What is a Blenderized Tube Feeding (BTF)?
Blenderized tube feeding (BTF) involves pureeing whole foods and liquids into a smooth consistency to be administered through an enteral feeding tube. This can be either a homemade mixture or a commercially prepared product. Historically, before the widespread availability of commercial formulas in the 1970s, blenderized foods were the standard for tube feeding. Today, BTF has seen a resurgence, driven by patient and caregiver desires for whole-food nutrition and reported improvements in gastrointestinal (GI) symptoms.
The rise of whole-food diets for tube feeding
Many patients and caregivers are drawn to BTF for a variety of reasons, including a desire to control ingredients, manage specific food allergies or intolerances, and improve perceived health outcomes. It allows for a more diverse diet, potentially incorporating foods shared during family meals, which can provide a sense of normalcy. However, this practice is not suitable for everyone and must always be managed in consultation with a qualified medical team.
Homemade vs. Commercial Tube Feeding: A Comparison
There are two main approaches to providing blenderized nutrition through a feeding tube: using homemade purees or commercially prepared blenderized formulas. Each has distinct advantages and disadvantages that must be considered.
| Feature | Homemade Blenderized Tube Feeding | Commercial Blenderized Tube Feeding |
|---|---|---|
| Nutritional Content | Variable; depends on ingredients and preparation. Requires careful planning and analysis with a dietitian to ensure adequacy. | Nutritionally complete with precise amounts of macronutrients, vitamins, and minerals. |
| Preparation | Time-consuming; requires shopping, blending, and proper storage. Needs a high-powered blender and meticulous food safety practices. | Ready-to-use; requires no preparation time and is shelf-stable. |
| Cost | Can be cheaper than commercial formulas, but costs for high-quality blenders and ingredients may be significant. | Costs may be high, though sometimes covered by insurance. Not all options are covered. |
| Convenience | Less convenient due to daily preparation and storage requirements. Challenging during travel. | Highly convenient; requires minimal effort and is easy to use on the go. |
| Hygiene | Higher risk of bacterial contamination if not prepared and stored with strict food safety measures. | Aseptically packaged and sterile, significantly reducing the risk of contamination. |
| Tube Clogging | Higher risk, especially with smaller tubes or insufficient blending/straining. Requires a larger bore G-tube (14 French or greater). | Lower risk of clogging due to a smooth, uniform consistency. |
Important Considerations and Risks
Using regular food in a feeding tube is a complex medical decision with several critical factors to address. Simply blending food at home without proper guidance can lead to serious health complications.
Candidate suitability
Not all patients are suitable for a BTF diet. Key considerations include the patient's age, medical stability, and the type of feeding tube.
- Tube Type: BTF is typically only recommended for gastrostomy (G-tubes) that feed directly into the stomach and are 14 French size or larger to prevent blockages. Nasogastric (NG) tubes and jejunostomy (J-tubes) are generally not suitable.
- Medical Condition: Patients with compromised immune systems, complex medical issues, or poor gastrointestinal function may not be good candidates.
- Age: For infants, it's generally recommended to wait until at least 6 months before introducing blended foods gradually, and only with medical supervision.
Potential risks and complications
- Tube Blockages: Improperly blended food with seeds, fibrous material, or thick skins can easily clog a feeding tube, which may require replacement and can be a significant inconvenience. High-powered blenders and fine-mesh strainers are essential tools to prevent this.
- Nutritional Inadequacy: Homemade recipes may be deficient in essential vitamins, minerals, and calories, especially if not carefully planned by a dietitian. It can be challenging to achieve the necessary nutrient density without increasing the total volume of food, which may cause intolerance issues.
- Bacterial Contamination: Without strict food safety and hygiene practices, blended food can become a breeding ground for bacteria. This risk is higher with homemade recipes compared to commercially sterile formulas, especially if the prepared food is left at room temperature for extended periods.
- Gastrointestinal Distress: Patients may experience nausea, vomiting, or diarrhea if the blend is not properly tolerated. The thicker consistency or the introduction of new foods requires a gradual approach.
Steps for Safe Homemade Blenderized Tube Feeding
If your healthcare team determines that a BTF is appropriate, these steps are crucial for safety:
- Consult with a Dietitian: A registered dietitian is essential for creating a nutritionally complete and safe recipe plan tailored to your specific needs.
- Invest in Quality Equipment: A high-powered blender is a must for achieving the necessary smooth consistency. You may also need measuring equipment, a food thermometer, and airtight storage containers.
- Prioritize Food Safety: Practice impeccable hygiene. Wash hands, surfaces, and all equipment thoroughly. Avoid cross-contamination by using separate cutting boards for raw meats and produce.
- Prepare and Store Correctly: Prepare batches that will last no more than 24-48 hours when refrigerated. Never leave prepared food at room temperature for more than two hours. Label containers with the contents, date of preparation, and 'use by' date.
- Achieve the Right Consistency: Blend for several minutes until the mixture is completely smooth and can be drawn easily into a syringe without resistance. Strain the mixture to remove any remaining particles, especially if using a less-powerful blender.
- Administer Carefully: Use the correct method (usually bolus feeding via syringe) and flush the tube with water before and after each feeding to prevent clogs.
Conclusion
Yes, it is possible to put regular food in a feeding tube, but it is not a simple DIY project. While a blenderized diet offers potential benefits like improved GI tolerance and the psychosocial advantage of eating 'real' food, it comes with significant risks, including tube blockages, nutritional deficiencies, and bacterial contamination. Unlike sterile commercial formulas, homemade BTF requires a substantial commitment to safe food preparation, sanitation, and nutritional accuracy. The decision to pursue a blenderized diet should always be made in close consultation with a medical team, including a dietitian, to ensure it is both safe and nutritionally adequate for the individual's specific needs.
To find more guidance and resources on blenderized tube feeding, consider exploring organizations like the Oley Foundation, which provides support and resources for home nutrition support patients.
