Transcription
Presents:To Blend or Not to Blend and Everything inBetweenWebinarThursday, January 15, 20154:00 PM – 5:00 PM Eastern3:00 PM – 4:00 PM Central1:00 AM – 2:00 PM PacificPresenter:Lisa Epp, RDN, LD, CNSC19444
To Blend or Not to Blend andEverything in BetweenLisa Epp, RDN,LD,CNSCJanuary 15, 20151/15/2015
Learning Objectives1. Define criteria that should be met prior tostarting blenderized tube feeding2. Be able to list tools needed to make andadminister blenderized tube feeding.3. Learn how to construct sample recipes forblenderized tube feeding4. Discuss differences between the premadewhole food formulasDate2
Why Blend? DateMay be less expensiveReflux, bowel regularityEat what family is eatingBenefits of whole foodsFood AllergiesVegan/organic/personal preferencesCan be safeCan meet nutrition requirements3
Why not? Increased work May be increased cost Possible tube clogging, tube wears out morequickly May be more difficult to travel Unable to tolerate bolus feeding Post pyloric tube Facility or hospital may not support itDate4
Criteria Talk to your primary care providerMature stoma14 french or greater tube (pre-pyloric)Determine a system for monitoringAdequate equipment available1/15/2015
Tools to get started SyringesBlender (commercial preferred)Air tight storage containers / labelingFood Safety Guidelines
Things to consider The manufacturers of feeding pumps havespecifically stated that their pumps are NOTto be used with anything but commercialformula so use a pump with real food atyour own risk Gravity bags didn’t work for us Hang time of food is 2 hours May lose insurance coverage for supplies Homemade vs manufacturedDate7
Recipe development Exchanges Standard recipe Plate ertrackertools/daily-food-plans.html
Standard Recipe 1000 kcalDate9
Family meals1/15/2015
Date11
Commercial products1.2.3.4.Real Food Blends Liquid Hope Compleat Compleat Pediatric 1/15/2015
Real Food Blends 1.2kcal/mL 4.17 for 330kcal Not recommended for smaller tubes ( 12french) or J-tubes Animal and vegetarian options13
Real Food Blends Pros Variety of foods available No additives, 100% real foodCons Made for bolus feeding, add water to gravityfeed May need to strain 2 hour hang time Billing concerns (B4149) Not a complete nutrition product DME availability Fruit juice, no whole fruitsDate14
Real Food Blends Coconut Calorie Booster 1 heaping Tablespoon 70kcal Mix with 2-4 ounces of fluid, pureed or softfood Not to be given via gravity bag or pump 29.95 for 284 gram canDate15
Liquid Hope 1.2kcal/mL 7.99 per 440kcalVeganPros Nutritionally complete Website states it works with pumpsCons 1/15/2015No fruitMay need to strain2 hour hang timeDME availability
Compleat 1.06kcal/mL 4.00 for 265kcalPros Can run safely on pump 8 hour hang time DME availabilityCons Some foodSome additivesInsurance approvalConsistency is thinner17
Compleat Pediatric 1 kcal/mL 4.00 for 250kcalPros Can run safely on pump 8 hour hang time DME availabilityCons DateSome foodSome additivesInsurance approvalConsistency is thinner18
“In between” AlcoholCaffeineFavorite foodsSeasonal foodsHydration1/15/2015
Patient resources DateFacebook groupsBlogsPinterestOley Foundation20
Future concerns ENFit Our testing showed increase in PSI needed Future state of health careDate21
ker-tools/daily-food-plans.html,accessed 1/06/20152. Dunn Klein, M & Evans Morris, S (2007). Homemade Blended FormulaHandbook. Tucson, Arizona: Mealtime Notions, LLC.3. http://www.oley.org/lifeline/TubetalkSO07.html, accessed 1/06/20154. Sullivan MM, Sorreda-Esguerra P, Santos EE, et al. Bacterial contamination ofblenderized whole food and commercial enteral tube feedings in the Philippines.J Hosp Infect. Dec 2001;49(4):268-273.5. Mokhalalati JK, Druyan ME, Shott SB, Comer GM. Microbial, nutritional andphysical quality of commercial and hospital prepared tube feedings in SaudiArabia. Saudi Med J. Mar 2004;25(3):331-341.6. Jalali M, Sabzghabaee AM, Badri SS, Soltani HA, Maracy MR. Bacterialcontamination of hospital-prepared enteral tube feeding formulas in Isfahan, Iran.J Res Med Sci. May 2009;14(3):149-156.7. Pentiuk S, O'Flaherty T, Santoro K, Willging P, Kaul A. Pureed by gastrostomytube diet improves gagging and retching in children with fundoplication. JPEN JParenter Enteral Nutr. May 2011;35(3):375-379.Date22
Thank You!23
Academy of Nutrition and DieteticsWebinar Site RosterJanuary – To Blend or Not to Blend and Everything in BetweenPlease note: Instead of this paper attendance roster, you can do an online attendance roster On the online roster, you will be asked to provide each attendee’s name and Academy/CDR number.OR, if you prefer to use this paper form, please fill out thefollowing: SITE registered under chairperson:Email:Phone: ()Academy Member 19.20.RDN/DTRAcademy Member #Questions can be directed to the Academy’s Professional DevelopmentTeam: Phone: 312/899-489
Presents: To Blend or Not to Blend and Everything in Between. Webinar . Thursday, January 15, 2015. 4:00 PM - 5:00 PM Eastern . 3:00 PM - 4:00 PM Central
