Blenderised Tube Feeds vs. Commercial Formula: Which Is Better for Gastrostomy-Fed Children?

Abstract

Blenderised tube feeds (BTF) have become a popular alternative to commercial formula (CF) for enterally fed children. This study sought to compare gastrointestinal (GI) symptoms, GI inflammation, and stool microbiome composition between children receiving BTF or CF. This prospective cohort study involved 41 gastrostomy-fed children, aged 2–18 years, receiving either BTF (n = 21) or CF (n = 20). The Paediatric Quality of Life Inventory Gastrointestinal Symptoms Scale (GI-PedsQL) was used to compare GI symptoms between the groups. Anthropometric data, nutritional intake, nutritional blood markers, faecal calprotectin levels, stool microbiota, and parental satisfaction with feeding regimen were also assessed. Caregivers of children on BTF reported greater GI-PedsQL scores indicating significantly fewer GI symptoms (74.7 vs. 50.125, p = 0.004). Faecal calprotectin levels were significantly lower for children receiving BTF compared to children on CF (33.3 mg/kg vs. 72.3 mg/kg, p = 0.043) and the BTF group had healthier, more diverse gut microbiota. Subgroup analysis found that 25% of caloric intake from BTF was sufficient to improve GI symptoms. The CF group had better body mass index (BMI) z-scores (−0.7 vs. 0.5, p = 0.040). Although growth was poorer in children receiving only BTF in comparison to the CF group, this was not seen in children receiving partial BTF. A combination of BTF and CF use may minimise symptoms of tube feeding whilst supporting growth.

Blended diet for enteral tube feeding in young people: A systematic review of the benefits and complications

“…Body fat % increase was significantly higher in the CF group (p = 0.0051). 50 In the cohort study by Chandrasekar et al, 46 there was no significant difference in height z-score between the two groups (p = 0.905). Children in the CF group had significantly higher weight (p = 0.0108) and BMI (p = 0.045) z-scores compared to BD.…”

“…47 The two included cohort studies demonstrate dietary fibre intake to be many folds higher in those on BD. 46,48 A recent review focusing on BD symptoms of adults and children on enteral tube feeds also supports the benefit of BDs in alleviating these symptoms. 27 The reduction in GI symptoms is likely directly linked to the reduction in medication use seen in the studies in this review.…”

“…Incidence of malnutrition (weight-for-height z-score below −2) was not significantly different between the groups (p = 0.183). 46 Transition to the BD and oral feeds 91% (29/32) in the study by Kernizan et al 49 and 86% (18/21) in the study by Batsis et al 47 Six patients on BD from three studies transitioned to full oral feeds. In the study by Kernizan et al, 49 three patients (9%) transitioned to oral feeding and a further two had an improvement in oral intake.…”

Pediatric formulas: Categories, composition, and considerations

“…Some products are deficient in micronutrients and require supplementation if used as the sole‐source of nutrition. BTF formulas have highly variable macronutrient compositions 8,25 Research demonstrates that children fed blenderized formula have more diverse microbiomes, compared with those fed commercial standard formula 34 …”

“…BTF formulas have highly variable macronutrient compositions 8,25 Research demonstrates that children fed blenderized formula have more diverse microbiomes, compared with those fed commercial standard formula. 34…”