Homemade Blended Homemade Blended FormulaFormula

Marsha Dunn Marsha Dunn Klein, MED., OTR/LKlein, MED., OTR/Lwww.mealtimenotions.cowww.mealtimenotions.co

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ObjectivesObjectives• 1. Describe why some parents are 1. Describe why some parents are

choosing homemade blended formulachoosing homemade blended formula• 2.Describe the similarities between HBF 2.Describe the similarities between HBF

and oral feeding food transitionsand oral feeding food transitions• 3.List precautions for HBF3.List precautions for HBF• 4. Describe anecdotal benefits4. Describe anecdotal benefits• 5. Understand specifics on how to 5. Understand specifics on how to

support families choosing to provide HBFsupport families choosing to provide HBF• 6. Describe how to start HBF and how to 6. Describe how to start HBF and how to

monitor itmonitor it

What is it?What is it?

• ““Blenderized formulaBlenderized formula””? ? ““Blenderized Blenderized feedingsfeedings””? Blenderized diet?? Blenderized diet?

• ““HBF celebrates the individual HBF celebrates the individual nature of the formula and the nature of the formula and the personal effort made in providing personal effort made in providing the loving tube fed mealthe loving tube fed meal”” (Nutrition (Nutrition Focus Sept/Oct 2004)Focus Sept/Oct 2004)

• Nurturing through feedings is a Nurturing through feedings is a natural parental responsenatural parental response

““Let food be your Let food be your medicine”….Hippocratesmedicine”….Hippocrates

A historical lookA historical look

• Homemade food dates back to Homemade food dates back to ancient timesancient times

• Homemade to Commercial Formula Homemade to Commercial Formula • Today…….increased optionsToday…….increased options

Tube Feedings are Tube Feedings are Mealtimes,too!Mealtimes,too!

Starbucks story

Support of optionsSupport of options

• We need to support families who We need to support families who want to do thiswant to do this– Common doctor/dietitian responsesCommon doctor/dietitian responses

• HBF is not for everyoneHBF is not for everyone• Nutrition conscious families are Nutrition conscious families are

interestedinterested• We can learn WITH familiesWe can learn WITH families• We can guide familiesWe can guide families

Anecdotal AdvantagesAnecdotal Advantages

• Parent responseParent response• Dietary diversityDietary diversity• Bowel healthBowel health• Reflux reductionsReflux reductions• GrowthGrowth• Increased volume tolerance Increased volume tolerance • Changes in oral interestChanges in oral interest

CautionsCautions• Clog tubeClog tube• Hygiene in preparationHygiene in preparation• Balanced nutritionBalanced nutrition• VolumeVolume• HydrationHydration• AllergiesAllergies• Bolus vs drip?Bolus vs drip?• Tube sizeTube size• PortabilityPortability

Relationship to Oral FeedingRelationship to Oral Feeding

Diversity provides the best nutritionDiversity provides the best nutrition

Similarities with oral feedingSimilarities with oral feeding

Continuum of optionsContinuum of options

………………Organic to commercial baby Organic to commercial baby foodfood

Each family eats differently……Each family eats differently……reflected in HBF choices………………reflected in HBF choices………………

““The RecipeThe Recipe””??

• Food Pyramid/ My PlateFood Pyramid/ My Plate• Weight and growth parametersWeight and growth parameters• Common senseCommon sense

Where to start?Where to start?

• Review plan with physician and dietitian Review plan with physician and dietitian • Knowledge of food pyramid guidelinesKnowledge of food pyramid guidelines• Go slowly with growth monitoringGo slowly with growth monitoring• One food at a time, watching for One food at a time, watching for

reactionsreactions• Slowly create boluses , adding foods and Slowly create boluses , adding foods and

subtracting formula as tolerance and subtracting formula as tolerance and growth supportgrowth support

Support ParentsSupport Parents

• InformationInformation• Medical Medical

Approval Approval • Dietitian Dietitian

supportsupport• Parent to Parent to

parentparent

ResourcesResources

• Nutrition FocusNutrition Focus ““Homemade Blended FormulaHomemade Blended Formula”” Sept/Oct 2004 Contact: Sharon Feucht, MA, Sept/Oct 2004 Contact: Sharon Feucht, MA, RD, RD, Nutrition FocusNutrition Focus, CDMRC, WJ-10 University , CDMRC, WJ-10 University of Washington, Seattle, WA 98195of Washington, Seattle, WA 98195

• Homemade Blended Formula HandbookHomemade Blended Formula Handbook, Klein , Klein and Morris, Mealtime Notions (2008) and Morris, Mealtime Notions (2008) www.mealtimenotions.comwww.mealtimenotions.com

• Oley Foundation Oley Foundation www.oley.org

• An overview of Tube Feeding: From Ancient An overview of Tube Feeding: From Ancient Times to the Future, Times to the Future, Ronni Chernoff, SAGE Ronni Chernoff, SAGE Journals Online Nutrition in Clinical Practice, Journals Online Nutrition in Clinical Practice, Vol. 21, No. 4, 408-410 (2006)Vol. 21, No. 4, 408-410 (2006)