Blended diet 101

Whenever I tell people we did blended diet g-tube feeds for 12 years vs using pre-made, sugar filled commercial formula, they look at me like I have two heads.  I have gotten a lot of comments as well. 

The top 3

“OMG!!! that is too much work; i don’t have time to do that”

“My child can’t handle real food”

“How can this be better than scientifically made, nutritional complete out there?”

I have done previous posts on blended diet but I thought I would do an update on blended diet, providing step by step directions. 

Step one: get a blender.  For those that do blended diets, it is recommended in getting a commercial grade blender, such as a Vitamix or a Blentec.  We have a Vitamix blender.

Step two: start with basic ingredients: yogurt, applesauce (or any type of baby food), a grain (baby rice cereal or oatmeal is a great starter) and a liquid.  You can use water, milk, juice or formula.  

Step Three: combine all ingredients in the blender and blend until it becomes a liquid. Or smoothie type texture. 

Step Four: use a syringe and the bolus extension to push the blends through your child’s g tube. Then flush with a bolus of water (we used 20cc) amount will vary on your child age, weight and form of EB.  A nutritionist will help you determine how much free water your child needs per day.

Once you get comfortable with blending basic items, you can branch out.  Some people just blend up what they made for breakfast/lunch/dinner for their family, and feed that to their tubie.  The goal of a blended diet is to provide a healthy, well balanced whole food alternative to commercial formulas.  Each blend can be tailored to your child’s specific dietary needs.  

In EB, the goal is a high calorie, high protein, and low sugar diet.  Those with EB need anywhere from 100-300% more calories than a child without EB that is the same age, along with 115-200% more protein than a child without EB what is the same age,  Those with EB also need a lot of fluid in their diet to replenish what is lost from wound drainage and to aid in healthy kidney function and reduce constipation.  

A nutritionist can help you figure out what your child needs in their diet, as well as how much free fluid they need per day.

We use this calculator to determine what our child needs from a nutritional standpoint and we use the results from his previous blood work to see if we need to add any additional nutrients.  

I have done a tremendous amount of research on the nutritional content of a wide variety of food to figure out which combine of foods would get us the highest calorie, yet low volume blends (our child is volume sensitive)  Bur there are many apps out there that all your have to do is add the ingredients you are using, and it will calculate the nutritional value of those items.  One app I like is called Track.  All you have to do is add the food and quantities and the app calculates the calorie total and breakdown of the nutrients.   

For our blends we included the follow ratio in each batch:

3 cups of vegetables

3 cups of fruits

1 cup of whole grain (oatmeal, pasta, brown rice, quinoa) 

1 cup of  an animal based protein (eggs, cook chicken, cooked fish, 

1 cup of a plant based protein (seeds, tofu, lentils, beans peanut butter)

1 cup of a dairy product (yogurt, heavy cream, kefir, cottage cheese) 

A liquid base: milk (cow, goat, almond, rice) broths (chicken, vegetable, bone),  various juices (pear, prune, apple)  this amount can vary depending on how thick or thin you prefer the blends. 

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I blended all those items together then divided it up into the serving sizes we give per feed (this will vary from person to person).  For us it was 6oz.   I then continued to blend that ratio of those items until I had enough to make 7 days worth of feeds.  You can use Tupperware containers or Ziploc bags or breast milk bags to store each serving.   Once the blends are diving into individual servings, I then add one or more high calorie, low volume additions to EACH servicing size to increase the calories for that serving size.  I kept 2 days worth in the fridge and froze the rest, pulling out a day's worth at a time. 

*High calories low volume additions: peanut butter powder, flaxseed oil, olive oil, heavy cream, (benecalorie, duocal or liquidCal or beneprotein- these are all commercial made additives that can be easily mixed into blends.) 

One of the benefits of blending food is you can pick and choose what you want to use.  We used either fresh or frozen fruits and vegetables, depending on what was in season, and what his need was based on his blood work.  We aimed for using things high in iron, vitamin D, vitamin C and foods known to reduce inflammation.  I created a spreadsheet of how many calories, and which vitamin/nutrients each food was high in.  My favorites were kale, spinach, sweet potatoes, cooked apples, blueberries, mangos,  bananas, boiled chicken, hard boiled eggs, bone broth, kefir, brown rice, tofu, almond milk, prune juice, and peanut butter.  But I tried to use a variety of each category of food.  It is easy to make it a vegetarian diet, or a diary free diet as well. 

We saw consistent weight gain, quicker wound healing, less inflammation/pain and no issues with constipation.  He had more energy as well.  It also allowed him to eat anything he wanted, because he was getting all the good, nutritious food through his tube. No more fighting at meals to get him to eat fruits and vegetables.  

I’ll be honest, this is a lot of work, especially in the beginning when I was trying to figure out what to use, how much, etc.  But once I figured out how many calories he needed per day and the ratio of vitamins, minerals and nutrients, it became much easier and was just a part of my weekly routine.   But overall it was worth the extra work. I made our child MUCH healthier by being on a blended diet.