{this blog is written by G’s mom} When my son got his g-tube placed in May 2019, I was adamant that I was going to continue to feed him real food and not feed him enteral formula. His tube was not a surprise so I had plenty of time to learn and prepare for the transition. I purchased two books that I highly recommend (Homemade Blended Formula Handbook is number one!):
Homemade Blended Formula Handbook by Klein and Morris https://smile.amazon.com/Homemade-Blended-Formula-Handbook-Marsha/dp/0692651241/ref=mp_s_a_1_1?keywords=homemade+blended+formula+handbook&qid=1574017315&sprefix=homemade+blend&sr=8-1
Complete Tubefeeding by O’Gorman https://smile.amazon.com/Complete-Tubefeeding-Everything-tubefeeding-nutrition/dp/1470190222/ref=mp_s_a_1_3?keywords=homemade+blended+formula+handbook&qid=1574017429&sprefix=homemade+blend&sr=8-3
There are SO many benefits to feeding real food through the g-tube and it is not difficult or complicated. Actually, blending for tube feeds isn't all that different than what I was already doing when I blended my son's oral purees! Here is how I do it:
1) I Stockpile. Every month or so I batch blend fruits and vegetables and freeze them in 4oz containers. This way I always have variety on hand. I also batch cook meats (or make extra) and freeze in individual portions. I always have granola and Belvita Biscuits (great calories!), honey, apple sauce, and some baby food jars in the pantry too for quick add-ins. In my fridge I keep grass-fed whole milk, grass-fed butter, real maple syrup, and organic yogurt as well as nut butters especially for him, and I keep high quality extra virgin olive oil and avocado oil on hand.
2) I blend as much of what we eat as I can. Last night I made meatloaf so today my son had that in his blend. He has no allergies or food restrictions so as long as it can be blended (and anything can!) he can have it.
3) I make two blends per day and divide it into four feedings. I make a breakfast style blend and a lunch/dinner style blend. I make sure to include all food groups and reach my calorie goal for the day. The "Homemade Blended Formula Handbook" is great for understanding what goals should be for calories and water intake and gives sample meal plans that break down recommended food group amounts. My son also has a dietician on his medical team who I consult with about calorie and fluid goals as well as vitamins and monitoring of his bloodwork in conjunction with his GI team.
4) I keep Real Food Blends brand g-tube meals in the pantry for emergency use (like to take to the hospital) or for days when we will be away from home and I need to use the feeding pump. Sometimes it is tricky with blending to get the right consistency for the pump so RFB makes it easy. I also have used Whole Story Meals which is a powered product that you just add liquid to. So easy! Usually I feed my son by pushing the food with a 60ml syringe.
Here are some tools I use for blending and feeding:
O-Ring Syringes - Before my son got his g-tube I spent a lot of time researching and learning about home blending for g-tube eaters (highly recommend “Blenderized RN” private Facebook group). Many, many moms were recommending o-ring syringes. They work better and last longer than the syringes the DME gives you with your g-tube supplies. Now that he is bolus fed and not on the pump, we use these syringes every meal. I purchased 6 of the 60ml and 3 of the 100ml. https://www.squirrelstore.com/product/80013
Squeasy Gear - Another product I learned about on Facebook is Squeasy Gear. It is a complete game changer for bolus feeding! I can fill my Squeasy Gear bottle, grab a syringe, and feed an entire meal with no mess. Amazing! I get the 16oz. Easy to clean and, unlike the dreaded pump, all the food comes out with no waste. http://squeasygear.com/16oz-aqua-squeasy-sport/
Blentec Total Blender - If you are going to blend for your g-tube eater you really should get a high quality blender. They are expensive, but worth it considering you’ll use it for literally every meal you make! I got a Blentec Total Blender at Costco (on sale!) and it came with both a WildSide large jar and the Twister smaller jar. I use the large jar for batch blends and the small one for single meals. I also purchased the mini WildSide jar and use it for small daily blends too. It liquifies homemade chicken soup with veggies in one minute! https://www.costco.com/Blendtec-Total-Blender-with-WildSide%2b-Jar-%2526-Twister-Jar.product.100052400.html
Sieve Strainer - Just to be doubly cautious, I always strain my blends before pushing them through the g-tube. I like this sieve strainer because it is extra fine and gives me confidence that there are no grits or lumps that could cause me trouble. https://www.amazon.com/OXO-Good-Grips-8-Inch-Strainer/dp/B00004OCLX/ref=sr_1_fkmrnull_3?keywords=oxo+8+inch+sieve+strainer&qid=1558381800&s=home-garden&sr=1-3-fkmrnull
I love blending for my son. It makes me happy knowing he is getting a good variety of nutrition and can eat what our family is having. It is also fun on holidays giving him those special foods like everyone else. Even pie!
For Reference (no surprise - real food is superior to enteral formula):
"A SickKids-led collaborative study with Children’s Hospital of Eastern Ontario (CHEO) has shown the benefits of switching gastrostomy tube (G-tube)-fed children from commercial formula to homemade puréed food." Read the article here: https://www.sickkids.ca/en/news/archive/2018/sickkids-led-study-shows-success-with-a-blenderized-diet-for-children-with-g-tubes-/
"Pureed by gastrostomy tube diet improves gagging and retching in children with fundoplication" https://pubmed.ncbi.nlm.nih.gov/21527599/
"Blenderized Enteral Nutrition Diet Study: Feasibility, Clinical, and Microbiome Outcomes of Providing Blenderized Feeds Through a Gastric Tube in a Medically Complex Pediatric Population" https://pubmed.ncbi.nlm.nih.gov/29338077/
"Efficacy and Tolerance of Blended Diets in Children Receiving Gastrostomy Feeds" https://pubmed.ncbi.nlm.nih.gov/31549432/
"Health Outcomes and Quality of Life Indices of Children Receiving Blenderized Feeds via Enteral Tube" https://pubmed.ncbi.nlm.nih.gov/31128885/
Update: My son is now fed via j-tube. Check out my updated blog on what he "eats" now: https://artforhopelovecure.wixsite.com/cdkl5/post/update-how-i-do-a-blenderized-j-tube-diet-for-g