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)