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MyTubeFeeding.ca | Nutrition and Tube Feeding Formulas

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Importance of good nutrition

Tube feeding is a way of providing nutrition to people who cannot eat and drink enough by mouth. There is a wide range of tube feeding formulas available to provide the nutrition your body needs. Learn more about nutrition and tube feeding formulas.

Why does good nutrition matter?

A healthy diet is more than just "food" – it provides fuel as well as the building blocks to keep or restore health and to help with healing.

Maintaining a healthy diet and good nutrition is important for everyone, but is crucial to the person who has an illness, is receiving certain medical treatments, recovering from surgery, or has had unwanted weight loss. Your body may be working extra hard to restore good health, and this may increase your nutrient needs. The nutrients needed by the body include:

  • carbohydrates
  • vitamins
  • protein
  • minerals
  • fat
  • water

These nutrients work together to maintain and build body tissue and provide energy for your body. Normally, these nutrients are provided by eating a variety of foods. However, because of your special needs, you are getting your nutrition in a liquid form through a tube.

Types of formulas

There is a wide range of tube feeding formulas which may come in different types of packaging. Your healthcare professional will consider your unique needs when choosing a formula – this includes not only your nutrition needs but also the feeding method you are using at home.

Standard formulas are nutritionally complete and are designed for people who require tube feeding and have normal digestion. Standard formulas include the nutrients required to help achieve and maintain health. Standard formulas can be administered through a feeding tube or taken orally; depending on the formulation, product packaging and the persons feeding needs. Some formulas also contain additional ingredients such as fibre, to help support digestive health.

Examples of standard formula include the different calorie options of Isosource®. Ask you Healthcare professional which formula is right for you.

Isosource® and Compleat® are examples of standard formulas.


COMPLETE NUTRITION FORMULAS WITH REAL FOOD INGREDIENTS

Ready-To-Use Commercial formulas
Some commercially prepared formulas are made with real food ingredients such as vegetables, fruit, brown rice and chicken, along with added vitamins, minerals, fibre and other nutrients.  These formulas may be suitable for adults and children who are looking for a convenient ready-to-use formula that contains real food ingredients that are familiar and recognizable. They are appropriate for both short and long term tube feeding.
Example of real food containing formula is Compleat®.

Home-made Blenderized tube feeding formulas
Tube feeding formula can also be prepared at home by blending together your own food ingredients. While home-prepared formula can be more economical than commercial formulas, daily preparation may be time-consuming and care must be taken to make sure all nutrient needs are provided, including protein, carbohydrate and fat and important vitamin and minerals. Care must also be taken to follow clean handling, preparation, and storage of the home-blended formula, to help ensure a food-safe final product. Consult with your Healthcare Professional for help and advice for preparing home blenderized tube feed.
Some individuals choose to use a commercial ready to use formula as a base for their homemade blenderized tube feeding recipes. A nutritionally complete formula such as one of the Compleat® products may be used as a base for a home-blenderized tube feeding. A variety of other foods, including fruits, vegetables, and a protein source, can then be added to the base and blended together.

Benefit of Real Food Ingredients
A formula with real food ingredients, whether commercially prepared or homemade, may help to normalize meal times for you and your loved ones as everyone is consuming easily recognized, real food ingredients.
Ask your Healthcare Professional which formula is right for you.


Semi-elemental/Peptide-based Formulas

Like standard formulas, semi-elemental formulas are nutritionally complete. Semi-elemental formulas are different because they contain some nutrients, like protein and fat, which are 'broken down' into smaller units to make them easier to digest. This is the reason these formulas are also called "peptide-based" formulas – because "peptides" is the name used to describe smaller units of protein. Some semi-elemental/ peptide-based formulas can also be used for both tube-feeding and oral feeding, and some contain ingredients, such as fibre and fish oils.

PEPTAMEN® is an example of a semi-elemental/peptide-based formula.

Specialized formulas are available for people with particular needs such as kidney disease, Crohn's disease, diabetes or those with severe trouble digesting fat and protein.

Novasource®, Modulen® and Vivonex® are examples of specialized formulas.

