‘It’s Just Food, Blended’: Exploring Parents’ Experiences of Choosing Blended Diet for their Tube-fed Child.

Durnan, Sarah; Toft, Alexander; Flaherty, Helen; Coad, Jane

doi:10.1016/j.jand.2019.06.110

Cited by 7 publications

(21 citation statements)

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“…Although the time associated with administering the feed via the 14‐Fr tube was significantly quicker than for narrower tubes, extrapolating to delivering the feed for a whole day, in addition to making it, would be considerably more time‐consuming for carers than using a standard formula. This additional time commitment has been reported by carers but accepted as necessary to enable blended feeding . In addition, the force required to empty the syringe may be challenging for frail carers.…”

Section: Discussionmentioning

confidence: 99%

“…Although sterile formula feeds are associated with least microbial risk, sterile production of blended feeds would be hard to achieve in a domestic setting. In addition, complex procedures need to be reconciled with the concept of home blended feeding being ‘just food’ and the social benefits of being included in a family meal , which are considered as highly important by those choosing to use this method of feeding. Feed sterility may not be an appropriate goal for those who required enteral tube feeding but are otherwise physically stable and not immunocompromised.…”

Section: Discussionmentioning

confidence: 99%

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A laboratory‐based evaluation of tube blocking and microbial risks associated with one blended enteral feed recipe

Madden

Baines

Bothwell

et al. 2019

J Human Nutrition Diet

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Background Concerns associated with blended enteral feeds include the risk of blocked tubes and microbial contamination, although the available evidence is limited. The present laboratory‐based investigation aimed to examine these risks in a blended feed providing a nutritionally adequate intake for a hypothetical patient. Methods A one‐blended feed recipe was made using three different methods (professional, jug and stick blenders) and three storage procedures. Feed samples were syringed via 10‐, 12‐ and 14‐French (Fr) enteral feeding tubes and both blockages and the time taken were recorded. Feed samples were diluted, plated on agars, incubated and bacterial colony‐forming units (CFU) counted. After storage at −80 °C, identification was undertaken using 16S rRNA polymerase chain reaction sequencing. Results Two blockages occurred during 27 administrations of feed made using a professional blender, although they were resolved with a water flush. No blockages occurred with the 14‐Fr tube and administration was quicker with wider tubes (P < 0.00001). There was no significant difference between the total bacterial CFU of feeds prepared using different methods (P = 0.771) or stored differently. The genus of bacteria identified included Enterococcus, Bacillus, lactose‐fermenting Enterobacteriaceae, Pseudomonas and Staphylococcus. Pathogens, such as Clostridium spp., Salmonella spp. and Vibrio spp., were not identified by phenotypic tests used. Sequencing identified Escherichia coli, Shigella spp., Streptococcus lutetiensis and Staphylococcus epidermidis. Conclusions The present study found no risk of tube blockages when one blended feed recipe made using three methods was delivered via a 14‐Fr tube. There is concern about bacterial contamination, although this was not influenced by the methods of preparation or storage used in the present study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A laboratory‐based evaluation of tube blocking and microbial risks associated with one blended enteral feed recipe

Madden

Baines

Bothwell

et al. 2019

J Human Nutrition Diet

View full text Add to dashboard Cite

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“…30 This is particularly vital in this field because an absence of dietetic support is cited as a key barrier to caregivers adopting a BD. 5 Factors driving this disconnect between patient demand and dietetic provision include a lack of training and awareness, and a significantly greater perceived than actual risk. 7 Therefore, it is important that healthcare professionals who support patients on BD have access to the latest research in this field to facilitate evidence-based practice.…”

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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“…Research by Fabiani et al (2020) and Schmidt et al (2019) showed a reduction in diarrhoea associated with a blended diet in a critical care setting. Qualitative studies reflect improvements in gastrointestinal symptoms alongside descriptions of improved skin, hair and nails (Durnan, 2018; Phillips, 2019). Furthermore, families report an increased sense of control over food choices for both therapeutic effect and inclusion in family mealtimes (Durnan, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Qualitative studies reflect improvements in gastrointestinal symptoms alongside descriptions of improved skin, hair and nails (Durnan, 2018; Phillips, 2019). Furthermore, families report an increased sense of control over food choices for both therapeutic effect and inclusion in family mealtimes (Durnan, 2018). This may be more pertinent to long-term home ETF compared to short-term ETF during acute illnesses.…”

Section: Introductionmentioning

confidence: 99%

Introduction of blended diet for enteral tube feeding in paediatrics: A case report

Phillips

2021

Nutr Health

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Background: Advances in medical technology have resulted in changes to enteral tube feeding (ETF). Standard practice in the UK is to use commercial formula for ETF via the stomach or small intestine; however, blended diets are becoming increasingly popular. Emerging evidence shows benefits of a blended diet although evidence informing clinical guidance is sparse. Consequently, there is disparity in practice, and it remains unclear which patient groups may benefit most from a blended diet. Aim: To demonstrate the initiation of a blended diet in clinical practice. Methods: This case report features a 2-year-old child requiring ETF in the context of hypotonia, developmental delay and faltering growth. Results: In this instance, a blended diet resulted in improved gastrointestinal symptoms and adequate growth. Conclusion: This case demonstrates the successful implementation of a blended diet and associated benefits. Blended diets may benefit others requiring ETF and should be considered on an individualised basis.

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‘It’s Just Food, Blended’: Exploring Parents’ Experiences of Choosing Blended Diet for their Tube-fed Child.

Cited by 7 publications

References 0 publications

A laboratory‐based evaluation of tube blocking and microbial risks associated with one blended enteral feed recipe

A laboratory‐based evaluation of tube blocking and microbial risks associated with one blended enteral feed recipe

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

Introduction of blended diet for enteral tube feeding in paediatrics: A case report

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