Blenderized tube feeding for children: an integrative review

Schmitz, Érica Patrícia Cunha Rosa; Silva, Eliziane Costa da; Lins-Filho, Ozeas L; Antunes, Margarida Maria de Castro; Brandt, Kátia Galeão

doi:10.1590/1984-0462/2022/40/2020419

Cited by 9 publications

(17 citation statements)

References 27 publications

(68 reference statements)

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“…11 There is no consensus on the mechanism by which BTF reduces adverse GI symptoms but proposed explanations include increased viscosity that slows gastric emptying, improved nutrient profile provided by whole foods that exert a more physiologic gastric motility profile, and improved microbiome conferred by a diverse, whole-food diet. 25 McClanahan et al transitioned 10 medically complex CF-fed children to a plant-based CF and compared fecal microbiota before and after transition. They found significant reductions in pathogenic bacteria and increases in commensal microbes after transition.…”

Section: Discussionmentioning

confidence: 99%

Blenderized food tube feeding in very young pediatric patients with special healthcare needs

et al. 2023

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BackgroundUp to 85% of children with severe developmental disabilities have feeding disorders and require enteral tube feeding. Many caregivers desire blenderized tube feeding (BTF) instead of commercial formula (CF) for their child, citing a desire for a more physiologic feeding, to reduce gastrointestinal (GI) symptoms and/or promote oral intake.MethodsIn this retrospective, single‐center study, medical records (n = 34) of very young children (aged ≤36 months) with severe developmental disabilities were reviewed. Comparisons of growth parameters, GI symptoms, oral feeding, and GI medication use were made between the initial introduction of BTF and again at the last patient encounter when the children aged out of the program.ResultsOf the 34 charts reviewed (16 male and 18 female patients), comparisons between baseline BTF introduction and the last patient encounter indicated reductions in adverse GI symptoms, significant GI medication reduction (P = 0.000), increased oral food intake, and nonsignificant improvements in growth parameters. These positive outcomes were realized whether children received full or partial BTF or type of BTF formulation.ConclusionConsistent with similar research studies, transitioning very young children with significant special healthcare needs from CF to BTF resulted in improvement in GI symptoms, reduced need for GI medications, supported growth goals, and contributed to improved oral feeding.

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Section: Discussionmentioning

confidence: 99%

Blenderized food tube feeding in very young pediatric patients with special healthcare needs

et al. 2023

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“…Caregivers in seven papers have almost unanimously reported that their child appears happier and healthier receiving blended feeds in comparison to commercial feeds (Breaks, 2019;Breaks et al, 2018Breaks et al, , 2022Durnan, 2018;Johnson et al, 2013;O'Sullivan et al, 2019;Phillips, 2019;Trollip et al, 2020) with one paper suggesting anecdotal reports of children who experience symptom improvement on blended feeds are abundant (Zettle, 2016). On commencement of blended feeding improvements were noted almost immediately in 10 papers (Breaks, 2019;Breaks et al, 2018Breaks et al, , 2022Dipasquale et al, 2022;Durnan, 2018;Johnson et al, 2013;O'Sullivan et al, 2019;Phillips, 2019;Schmitz et al, 2022;Trollip et al, 2020). Five papers stressed that improvements in feeding and volume tolerance were highlighted in addition to a decreased aversion to feeding (Dipasquale et al, 2022;Durnan, 2018;Johnson et al, 2013;O'Flaherty et al, 2011;O'Sullivan et al, 2019).…”

Section: Physical Well-beingmentioning

confidence: 99%

“…Commercially prepared blended feeds are cited in the literature and adopted alongside homemade blended feeds with improvements noted in constipation reduction, reduction in use of laxatives, reduced gagging and better feed tolerance (Siddiqui et al, 2021). It was also noted by Schmitz et al (2022) that there was a reduction in hospitalisations supporting Hron et al (2019) findings that rates of emergency department and hospital admissions were lower in children receiving blended feeds.…”

Section: Physical Well-beingmentioning

confidence: 99%

“…Professionals find there is a lack of evidence and discussion to support the use of blended feeding in practice and guidelines are needed to inform policy related to the topic (Escuro, 2014; Oparaji et al, 2019; Weeks, 2019). Although review papers have been published (Bahramian et al, 2021; Breaks et al, 2018; Brekke et al, 2022; Coad et al, 2017; Schmitz et al, 2022), these were either deemed out of date or had different aims. This present up‐to‐date review is broader in nature encompassing a breadth of material and was conducted to give a better understanding of the topic with the aim of summarising the published evidence about blended feeding in gastrostomy‐fed children.…”

