Here you'll find advice on how to start a blended diet via a gastrostomy.
Tube Feeding.
When a child is unable to orally eat enough to survive the decision is made to insert a feeding tube directly into the stomach. Many hospitals will still place a PEG (Percutaneous Endoscopic Gastrostomy) first and then change to a gastrostomy Button (G-button), some will place a G-button first. The difference between a PEG and a G-button is that the PEG is a tube that can last for months or years and normally has to be removed or changed by a surgeon at the hospital, the G-button can be changed easily by the district nurse or a parent/carer, once trained.
There are different types of tubes depending on where they are placed. G Tube (Gastrostomy tube - placed in the stomach), J Tube (Jejunostomy Tube- placed in the Jejunum), GJ Tube (Gastrostomy-Jejunostomy Tube- placed in the jejunum via the stomach).
Feeding via a tube into the stomach.
This post is about feeding directly into the stomach via a PEG or button.
Which blender do I need?
Before you go off and buy a new blender, if you already have one, see if it will do the job. If you decide you need to buy a new one, a lot of people love the Vitamix and this is great for large amounts of blends, but if you want a smaller blender then the Nutribullet is really popular.
What else do I need?
You will need syringes and caps, bottles, some people use the reuseable baby weaning pouches,or a flexiflo bottle often supplied by dieticians. The bottle pictured below is a glass one I bought from Amazon, but you cannot fit the 60ml syringe into this to draw up food so I prefer the plastic ones. You might find something even better that works for you.
Other useful items are a bowl, sieve and funnel.
Ok, I have everything so what do I feed via the tube?
If you were already feeding your child orally but now have to change to tube feeding then you already know what to feed your child, you just might need to add more fluids to get the right consistency for the food to fit down a tube.
If you are transitioning a young child from infant formula, breast milk or a medical feed/formula, then begin as you would when weaning a child who eats orally- blended vegetables and fruits. (Ella's Kitchen Food pouches are popular).
If you are moving an older child or an adult from a medical feed than some families will transition gradually by replacing one meal a day for a week, then two meals a day for a week until all meals are blended food, alternatively some people can go straight to a full blended diet, especially if they used to eat orally.
How do I make up a meal?
You will find on your blended diet journey that you are constantly tweaking and adapting recipes due to weight, tolerance of volume or medical issues. But that is the beauty of a Blended diet, you can adapt what your child is eating to help with their constipation, manage a cold or fever, reduce reflux etc.
An example would be portions from these categories: meat/beans/nuts, fruit, vegetables, good fats such as oils, grains and dairy/dairy substitute.
Coming soon ebook : Blended Diet Recipes - Free from dairy and gluten.
What liquid should I add to the food?
It is important not to 'water down' the food, especially if volume tolerance or calories are an issue, but you need a consistency you can gently push down the tube. Here are some suggestions of liquids that you can use:
Milk or non dairy alternatives.
Coconut milk
Gravy (we occasionally use a gluten free variety)
Oils: Olive, Avocado, sesame, flax...
Juice- prune, apple, pineapple
Passata
How do I know everything is blended! Will it fit down the tube?
If the food will suck up the syringe, it will probably go down the tube, but if you aren't sure or you are transferring the blend directly to bottles you can pour through a sieve just to be sure.
How much BD should I give?
This answer to this question will vary greatly, it will depend mainly on volume tolerance, whether oral food is also eaten and other medical issues.
Remember to Flush before and after every meal- Flush is an amount of water given before and after, usually between 10ml-50ml again depending on volume tolerance.
As an example you might feed between 120ml-240ml per meal 3x a day. You might give 2 snacks of 60 ml.
I need more help!
I always advise parents to find a support group, facebook is great for this, you can browse and search for information or ask questions. Parents are an amazing source of information and advice.
Please always feel free to contact me and I will answer any questions I can or I will signpost you to who can help.
Michelle
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