What is Blenderized Tube Feeding (BTF)?
Blenderized tube feeding (BTF) is an approach to enteral nutrition that involves using whole foods, cooked and blended into a liquid consistency, and administered through a feeding tube. This differs from standard enteral formulas, which are typically synthetic liquids manufactured with added vitamins and minerals. Patients and caregivers may choose BTF for a variety of reasons, including better gastrointestinal tolerance, perceived health benefits of whole foods, and a desire to incorporate real food into the diet. Examples of blenderized tube feeding fall into two main categories: homemade recipes and commercially prepared products.
Homemade Blenderized Tube Feeding Examples
Homemade blends offer maximum customization and flexibility, allowing caregivers to incorporate a wide variety of fresh, whole foods. These meals are often created to mirror typical family meals but in a safe, liquid form. Consultation with a registered dietitian is crucial to ensure nutritional adequacy.
Sample Homemade Breakfast Blend
- Ingredients:
- 1 cup cooked oatmeal
- ½ cup pureed fruit (such as canned peaches or ripe banana)
- ½ cup yogurt (dairy or plant-based)
- 1 tbsp nut butter
- 1 cup milk or milk substitute
- Water or juice to thin to the desired consistency
Sample Homemade Lunch Blend
- Ingredients:
- 2 oz cooked and shredded chicken
- ½ cup cooked brown rice
- ½ cup cooked and pureed vegetables (such as carrots and sweet potato)
- 3 tsp olive oil
- Broth or water to thin
Sample Homemade Vegetarian Blend
- Ingredients:
- ½ cup cooked quinoa
- ½ cup black beans, rinsed and cooked
- ½ cup avocado
- ¼ cup finely blended kale (cooked)
- ¼ cup orange juice
- Olive oil and spices to taste
General Ingredient Examples for Homemade Blends
- Proteins: Cooked chicken, tender beef, fish, eggs, tofu, legumes, beans, lentils, cheese, and yogurt are all good options. For meats, high-moisture cooking methods like braising or steaming are recommended.
- Carbohydrates: Cooked whole grains such as oats, brown rice, and quinoa are excellent sources of energy. Cooked starchy vegetables like potatoes, sweet potatoes, and pasta also work well.
- Fruits: Canned fruits, pureed fresh or frozen fruit, and applesauce are common choices. Some fruits with small, hard seeds (like berries) may require straining.
- Vegetables: Cooked and pureed carrots, spinach, butternut squash, and peas are easily blended. Cooking fibrous vegetables can help them blend more smoothly.
- Fats: Sources like olive oil, canola oil, avocado, and nut butters provide concentrated calories. Starting with a small amount of oil is recommended to assess tolerance.
- Liquids: Water, broth, milk, juice, or nutritional supplement drinks can be used to achieve the correct consistency.
Commercial Blenderized Tube Feeding Products
For those who prefer convenience or need a nutritionally complete option without the extensive preparation, several commercially available ready-to-use BTF products exist.
Examples of Commercial BTF Products
- Liquid Hope™: An organic, whole-foods, plant-based meal replacement formula.
- Real Food Blends™: Offers a variety of pre-made, shelf-stable meal options based on real food ingredients, such as salmon with oats and squash, or chicken with barley and carrots.
- Compleat®: A formula made with real food ingredients, including chicken, peas, and carrots.
- Kate Farms™: Provides a range of plant-based formulas that can be used as blenderized alternatives, such as Core Essentials and Peptide Plus.
Homemade vs. Commercial BTF: A Comparison
| Feature | Homemade Blenderized Tube Feeding | Commercial Blenderized Tube Feeding |
|---|---|---|
| Customization | High. Allows for complete control over ingredients, consistency, and macronutrient ratios. | Low. Pre-packaged and formulated to a set recipe. |
| Preparation Time | High. Requires significant time for cooking, blending, and cleaning. | Low. Ready-to-use, requiring no preparation beyond chilling or warming. |
| Cost | Varies. Can be less expensive than commercial formulas, but costs depend on food choices. | Higher upfront cost per meal, but consistent pricing and no ingredient prep costs. |
| Nutritional Control | Requires careful tracking with professional guidance to ensure a balanced nutritional profile. | Nutritionally complete and balanced, as verified by the manufacturer and dietitians. |
| Shelf Life | Short. Typically needs to be prepared in 24-hour batches and refrigerated or frozen. | Long. Shelf-stable for extended periods until opened. |
| Safety Risk | Increased risk of bacterial contamination if proper food safety and hygiene protocols are not followed. | Lower risk of bacterial contamination due to sterile packaging. |
Important Considerations for Blenderized Feeding
Tips for Preparation and Administration
Achieving the right consistency and ensuring safety are paramount for successful BTF. High-powered blenders are highly recommended for the smoothest possible texture. After blending, straining the mixture can help remove any remaining skins, seeds, or fibers that could clog the tube. Always use clean equipment and practice good food safety, especially when using ingredients like meat and eggs, which must be cooked thoroughly. Homemade batches should be stored safely in the refrigerator for up to 24 hours. If the blend is too thick, liquids like water, broth, or juice can be used to thin it. Warm foods blend more easily, but the final blend should be administered at room temperature to avoid discomfort.
The Importance of Medical Guidance
Regardless of whether a homemade or commercial approach is used, it is essential to work with a medical team, including a gastroenterologist and a registered dietitian, before beginning BTF. They can help assess the patient's nutritional needs, determine the appropriate formula or recipe, and monitor progress. Starting slowly and monitoring for tolerance is a key step when transitioning to a new blend. The Oley Foundation is an excellent resource for information and support regarding tube feeding, including blenderized diets Oley Foundation.
Conclusion
Blenderized tube feeding provides a compelling alternative to traditional commercial formulas by incorporating real food into a patient's diet. The options range from flexible and customizable homemade blends using a variety of whole food ingredients, to convenient and nutritionally balanced commercial products. While homemade BTF requires more preparation and strict food safety, commercial options offer a simple, ready-to-use solution. Consulting with a healthcare professional, especially a registered dietitian, is vital to ensure that any BTF plan is safe, well-balanced, and tailored to the individual's specific needs.
