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How I Do a Blenderized J-tube Diet for My Son

Updated: May 27, 2022


{this blog is written by G’s mom} I fought getting a G/J tube for my son for too long because I thought it meant that I couldn’t blend his food anymore. Luckily I did my research and, armed with information and using my voice, I was able to collaborate with our GI and dietitian to give him real food through the j-tube instead of the normally prescribed enteral formula. Changing to J feeds was surprisingly much easier than I anticipated and we actually love it now. Because he doesn’t have food in his belly, his reflux is much improved and he can “eat” anywhere and in any position - even laying down! On G feeds he had to be sat upright during feeding and for a long while after. No more! It is a bit of a bummer that he no longer has “meal times” - his feeding pump runs 22 hours a day or so - but the benefits definitely outweigh any drawbacks.


Here is how I make my son’s j-tube blend:

  1. We get all 6 flavors of Real Food Blends (https://www.realfoodblends.com/) covered by insurance and he gets two pouches a day with his blend. After looking at the nutrition information, I grouped the pouches in pairs and we rotate them. One day he has the chicken and the egg, the next he has the turkey and the beef, and the third he has the wild salmon and the quinoa and we rotate over and over.

  2. I add in homemade blends of extra fruits and vegetables - usually 4oz of puree. I focus on fruits and vegetables that are not already included in Real Food Blends like broccoli and berries, swiss chard, melons, mushrooms, anything - variety is the key. Initially I used baby food because the dietitian wanted to see labels, but we moved quickly away from that.

  3. Finally, I add 1 tablespoon of a nut butter or 4 tablespoons of hummus, 8oz of grass-fed whole milk and 4oz of Pediasure Harvest. Pediasure has a poor reputation in the blended diet world, but to me the Pediasure Harvest has ingredients I am comfortable with, it is a supplement to his feed and not his entire feed, it tastes good (I’ve tasted it), and it helps us meet his calorie goals in an easy way.


Every morning, I blend everything (minus the milk) together with a ¼ tsp of iodized salt. Then I stir in the whole milk (blending milk creates lots of air bubbles in the blend), sieve strain the blend into a pour-able bowl, and pour it equally into two baby formula pitchers that I got on Amazon (Munchkin Smart Blend Formula Mixing Pitcher, Green, 24 Ounce**). I then add water to reach our volume goal. I keep the pitchers in the refrigerator and pour more blend into his feeding bag throughout the day as needed. I like using two pitchers because right now my son has the first pitcher during the daytime and the second pitcher overnight.


**A word about the Munchkin pitchers. I still use them, but the insert that mixes was very difficult to keep clean. I found that my Magic Bullet lids fit on these pitcher bases so I now only use the pitcher base and not the mix top. I was able to find on Amazon a pour spout top compatible with the Magic Bullet so I am still able to pour from these Munchkin pitcher bases with ease.


Because we are feeding into the J, we are back to using the pump. Blended food can sometimes be too thick to run through the pump effectively. Modifying the bag helps tremendously with this. You can learn about modifying the bag by doing a search in YouTube.


FOOD SAFETY - PLEASE NOTE: Real food is NOT the same as enteral formula. Enteral formula can hang freely during the day without ice packs, but real food needs to be kept at refrigerator temperature when it is hung more than 2 hours. I hang my son’s food in a custom insulated lunch bag specially made for tube feeding that I got on Etsy (https://www.etsy.com/shop/MightyMooseAlters?ref=search_shop_redirect) with two ice packs. Initially I checked the temperature using a small thermometer. Being outside in hot temperatures will make the ice melt faster. Awareness is key with food safety.


When my son got his g-tube, I blended all of his food and it was the greatest joy to be able to do so (read our g-tube how-tos including the blender and other tools we use here https://artforhopelovecure.wixsite.com/cdkl5/post/how-i-do-a-blenderized-gtube-diet-for-g). Even though I am not blending fully like I used to, I am happy with our current plan and with our medical team’s willingness to listen and collaborate with me. I am proud to say that my son is the first child at our children's hospital who has done a blended diet through the j-tube! Because of this initially we had labs drawn more than normal and I am happy to report that all looks good (we do give a multivitamin with iron through the g-tube as iron is absorbed in the Duodenum (who knew?) and his j-tube feeds past that into the Jejunum which is the small intestine. My son is growing beautifully, looks healthy, and is doing well from a nutrition standpoint. As he grows, I will increase calories by incorporating more home blends of fruits, vegetables, proteins, fats, and grains.


Resources:

Need help talking to your medical team about doing a blended diet in the j-tube? Check out this blog post from registered dietitian and tube feeding expert, Claire Kariya. https://www.naturaltubefeeding.com/post/blended-food-j-tubes

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