Blenderized Tube Feeding in Pediatric Patients: A Systematic review

Abstract

Background: Enteral feeding (EF) is the delivery of liquid nutritional support through a tube for hospitalized patients with gastrointestinal dysfunction who are incapable of eating or unable to meet their nutritional requirements via the oral route. Hospitals’ reports indicate an increased interest and demand for blenderized tube feeding (BTF) as an alternative to commercial enteral formulas particularly in families of tube fed children. In particular, by increasing food sensitivity and more complex identification in children, BTF allows families to adjust their diet to their children's needs. This systematic review aimed to summarize the published evidence regarding BTF in pediatric patients.
 Methods: Literature search was conducted in four databases, including Scopus, PubMed, Science Direct, and Google Scholar, using multiple keywords, such as blenderized tube feeding, blended formula, homemade enteral nutrition, pediatric, and children. Out of 103 retrieved articles, 6 were selected and reviewed.
 Results: Six articles were eligible to be included in the current review. The results showed that calories were approximately 1kcal/g, protein 13 -22%, fat 30 - 34%, and carbohydrates intake 45-55% of total energy intake.
 Conclusions: The results indicated that BTF is acceptable and can be administered to children; however, due to concerns about calorie and macronutrients deficiency, it should be providing under the supervision of a nutritionist. BTFs are a good choice among children; since they can improve gastrointestinal symptoms and are a good option for families who use EF for their children at home. Most pediatric patients use BTFs as a portion of their EF, making it necessary that nutritionists and physicians expand their knowledge about BTFs to appropriately care for these pediatric patients.

Blended feeding in gastrostomy‐fed children—A scoping review

“…Furthermore, blended feeding can be administered safely and can meet nutrient needs if managed by a knowledgeable medical team (Bobo, 2016). Dieticians are deemed essential in supporting careful selection and suitability of individuals for blended feeding and monitoring of effect thereafter by two papers (Bahramian et al, 2021; Jeffery et al, 2022).…”

“…However, it is noted that not all dieticians feel confident in the process of initiating blended feeding; hence, the need for information packs and guidelines for dieticians (Bremner & Brooks, 2022). Guidelines need to address issues around not only implementation but monitoring and how to address nutritional inadequacies as suggested in two papers (Bahramian et al, 2021; Jeffery et al, 2022). In addition to guidelines, O'Sullivan et al (2019) reported the need for training and information to support dieticians in the implementation of blended feeding and suggested the efficacy of a practical training course could be investigated to assess its potential to enhance professional competency in this area.…”

“…Papers included 12 narrative literature reviews (Bakewell et al, 2021; Bennett et al, 2020; Bobo, 2016; Carter et al, 2018; Chandrasekar et al, 2021; Elfadil et al, 2021; Fessler, 2015; Jeffery et al, 2022; Johnson et al, 2013; Martin & Gardner, 2017; Oparaji et al, 2019; Zettle, 2016), one systematic review (Bahramian et al, 2021), one integrative review (Schmitz et al, 2022), two scoping reviews (Breaks et al, 2018; Brekke et al, 2022), seven retrospective chart reviews (Alabbas & Dumant, 2022; Batsis et al, 2020; Kernizan et al, 2020; O'Flaherty et al, 2011; Pentiuk et al, 2011; Poole et al, 2021; Samela et al, 2017), five thesis (Bills, 2015; Breaks, 2019; Bronston, 2016; Durnan, 2018; Schoenfeld, 2013), seven case studies (Brown, 2014; Dipasquale et al, 2022; Gallagher et al, 2018; Khan et al, 2020; Phillips, 2022; Siddiqui et al, 2021; Thomas, 2017), three clinical guidelines (Bremner & Brooks, 2022; Escuro, 2014; Weeks, 2019), one opinion piece (Brown, 2015a), four conference abstracts (Brown, 2015b, 2018; Coles & Gallimore, 2021; Quigley & O'Sullivan, 2017), one rapid review (Coad et al, 2017), three qualitative studies (Durnan et al, 2019; Phillips, 2019; Soscia et al, 2021), nine quantitative survey designs (Armstrong et al, 2017; Boston & Wile, 2020; Epp, 2018; Epp et al, 2017; Johnson et al, 2015, 2018; Kariya et al,…”

“…Professionals find there is a lack of evidence and discussion to support the use of blended feeding in practice and guidelines are needed to inform policy related to the topic (Escuro, 2014; Oparaji et al, 2019; Weeks, 2019). Although review papers have been published (Bahramian et al, 2021; Breaks et al, 2018; Brekke et al, 2022; Coad et al, 2017; Schmitz et al, 2022), these were either deemed out of date or had different aims. This present up‐to‐date review is broader in nature encompassing a breadth of material and was conducted to give a better understanding of the topic with the aim of summarising the published evidence about blended feeding in gastrostomy‐fed children.…”