Have you decided to blend up real food for your feeding tube, or for the tubie in your life, instead of using commercial formulas? This is usually a harder path to take, without a lot of support from medical personnel. Here are some tips your nutritionist or doctor probably didn’t tell you – and probably doesn’t know.
1. Modify the Bag
If you run your blended food through a feeding pump, first, choose an Infinity pump. Infinity works SO MUCH better for blended diets than Kangaroo. Second, if you’re experiencing a lot of alarms and troubles getting the feed through the pump, modify the bag by snipping off the flow limiter.
Look at the cartridge part of your feeding set (the hard plastic part with the blue). One of the blue tubes has a picture of a drop of water on it. Pull that off. Underneath, you’ll see what’s in the picture. See the part I circled? It’s like a little knob? Cut, snip, or break that part off. (I prefer to just bend it back and forth until it breaks off.) Reassemble the cartridge. Voila.
2. Cap your syringes
We wrote a whole blog post about this! Many 60 mL syringes don’t come with caps, which is a shame. But you can use old extensions (clamp them shut near the part that connects to the syringe, cut off the extra) or even the caps from your feeding sets, if you also use a pump.
3. Insulated Tote To Safely Carry Filled Syringes
Formula is much easier to carry around. It’s shelf-stable. But actual food isn’t – particularly not when blended up. Many feeding tube users find they prefer to carry their feeds already drawn up into syringes for feeding on the go, rather than carry a single syringe and a jar or bottle full of food. Refilling syringes can get messy and usually requires more of an interruption to your day, whereas bringing prefilled syringes reduces the hassle factor quite a bit. If you find you prefer toting prefilled syringes, our Syringe Tote is for you. I’m so excited about this newer addition to my line of feeding tube accessories! It’s double-insulated, has two large compartments inside, and one small compartment, and it’ll hold 5-6 60 mL full syringes plus an ice pack and small accessories like a 20 mL syringe, Gtube cushions, a few predrawn liquid medications, etc.
4. Know your extension
Some people feed their blenderized diet directly into the button using a slip tip syringe. Some people prefer to feed through the more typical Y-Port extension. But many tube feeders prefer one of the two single-port (or bolus port) extensions – the right-angle bolus extension or the straight bolus extension. I personally prefer the right angle bolus extension for pump feeding (no med port to pop open) and the straight bolus extension for syringe feeding (requires less pressure, in my opinion). Get a few of each from your DME and see what you like.
5. O Ring syringes
Regular rubber-plunger syringes stop working after a VERY short period of time. Many blenderized diet users prefer syringes with an O-ring instead, such as the Miracle Syringe. These syringes are often sold by stores that cater to squirrel rehabbers. O-Ring syringes are also sometimes available through DME suppliers, so be sure to ask before you pay out of pocket. Miracle Syringes are Catheter-tip, but you can also get adapter tips to make them into a slip tip if you prefer to feed directly into the button, without using an extension. If you use EnFit, NeoMed makes O-Ring EnFit syringes that you can get through your DME or online medical supply stores. Why bother with getting an O-Ring syringe? They last forever and glide like an Olympic ice skater. I bought a handful of syringes in 2013. I still use them. They still work like a dream.
6. Oil Syringes
If O Ring Syringes aren’t an option for you, you might notice that the rubber plunger syringes provided by your DME start to stick after a very brief period of time. Putting some oil (olive, coconut, any food oil) on the plunger will help keep it sliding smoothly – some people prefer to dip the entire plunger in oil, while others prefer to just slide a few drops down the inside of the syringe.
7. Don’t open RFB all the way
If you use Real Food Blends, don’t open the packet completely! If you’re filling syringes, just open a corner of the packet, and stick the syringe in. If you’re filling a feeding set (bag), just open a corner of the packet and you’ll have more control over where that food goes – and it’ll be easier to squeeze out every last bit.
8. Get a longer hang time with an insulated bag cover.
So many nutritionists and doctors shoot down the idea of a blended diet solely on the basis that the food can’t hang at room temperature for long. And they’re right – it can’t. But it’s like they’ve never heard of insulation and ice packs. Insulated covers plus an ice pack for your feeding sets allow you to have a longer safe hang time – even all night without having to refill. They also will let you carry a feed all day at a safe temperature without having to refill. These really make tubie life just so much easier.
9. Fill pouches with syringes, Fill Syringes with Pouches
Some blended diet users like using baby food packets (either single use or resuable) to carry their blends. Yes, some makers of empty baby food packets sell fancy, expensive equipment to fill the bags, but you don’t need that. You, you lucky tube feeder, have access to syringes! Use your 60 mL syringes to fill the pouches. And then when it’s time to feed, if you push with a syringe, do the reverse – stick the tip of the syringe in the pouch’s opening and pull back on the plunger while gently squeezing the pouch from the bottom up. Easy, and no mess!
10. You do You: junk food, batch/meal, healthy, regular diet
There are so many ways to tube feed, and so many ways to approach a blended diet. You do what works best for YOU. Don’t worry about what Suzie on Facebook does. If you/your tubie doesn’t have any special dietary needs, and if they’d be eating a typical diet if they didn’t have a tube, there’s no reason you HAVE to do anything special just because they DO have a tube. Even with most dietary restrictions, most oral eaters don’t create spreadsheets to manage their daily intake.
If you want to feed chocolate cake through the feeding tube (and there aren’t any legitimate medical reasons not to), go for it. Regular people eat junk food occasionally, and tubies are just regular people who eat via a different route. Does it make more sense to you to bland up a whole day’s worth of food at once? Or a whole week’s? A whole month’s? Do it (use safe storage methods). Does it make more sense to you to blend per meal, just blending up what you’re cooking for everyone else, or what you’d typically cook for yourself? Do it.
Do you want to have your blended diet be super healthy? Go for it. Do you want to serve just a regular, every day, American diet? Go for that. Do you want to make a huge spreadsheet to track every calorie and every micronutrient? Do it! Do you want to never ever do that? Unless there’s a medical reason you need to, don’t!
*obviously, a certain portion of tube fed people DO have dietary restrictions, ranging from issues with food allergies to needing a renal diet, to being unable to digest most foods. Please use your common sense here.
11. Squeasy Gear
I don’t personally use Squeasy Gear, so I can’t provide any sort of personal recommendation, but many blending families swear by it for easy storage and portability of blended feeds.
12. Sharpie scrubs off glass
If you store your blends in glass jars, use a sharpie to label them. So many people try to use crayon, or stick on labels, or dry erase marker. Just use a sharpie. It won’t rub off… but when you wash the jar, your kitchen dish scrubby will take it right off.