Section: Introductionmentioning

confidence: 99%

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Blended feeding in gastrostomy‐fed children—A scoping review

Doyle,

Louw,

Shovlin

et al. 2024

Child

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BackgroundBlended feeding has become increasingly prevalent in recent years with its practice gaining some momentum. With anecdotal reports of benefits and little evidence of harm in the literature regarding blended feeding, this scoping review was deemed important. The aim of this scoping review was to summarise the published evidence about blended feeding in gastrostomy‐fed children.MethodThe scoping review methodology used included searches in specific online databases: PUBMED, PsychINFO, CINAHL, SCOPUS, AMED and EMBASE for articles that addressed issues pertaining to blended feeds in gastrostomy‐fed children. Grey literature was also considered. Inclusion criteria included papers that pertained to information and research on blended feeding in gastrostomy‐fed children. Studies published in English over the past 11 years (2011–2022) were included. This resulted in 59 papers being included in this scoping review.ResultsThematic analysis of the literature identified eight overall themes. It was clear that parents found blended feeding promoted the normalising of feeding, their own involvement in decision‐making around foods and promotion of a socially inclusive mealtime. The need for dietician and health professional input and support is key, whereas a lack of guidelines acts as a barrier to blended feeding. Furthermore, risks associated with blended feeding are identified but also the benefits to the physical well‐being of the child are considered.ConclusionThe review was comprehensive in that it identified a broad range of literature, exploring the extent, range and nature of research activity related to the use of blended feeds. The lack of original research is a concern. However, it is expected this review will provide direction for researchers, and in particular inform policy and practitioners working in the field where blended feeds may be an option for gastrostomy‐fed children.

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“…Previous reviews have explored the safety and feasibility of BD, 31 summarised health outcomes, 1 and explored nutritional adequacy and composition of BD. 25 Additionally, a recent qualitative integrative review by Schmitz et al 32 found positive outcomes for children using BD including reduced GIS, increased family satisfaction and adequate nutritional BD composition from 11 studies. However, to date, no systematic reviews have explored the effect of BD on GIS.…”

Section: Introductionmentioning

confidence: 99%

A systematic review examining the impact of blended diets on the gastrointestinal symptoms of people who are enterally fed

Peers

Boocock

Burn

2022

J Human Nutrition Diet

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Background: Adults and children who are enterally tube-fed can experience adverse gastrointestinal symptoms (GIS). Observational data suggests that blended diets (BD) could mitigate such symptoms, with potential to improve quality of life and clinical outcomes. We present a novel systematic review examining the impact of BD, compared to commercial feeds, on GIS of adults and children who are tube-fed. Methods: The protocol was registered with PROSPERO (CRD42021261147). Four electronic databases were searched from inception to August 2021. Search terms included 'tube-fed', 'blended diet' and 'formula'. Inclusion criteria were intervention studies comparing blended and commercial feeds using quantitative measures of GIS. Heterogeneity of outcome measures precluded meta-analysis; therefore, a narrative synthesis was conducted. Results: Six papers (n = 219), including two randomised control trials (RCT) and four single arm pre-post studies, were identified. Equal numbers studied in-and out-patients, adults and children. Risk of bias was notable for all studies. Equivocal and insufficient evidence prevented consensus on outcomes of vomiting, gagging, oral intake, bloating and constipation. However, one RCT and two single arm pre-post studies suggest that diarrhoea symptoms may be improved on BD. Conclusions: Diarrhoea is prevalent in tube-fed populations and associated with adverse outcomes. Improvements in diarrhoea symptoms attributed to BD may be clinically important. Our findings are congruous with the wider observational evidence base, and support recommendations of the British Dietetic Association. BD may pose a viable alternative to commercial formula, and may mitigate symptoms of diarrhoea for adults and children who are tube-fed.

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Blenderized tube feeding for children: an integrative review

Cited by 9 publications

References 27 publications

Blenderized food tube feeding in very young pediatric patients with special healthcare needs

Blenderized food tube feeding in very young pediatric patients with special healthcare needs

Blended feeding in gastrostomy‐fed children—A scoping review

A systematic review examining the impact of blended diets on the gastrointestinal symptoms of people who are enterally fed

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