How I Transitioned My G-Tube Twins to a Blended Tube Feeding Diet
I knew from the beginning of our tubie journey that if the boys were still being tube fed by 12 months old (corrected age), then I was going to blend them real food. This is how I did it!
Before I start, I should add that I am not a doctor, dietician, etc and what works for my kids may not work for yours, or be appropriate for certain medical conditions, or whatever. So, don’t take this as medical advice. 🙂
I’m also not going to rant on about the grossness of enteral tube formulas. Please note I said ENTERAL, not regular baby formula. Don’t email me or DM me with “fed is best” shit, LOL. I am not talking about breastfeeding vs formula feeding “typical”, healthy babies or shaming anyone for their choices, even those who choose to feed their tubie kids these specialty tube-feeding formulas that I think are gross (Nestle Compleat, Kate Farms, Pediasure etc). I literally don’t care what YOU feed YOUR kid. I just don’t want that for mine. No shaming, no judgment, everyone do whatever works for THEIR family, ok!
Now that those disclaimers are out of the way… 😉
As the boys approached 12 months corrected age, I became antsy to figure out how I was going to switch them to real food, since it was apparent oral eating was not going to magically happen by then. We had been in feeding therapy for 9 months at that point with zero progress, though that’s a topic I’ll write about another time. Without going into details, our “eating team” we saw regularly was/is a huge source of anxiety and stress for me, doesn’t act in the best interests of my children, and honestly made me so angry many times for various things, including pushing these tube formulas on me without being able to answer what the ingredients are, why real food would not be better, how to get started with real food blending, or literally any logical reason why they shouldn’t have real food.
They also perpetuated the boys’ severe reflux for much longer than necessary. It wasn’t until we finally bit the (financial) bullet and hired a private feeding therapy team (Growing Independent Eaters) that we solved 95% of the boys’ reflux in like TWO WEEKS and I suddenly had two happy, smiley babies (most of the time… I mean they’re still babies lol).
ANYWAY. This isn’t about my anxieties around feeding therapy, though I could write a novel on that!
I was determined to feed the boys real food after they hit 12 months corrected, just as most people do with their typical kids (obviously some continue breastfeeding longer! but I mean the introduction of table foods as the main meal instead of milk/baby formula).
I faced a lot of opposition and if it wasn’t for the strong convictions I had and my ability to grow a backbone around that time (it was still new), I probably would have caved to the pressure and been forced to feed the boys Nestle Compleat or Pediasure as their SOLE source of nutrition. (barf)
Our pediatrician wasn’t against blended diets, but had no advice for me deferring me to other specialists, who then deferred me to other specialists, who then deferred me to…. you get the idea. An endless bureaucratic chain of no one actually helping me. Our eating team, as described above, said things like “I wouldn’t have time to blend”… um, ok. So what would I do if they ate by mouth? Just, not have time to make them food so they’d starve? Obviously you find the time in the day to feed your children, people, no matter how busy you are! Jeez.
Other statements I was told by various medical people on our “team”:
- “The enteral formulas are the exact same as food so there’s no point in blending.” (Oh really, is a diet of maltodextrin, sugar and corn syrup with a multivitamin thrown in the same as food? Is it really? Yes, those are the real first 3 ingredients in this shit.)
- “Nestle Compleat Organic blends is….. ORGANIC!!!!” (Oh wow, thanks for the newsflash. It’s got some mangoes in it…. and then all the other shit that’s in the other crap formulas. Cool.)
- “It’s not safe. There could be bacteria.” (Yes, I know how to cook/prepare food safely and properly. You mean I shouldn’t touch raw chicken and then rub those hands all over every other piece of food I eat? Shiiiiiiiit.)
- “The (crap) formulas are free!” (Garbage is also free on the side of the road. Do I pick up every piece of garbage I see, giddy with excitement at how FREE it was?)
- “A blended diet isn’t complete nutrition!” (Do you eat the exact same thing every single day with the exact same calorie content and nutrient content? Ohhhh no, I didn’t think so. It’s called variety, also known as healthy eating.)
- “They need PRECISELY 800 calories a day!” (I appreciate the calorie target and will base my blends on that target. One day they may get 700, the next 900… also called variety. No one eats that precisely!)
These are all things said by doctors, dieticians, etc… people who work with tube-fed children exclusively. So, it’s not a lack of knowledge issue about tube feeding. It’s literally their job to care for tube-fed kids. And these are the things they say and believe? Eeegad.
And the most angering thing I was told?
“We need to ask Dr. X, Dr. Y and Dr. Z and then we’ll LET YOU KNOW if they approve a blended diet for the boys.”
