Essential Considerations Before Making NGT Food
Before you start blending, it's crucial to consult with a healthcare professional, such as a registered dietitian. Homemade blends are not suitable for all patients, particularly those with thinner nasogastric tubes, jejunal tubes, or compromised immune systems, due to a higher risk of tube blockage and bacterial contamination. Your healthcare team will confirm if blenderized tube feeding (BTF) is appropriate and help you create a nutritionally balanced plan.
Commercial vs. Blenderized Tube Feeding
Choosing between commercial formulas and homemade blenderized food is a key decision, with each option offering distinct advantages and disadvantages.
| Feature | Commercial Formula (CF) | Homemade Blenderized Food (BTF) |
|---|---|---|
| Nutritional Content | Precisely quantified nutrients, sterile, and tailored for specific medical conditions. | Contains whole foods with a wider variety of natural vitamins, minerals, and fiber. |
| Cost | Generally more expensive, though often covered by insurance for medically necessary cases. | Can be less expensive directly, but costs for equipment (e.g., high-powered blender) are typically out-of-pocket. |
| Preparation | No preparation needed; sterile and ready to administer. | Requires meticulous food preparation, blending, and proper storage to ensure safety. |
| Risk of Clogging | Lower risk of tube clogging due to controlled viscosity. | Higher risk of clogging, especially with thinner NGTs; requires precise blending and straining. |
| Bacterial Risk | Essentially zero risk due to sterility. | Higher risk of bacterial contamination if strict food hygiene and storage protocols are not followed. |
| Feeding Method | Administered by pump for thinner formulas or syringe for thicker ones. | Best for bolus syringe feeding due to thicker consistency; requires a larger bore tube. |
| Gastrointestinal Effects | Some patients report adverse GI symptoms like reflux or constipation. | Many patients report improved tolerance and fewer GI symptoms. |
Step-by-Step Guide for Preparing NGT Food
Once you have clearance from your healthcare team, follow these steps to prepare homemade blends safely.
Step 1: Gather Your Equipment
- High-powered blender: This is essential for achieving a completely smooth, liquid consistency required to prevent tube blockages. Examples include Vitamix or Blendtec.
- Measuring cups and spoons: Ensure accurate portioning for calorie and nutrient control.
- Large syringe (e.g., 60ml): Used for administering the feed via the bolus method.
- Strainer or sieve: To ensure the blended food is completely smooth and free of particles.
- Airtight containers: For safe storage of prepared blends in the refrigerator or freezer.
- pH strips: Used for checking tube placement, though not all protocols rely on this solely.
Step 2: Choose and Prepare Your Ingredients
- Select nutritious foods: Use a variety of fruits, vegetables, lean proteins, healthy fats, and grains. The key is balance. Ideas include well-cooked chicken, eggs, spinach, sweet potatoes, bananas, and oatmeal.
- Wash and cook thoroughly: Practice excellent food hygiene. All food, especially meats and vegetables, must be cooked to a safe internal temperature to kill bacteria.
- Chop into small pieces: Cut food into small, uniform pieces to facilitate blending.
Step 3: Blending and Consistency
- Use adequate liquid: To achieve the right viscosity, use a sufficient amount of liquid. Options include milk, formula, cooking water, or broth. A dietitian can advise on the best choice based on nutritional needs.
- Blend until completely smooth: Blend the mixture until no chunks or fibrous strings remain. The consistency should be similar to smooth cream and should pass easily through a syringe without resistance. If it's too thick, add more liquid. If too thin, add starchy vegetables or grains.
- Strain the blend: For extra safety, especially with NGTs, straining the blend can catch any remaining particles that could cause a blockage.
Recipe Example: High-Protein Blenderized Shake
This recipe can serve as a base, but should always be tailored by a dietitian for specific nutritional needs.
Ingredients:
- 1/2 cup cooked chicken breast
- 1/2 banana
- 1/4 cup cooked sweet potato
- 1/4 cup low-fat plain yogurt
- 1 tbsp peanut or almond butter
- 1 tsp canola oil
- 1 cup milk or commercial formula
Instructions:
- Combine all ingredients in a high-powered blender.
- Blend on high speed for 1-2 minutes until completely smooth.
- Check the consistency. If too thick, add more milk. If too thin, add more banana or yogurt.
- Strain the mixture through a fine-mesh sieve to ensure no lumps remain.
- Administer the blend or store it safely.
Important Safety and Handling Procedures
Proper handling is critical to prevent bacterial growth and other complications.
- Storage: Store unused blended food in the refrigerator for no more than 24-48 hours. Freeze larger batches in individual portions for up to three months.
- Warming: Warm blends gently by placing the container in warm water. Never use a microwave, as it can create hot spots that could burn the patient and degrade nutrients.
- Administration Time: Use prepared feeds within two hours if left at room temperature. After this period, bacterial growth can become a concern.
- Tube Flushing: Always flush the NGT with the prescribed amount of water before and after each feeding to prevent clogs.
- Tube Placement: Before every feed, verify the tube is correctly placed by checking the external markings and, if trained, testing the pH of stomach aspirate. If placement is uncertain, do not feed.
- Elevation: Keep the patient's head elevated at 30-45 degrees during and for at least one hour after feeding to prevent reflux and aspiration.
Conclusion: A Collaborative Approach to NGT Feeding
Making food for NGT feeding can be a rewarding way to provide natural, varied nutrition, but it requires diligent attention to safety and preparation. The risks of tube blockage and bacterial contamination, particularly with thinner nasogastric tubes, necessitate careful planning and expert guidance. Always work closely with a healthcare team, including a dietitian, to ensure the blend is nutritionally complete and safe for the patient's specific needs. With the right approach and proper precautions, homemade blenderized food can be a safe and beneficial option.
