Homemade Tube Feeding Formula…
Two Dietitians' Perspective
Ellen Duperret, RD and Jude Trautlein, RD
Ellen Duperret, R.D. is a dietitian for the Division of Developmental Disabilities in Tucson. Jude Trautlein, R.D. is a dietitian at Children's Clinics for Rehabilitative Services in Tucson, Arizona. Here are their thoughts on homemade tube feeding formulas:
Why did you originally think that commercial formulas were best for families of
children with tubes?
Commercial formulas are nutritionally complete, with regards to vitamins, minerals, proteins, carbohydrates, and fats. They are easy for families and the dietitian to quantify. Commercial formulas are safe in terms of food borne illness if they are handled properly after the can is open. They are convenient for families to use. Families can simply open the can and pour it right into the tube feeding bag or syringe. Commercial formulas are also easier to use when families are not at home.Why did you previously think that homemade tube feedings were not the best
choice for families?
We were afraid that homemade tube feedings formulas wouldn't be as nutritionally complete. Homemade tube feedings are definitely harder to quantify and calculate. We felt that it would be too much work for families. Making homemade formula would require a good blender, which some families might not be able to afford. We were afraid of food borne illnesses if the homemade formula were not refrigerated, or if the blender were not washed well. Being on homemade formula would require more follow up with the dietitian; some families might not have a pediatric dietitian in their area, or might not have the time or money for follow up. We were worried that kids would have to have a feeding tube instead of a button to receive homemade formulas. And finally, we thought that some kids who cannot handle extra volume might not be able to meet their nutritional needs.What made you change your minds about homemade tube feeding formulas?
We found that certain motivated families could do homemade formulas, and that their kids indeed grew and thrived. Making homemade formula seeMEd to be very fulfilling for parents and caregivers because they felt like they were feeding their kids. We found that it helped tremendously with some kids with constipation. And most interestingly, we discovered that switching to homemade formulas sometimes helped with the transition to oral feedings. The kids were burping up other flavors than just commercial formula, and this made them more likely to try those foods by mouth. And finally, we felt that homemade tube feedings offered a greater variety of nutrients.In what type of families, and with what type of child would homemade tube feeding formulas work the best?
Families definitely need to have enough time and money to invest in homemade formulas. It takes more time to prepare the food, freeze the leftovers if needed, clean the blender, etc. The family would need to invest in a powerful blender. (We found that some insurance companies are willing to help out with the purchase of a good blender. Also, some blender companies are giving a price break if they know that the blender is being used for a child with a tube). Another expense is the nutritious foods that will be blended. And finally a multivitamin that can be added to the homemade formula would need to be purchased. We have found that families that enjoy cooking are more likely to want to do homemade formulas. A family that is working on moving a child towards oral feedings would be a good candidate for homemade formulas. The child must be able to handle extra volume of formula, and must be on bolus feedings. (Homemade formula cannot be dripped in over a long period of time because of bacterial contamination). And finally, the family must have access to regular follow up with a dietitian.How does a family get started with homemade tube feeding formulas?
First, as stated above, find a dietitian in your area to work with to insure that your child is getting all the nutrients that he/she needs in the homemade formula. Second, as with any dietary change, start slowly and work up. Many families start with adding a little commercial baby food to the tube feeding formula. Make sure that one new food is started at a time in case the child has an allergic reaction to the food. Families can move from commercial baby food to pureed table foods over a period of time. Make sure that growth is monitored. Enjoy the process.
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