satisfaction after replacing the commercial enteral feeding with blenderized tube feeding. Conclusions: When guided and monitored by the healthcare team, a blenderized tube feeding ensures an adequate nutritional composition. The use of this method is also associated with positive health outcomes such as reductions in gastrointestinal symptoms and hospitalizations. Moreover, a high frequency of family satisfaction was verified.%

Blenderized tube feeding for children: an integrative review.

Abstract Background The use of homemade tube feeding formula has become increasingly popular for children requiring enteral nutrition. This project aimed to investigate nutrition and preparation of blenderized tube feeding in the field of children and adolescents with neurological impairment. Methods A scoping review was performed using established methodologies. In January 2021, we searched PubMed, Embase, CINAHL Complete, the Cochrane Central Register of Controlled Trials, and gray literature to identify relevant articles. Major findings Twenty‐two papers were included describing the composition of food items, preparation procedures, and food safety. No randomized controlled trials and only a few prospective studies were included. A broad variety of food items from all food groups and many examples of recipes were presented. Most recipes provided 1.0 kcal/ml but tended to contain less energy and nutrients than expected, which could be due to preparation issues, such as sieving and the high viscosity of the blend. Preparation requires a commercial‐grade household blender and diligence to ensure thorough household hygiene for adequate food safety. Conclusions This review revealed practical experience in the nutrition and preparation aspects of blenderized tube feeding but minimal empirical evidence. Multiple examples of the composition of food items and preparation procedures for blenderized tube feeding were found, but uncertainty regarding the ideal composition or preparation was also exposed. The future of blenderized tube feeding would benefit from clinically tested recipes that include an evaluation of nutrients, viscosity, and microbial contamination, as well as the effect of the food's appearance and scent on the target group.

Nutrition and preparation of blenderized tube feeding in children and adolescents with neurological impairment: A scoping review

During the last few years, there has been an observed increase in the demand for blenderized tube feeding (BTF) in the outpatient setting among the caregivers of children suffering from chronic illnesses. This study aimed to assess the clinical and biochemical effect of BTF on children's general health and determine the psychosocial effect of this feeding type on their families.This monocenter, retrospective study was conducted at the pediatric department of Rouen Hospital, France, and included ten children receiving a blended diet via enteral feeding tubes. Data were collected from the patients' profiles and by interviewing the caregivers to evaluate the clinical effects of BTF and its psychosocial effects on caregivers. Additionally, patients' medical records were reviewed for their nutritional status by assessing anthropomcetric measurements and biochemical markers recorded during follow-up visits.Ten patients were included (mean age, 6.2 years), and the mean BTF duration was 2.8 years. The patients were fed either homemade or commercial puree. Upper gastrointestinal symptoms such as vomiting improved rapidly after the introduction of blended food in six children (60%), where four experienced complete symptom regression and two showed marked improvement. Similarly, gagging and retching were alleviated in all cases. Diarrhea was alleviated in all cases, whereas constipation improved in three out of four patients. The families were satisfied with using natural BTF; however, caregivers cited the time taken to deliver blended food via syringe as a disadvantage.We observed an improvement in gastrointestinal symptoms after the use of blended feeding by gastrostomy. Additionally, BTF had a positive psychological effect on caregivers. 

/pdf/outcomes-of-blenderized-gastrostomy-feeding-in-children-at-3sbly08g.pdf

Outcomes of Blenderized Gastrostomy Feeding in Children at Rouen University Hospital

Prior to the 1970s, blending food and liquids and putting them through an enteral access device (EAD) was the most common form of enteral nutrition (EN). However, in the 1970s, blenderized tube feedings (BTFs) became less popular due to the emergence of modern commercial enteral formulas (CEFs). Recently, a cultural shift toward consuming a natural diet, consisting of whole foods, has led to a resurgence in the use of BTF. The increasing use of BTF in a variety of patient care settings identifies a need for practice recommendations that provide guidance for nutrition professionals and patients. Members of the American Society for Parental and Enteral Nutrition (ASPEN) Enteral Nutrition Committee identified salient clinical questions concerning BTF, conducted a comprehensive literature search, and subsequently developed practice recommendations pertaining to the use of BTF. This paper was approved by the ASPEN 2022-2023 Board of Directors. 

Blenderized tube feedings: Practice recommendations from the American Society for Parenteral and Enteral Nutrition.

Although commercial enteral formulas have been available on the market for several decades, a cultural shift toward consuming unprocessed foods with minimally added sugar has sparked interest in the preparation of home blenderized tube feedings for enteral feeding-dependent patients. Recent surveys, however, indicate lack of clinical awareness or familiarity in the management of this method of nutrition support. This article aims to equip the gastroenterologist with a guide for initiation, monitoring, and evaluation of a blenderized tube feedings regimen, and provides insights into an opportunity for greater partnership between the gastrointestinal provider and registered dietitian.

Home Blenderized Tube Feeding: A Practical Guide for Clinical Practice.

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Home Blenderized Tube Feeding: A Practical Guide for Clinical Practice.