Blended diets for gastrostomy fed children and young people: a scoping review

Abstract

There were gaps in the evidence base regarding the impact of blended diets on the health and well-being of the children who receive them and upon the carers who feed the children. The nutritional impact of blended diets is not fully understood and the knowledge and views of professionals involved in the care of those receiving blended diets varies.

Efficacy and Tolerance of Blended Diets in Children Receiving Gastrostomy Feeds

“…We noted that 21% of our patients developed mild constipation, but these symptoms did not cause any caregiver to discontinue the blended diet and resolved after dose adjusting PEG for each patient. Although the development of constipation has not been reported previously, this symptom was not formally assessed in other studies . Another study noted decreased stool output in children with intestinal failure and diarrhea when they received blended diets .…”

“…In the case of homemade diets, the preparation of the foods provides the caregivers the opportunity to nurture their child and participate more actively in the child's care. Alternatively, there are medical providers who oppose the use of blended diets due to safety concerns and nutrition variability . The contamination of blended diets with bacteria and coliforms at the time of preparation has been reported—with bacteria number increasing geometrically in the hours after preparation, predisposing patients to significant risk of foodborne illnesses…”

“…Previous studies have reported positive clinical outcomes with the use of blended diets, including reduced gagging and retching in gastrostomy‐fed children with fundoplication, and decreased stool output in patients with intestinal failure and chronic diarrhea . Additionally, a recent study reported that pediatric patients previously fed standard enteral formulas acquired a more diverse microbiome when switched to blended diets .…”

“…Additionally, a recent study reported that pediatric patients previously fed standard enteral formulas acquired a more diverse microbiome when switched to blended diets . Regardless of this emerging data, there is still hesitancy on the part of some medical providers who consider blended diets substandard and unsafe because of inadequate strong evidence for potential benefit, nutrient variability, and potential risk of foodborne illnesses …”

Celebrating international dietetic research

“…Our clinical nutrition portfolio has included a strong series of papers on renal nutrition, ranging from qualitative evaluations of how renal nutrition guidelines can be integrated into normal family life , to data providing evidence that female patients are at greater risk of sarcopenia in haemodialysis than males . For nutritional support and monitoring, we have published papers on the use of blended diets for gastronomy fed children and the successful use of novel smartphone applications for following up patients following bariatric surgery . Highlights in our paediatric portfolio for this year have included the demonstration of ethnic differences in infant feeding styles, which may associate with weight gain and future feeding behaviours ; a reflection on the challenges of weaning infants with phenylketonuria, where phenylalanine‐free protein substitutes play an important role ; and an evaluation of appropriate nutritional risk scoring tools for use with children with acute burn injuries .…”