A few months ago, one of my patients who relies on a tube feeding to meet her nutritional needs asked me to blog on this subject. She wanted to know what she could add through the tube to enhance her nutritional health.
When someone requires a tube into the stomach or intestines to feed, the dietitian involved (whether in the doctor’s office or with the home health company) will calculate the person’s individualized nutrient, calorie and protein needs. Based on those needs, a prescription for when to feed and how much to feed is written.
Nutrition formulas used through tubes are often similar to something like Ensure® but are typically unflavored. Generally speaking, four to eight (8oz) cans will provide 100% of the nutritional needs for most people. Products have some slight differences and do vary in water content and fiber.
The bottom line? If you are able to take 100% of the prescribed formula, you don’t need to add anything.
But…what if you want to?
J-Tubes or Jejunal Tubes
First off, if you have a J-tube, or jejunal tube into the intestines, it is not advised to insert anything into the tube aside from feedings and water.
J-tubes are smaller (thus more easily clogged) and feed directly into the small intestine (not the stomach). The small intestine does not expand and act like a reservoir like the stomach can, so feedings with a J-tube need to be given slowly with an infusion pump.
G-Tubes or PEG Tubes
If you have a G-tube or “PEG”, the tube feeds directly into the stomach. Unless part of the stomach has been removed, the stomach can act as a holding tank of sorts and a can or two of formula can be given at one time rather quickly.
When you feed directly into the stomach, you may be able to add some other liquid foods and beverages. Some patients choose to replace canned formula with blenderized foods.
CAUTION: DO NOT DO THIS WITHOUT FIRST DISCUSSING WITH YOUR PHYSICIAN, DIETITIAN OR OTHER HEALTHCARE PROVIDER.
The Pros of Blenderized Diets
Blenderized food may be much cheaper than formula, which may be helpful if insurance is not covering the cost of your formula.
Blenderized food may be more appealing (especially the smell) than formula.
If you enjoy cooking and have the energy to do so, blenderized food may allow you the pleasure of cooking again.
The Cons of Blenderized Diets
Blenderized food may not provide all the vitamins, minerals, fiber, hydration, and calories you need. It is difficult to formulate a well-rounded, calorie-dense diet that can get through your tube.
Blenderized food may clog your tube. Clogs can be serious and may result in another procedure to have the tube replaced.
Blending your own food can be inconvenient and time consuming.
If you’ve had surgery to your stomach or intestines, you may not be able to digest blenderized foods as well as formula.
Check out these resources if you want to add anything beyond water or formula to your tube:
Consult with the dietitian at your oncologist’s office, the local hospital or with the company providing formula to you.
If you have an interest in blenderized home tube feedings, consult a dietitian AND an expert resource, such as the Homemade Blended Formula Handbook by Marsha Dunn Klein, MEd, OTR/L and Suzanne Evans Morris, PhD, CCC-SLP. The book is written by a speech therapist in conjunction with a physician and two dietitians. It is somewhat geared towards children, but the information can apply to adults as well.
The Oley Foundation offers many resources for patients who want alternatives to commercial formulas and the opportunity to network with other patients who have first-hand experience.
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