Modular products are individual nutrients that may be added to formula for those who require additional nutrition. Modular products provide extra protein, fat or calories without adding much volume to the formula itself. If modulars are needed, your healthcare professional will teach you how to use them and provide a recipe if needed.

Microlipid®, MCT Oil and Beneprotein® are examples of modular products.

Microplipid is a registered trademark of Covidien AG and is used under licence.

Formula packaging & hang time

Tube feeding formulas come in different types of packages. Sometimes the terms "open system" and "closed system" are used to describe how the formula is packaged and delivered.

Open system formulas

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PACKAGING

  • Ready-to-use liquids in 'drink box' packaging, bottles, or cans
  • A powder that is mixed with water

DELIVERY

  • Open system formulas are fed using either a syringe or container that the formula is poured into before feeding

Closed system formulas

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PACKAGING

  • Pre-filled 1-1.5 Litre containers or pouches

DELIVERY

  • Closed system formula containers are 'spiked' or pierced with a feeding set before feeding

The term "formula hang time" refers to how long a tube feeding formula should remain at room temperature for feeding – after the formula package has been opened or the original package seal has been broken.

Open system formulas

  • Up to 8 hours* for ready-to-use liquids
  • Up to 4 hours* for powders that have been mixed with water

Closed system formulas

  • Up to 24-48 hours*

*Important Note: always check with your healthcare professional about the formula hang time for your tube feeding formula.

Storing your formula at home

The following information is a general guide. The formula package or your healthcare professional may provide other instructions for your particular formula.

  • Check the expiry date on your formula. Throw away formula that is past its expiry date.
  • Packages that have not been opened can be stored at room temperature.
  • Once a formula package is opened:
    • 'Drink box' packaging, bottles, or cans should be used right away OR covered and stored in the refrigerator. Use it within 24 hours. If not used in 24 hours, throw it away.
    • Pre-filled 1-1.5 Litre containers can be used up to 24-48 hours once spiked or pierced with a feeding set
  • Check the expiry date on your formula. Throw away formula that is past its expiry date.
  • Store powdered formula in a cool, dry place.
  • Check the package to see how long to keep the powdered formula after it is opened.

Common Questions and Answers about Formula Storage and Handling

Should I shake liquid feeding formula before using?

  • Yes. Always gently shake unopened liquid formula packages before using.

Do I need to refrigerate my formula before opening?

  • No. Most often, tube feeding formula is stored and used at room temperature. If a liquid formula package is opened and not used right away, it should be kept in the refrigerator for up to 24 hours.

Will using cold formula upset my stomach?

  • Cold formula may upset your stomach. You can take refrigerated formula out of the refrigerator for 30 minutes to slowly warm up to room temperature before feeding.

Helpful Tip

Helpful Tip

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POSTURE MATTERS: Try not to lie flat during or just after a feeding. Sit upright or lie at a 45-degree angle (about the height of three pillows) during a feeding and for 30 to 60 minutes after the feeding to help prevent nausea or reflux.

Helpful Tip

Helpful Tip

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KEEP A DIARY: to help you and your healthcare professional keep track of your progress and any questions you might have.

Helpful Tip

Helpful Tip

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PLAN AHEAD: If you will be traveling away from home, plan ahead. Leave early to allow plenty of time and bring extras of all your supplies. Find out if and where you can get supplies or formula at your destination and know the location of the nearest hospital, in case you need it.

OWN YOUR FEEDING TUBE:
 Learn how to use and live with your feeding tube in this five-part video series with Gunnar Esiason.

Nestlé Health Science has made every effort to include on this website only information that it believes to be accurate and reliable. This site contains information from a variety of sources including practice-based resources, guidelines from professional organizations, and experiences of healthcare professionals who have managed patients on home tube feeding. Information provided on this site is for education purposes. It is not intended to replace the advice or instruction of your healthcare professionals, or to substitute medical care. Contact a qualified healthcare professional if you have any questions regarding your tube feeding product, prescription and supplies, or if you have a specific question or issues about what is best for you as you manage your tube feeding at home.

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