Blended tube feeding prevalence, efficacy, and safety: What does the literature say?

Carter, Holly; Johnson, Kelly; Johnson, Teresa W.; Spurlock, Amy

doi:10.1097/jxx.0000000000000009

Cited by 27 publications

(69 citation statements)

References 18 publications

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“…However, not all patients are candidates for BTF. Patients must be medically stable, use a >14‐French tube, be at least 6 months old, and be slowly transitioned to blended food . BTF typically requires a higher volume to meet nutrient needs, so patients must be able to tolerate bolus feeding.…”

Section: Specific Patient‐related Issues (Tube Weaning Formula Prefementioning

confidence: 99%

“…HEN teams will need to assist caregivers of tube‐fed patients with navigation of school, travel, and potential hospital stays with their BTF. Through initial and ongoing feeding oversight, HEN teams with BTF training can help caregivers avoid the potential pitfalls of whole‐food feeding, including clogged tubes, inadequate nutrient provision, and microbial contamination . Frequent patient assessment and analysis/revisions of BTF recipes by the RDN is of particular importance in pediatric populations in which growth and higher susceptibility to malnutrition impact care.…”

Section: Specific Patient‐related Issues (Tube Weaning Formula Prefementioning

confidence: 99%

“…Patients must be medically stable, use a >14-French tube, be at least 6 months old, and be slowly transitioned to blended food. 53,54 BTF typically requires a higher volume to meet nutrient needs, so patients must be able to tolerate bolus feeding. HCPs should screen patients with metabolic disorders, medical diagnoses, and multiple food allergies that would prevent a successful BTF transition.…”

Section: Formula Preferencementioning

confidence: 99%

“…Through initial and ongoing feeding oversight, HEN teams with BTF training can help caregivers avoid the potential pitfalls of whole-food feeding, including clogged tubes, inadequate nutrient provision, and microbial contamination. 13,53 Frequent patient assessment and analysis/revisions of BTF recipes by the RDN is of particular importance in pediatric populations in which growth and higher susceptibility to malnutrition impact care. Resources are available to assist RDNs with patient screening, transitioning, and oversight.…”

Section: Formula Preferencementioning

confidence: 99%

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Addressing Frequent Issues of Home Enteral Nutrition Patients

et al. 2019

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The home enteral nutrition (HEN) population is a medically diverse group whose number has increased substantially in recent decades. Although medically stable compared with acute care patients requiring nutrition support, HEN population needs are unique and require a team approach to manage nutrition. Frequently encountered issues by the HEN team include mechanical issues of the tube site, gastrointestinal and metabolic problems, and patient preferences regarding tube weaning, formula selection, and compliance. A thorough search of the published literature on how to manage these issues was conducted using scientific healthcare databases with the following inclusion criteria: English only, last 10 years, and reviews and clinical trials. Where appropriate, references from the retrieved articles were hand‐searched for relevant articles older than 10 years and cited in this review. The purpose of this review is to provide the HEN team with strategies to address the top issues of home enteral feeding.

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Section: Specific Patient‐related Issues (Tube Weaning Formula Prefementioning

confidence: 99%

Section: Specific Patient‐related Issues (Tube Weaning Formula Prefementioning

confidence: 99%

Section: Formula Preferencementioning

confidence: 99%

Section: Formula Preferencementioning

confidence: 99%

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Addressing Frequent Issues of Home Enteral Nutrition Patients

et al. 2019

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“…Furthermore, although studies on safety and efficacy are limited, most published work indicates BTF confers advantages in selected patient populations . Caregiver or patient request, improved gastrointestinal function, and reduced tube‐feeding intolerance are primary reasons registered dietitian/nutritionists (RDNs) consider BTF in enterally fed patients . At least 5 published studies report effectiveness of BTF in symptom resolution of tube‐feeding intolerance, including gagging, retching, abdominal pain and bloating, constipation, and diarrhea .…”

Section: Introductionmentioning

confidence: 99%

Accepted Safe Food‐Handling Procedures Minimizes Microbial Contamination of Home‐Prepared Blenderized Tube‐Feeding

Milton

Johnson

et al. 2020

Nut in Clin Prac

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Background: The number of patients requiring home enteral nutrition (HEN) continues to increase. Many of these patients are interested in using blended food instead of, or in addition to, commercial enteral formula (CEF). Increased risk of food-borne illness is a concern of blenderized tube-feeding (BTF). This project assessed a standard procedure for minimizing bacterial growth of BTF prepared in the home setting. Methods: Fifty participants prepared BTF in their kitchens using a standard preparation procedure to minimize bacterial contamination. BTF was assessed for growth of aerobic microorganisms, Escherichia coli, Staphylococcus aureus, and coliforms at baseline, 24-hour, and 48-hour intervals after preparation for a total of 150 colony forming units (CFU) counts performed. Results: No sample had zero aerobic microbial counts; yet no substantial increase in microbial counts was observed during the 48 hours. At baseline and 24 hours, 5/50 (10%) had a CFU count of >10 4 , and at 48 hours, 6/50 (12%) exceeded 10 4 CFUs. Out of 150 CFU counts, 2 (1.3%) were just over 10 5 CFU/mL. Samples exceeding 10 4 CFU/mL were likely contaminated by common endospore-forming bacteria found in soil or by bacteria in milk that was close to its expiration date. Conclusion: In this study, 88% of the samples met the US Food Code criteria for safe food consumption; 10.7% met guidelines for marginal safety by other standards; and 1.3% slightly exceeded 10 5 CFUs. Established safe food-handling procedures can minimize bacterial contamination of BTF and consequently reduce risk of food-borne infection in HEN patients.

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Exploring Clinical Outcomes and Feasibility of Blended Tube Feeds in Children

Chandrasekar

Dehlsen

Leach

et al. 2021

J Parenter Enteral Nutr

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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.

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Blended tube feeding prevalence, efficacy, and safety: What does the literature say?

Cited by 27 publications

References 18 publications

Addressing Frequent Issues of Home Enteral Nutrition Patients

Addressing Frequent Issues of Home Enteral Nutrition Patients

Accepted Safe Food‐Handling Procedures Minimizes Microbial Contamination of Home‐Prepared Blenderized Tube‐Feeding

Exploring Clinical Outcomes and Feasibility of Blended Tube Feeds in Children

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