They’ll LET ME KNOW.
Oh, how generous of them for letting me the fuck know!
So glad they’d LET ME KNOW what I can and cannot feed my own damn children, who do not have any medical conditions requiring a special diet.
I stewed over that for MONTHS (because it took them 2 months to “let me know” it was approved). Of course in that time, I had already switched them over to a blended diet by myself, with some help from the trusty Internet and some wonderful people I’ve met on social media with so many helpful tips.
Yeah, I had to go to the internet to find out how to feed my kids! We see a million doctors and specialists and teams with daily appointments but god forbid ANYONE could help me practically, actually switch to a blended diet… Your tax dollars at work!
How I Switched Them to Blended!
OK, so now getting to the actual point of the post. 🙂 Here is step by step how I did it. Of course this may not work exactly the same for your child/children, but I hope it at least helps serve as a place to start researching blended diets, the benefits, and how easy it is once you get past that initial switching period!
First, I did a lot of research for HOW to blend. It sounds silly. Just throw food into a blender and hit “blend”, right? NO MY FRIEND. NO. You need to know the best kind of blender to get (Vitamix or Blendtec – Blendtec has a medical discount program available!), what kinds of things don’t blend well (potatoes 🤦🏼♀️), troubleshooting blends that are too thick/thin, how to get it to run through your pump, etc.
Here are my favourite places to research:
Crunchy Tubie Mama – she writes a lot about Nestle, Abbott (and other formula companies) and writes the truth about their products. Also provides great tips to get started blending and coaching services. I hired her to help transition the boys over and it was really helpful!
After getting familiar with blending, I played around trying to make recipes to meet their calorie and macro goals OBSESSIVELY (since I was conditioned by our feeding team to make sure they had exactly 800 calories, 960ml of total fluids, etc per day). Then, I got fed up with that bullshit and bought the recipe book from Natural Tube Feeding instead. LIFE SAVER.
Her recipes are usually 30 cal per oz (a good target to hit to keep volume down for volume-sensitive kiddos), delicious and easy to make. BEST THING I EVER BOUGHT. There are also lots of great recipes in the Files section of the Blenderized RN Facebook group I mentioned above.
Then I entered what I will now refer to as the 2 Weeks of Hell.
I tried to feed the boys one blended meal per day (I was still pumping so the others were breastmilk as usual). It was a disaster. My blends were too thick, the pump kept alarming, they puked it all up… although they puked up breastmilk all the time too so it wasn’t anything new.
I was so frustrated and really wanted to make blending work, but I didn’t see how it was going to get any better.
Then I found Veronica’s method for switching kids over using bone broth. Basically you make homemade bone broth (she has her broth recipe videos here which are super easy to follow), swap that in over a period of 2-7 days, then start gradually adding other items into the broth soup to build up tolerance to foods.
I used this approach with the boys, slowly over a week, along with the tips from Crunchy Tubie Mama on what meals to serve (she provided me some simple starter recipes for oatmeals, lunches, simple dinners, etc that were a great starting point). Over 1-2 weeks, I added in more ingredients.
For example, the first couple days were JUST clear bone broth (for 1-2 meals a day, the rest milk). Then on the 3rd day, I added chicken and carrots to the broth. That went well. Then the next day, I added rice to it. Then the next day, I made a breakfast of egg and avocado and milk. Then the next day, oatmeal. Then added fruit to the oatmeal…
You get the idea. Basically I slowly made meals more complex as the weeks went on, instead of my initial strategy which was just giving them these pretty rich meals (protein, carbs, fats – multiple ingredients) all at once, which I don’t think their stomachs were prepared for, having never had any food before.
After about 2-3 weeks, puking diminished. I started using all the recipes from the Natural Tube Feeding book (and still do) with no issues. They didn’t make the boys puke like before! It was magic!
The biggest change came when I switched to bolus syringe feeding thanks to the help of Growing Independent Eaters, who helped me figure out a new schedule and how to push the blends quickly but in a way that actually helped reflux. Feeds went from taking 2 hours on the pump to 30 mins with a syringe (!) (+30 mins resting time upright after). LIFE. CHANGING.
The boys still have reflux but it’s so much better now, and both are much more comfortable. Jaxon started smiling all the time and laughing – finally free of belly pain. It’s truly made such a difference and I’m so glad I stuck out the first few tough weeks of learning what works to get to where we are now.
How I Blend Now
I don’t freeze much. I typically blend enough for 2 days at a time (the longest a blend should be stored in the fridge), and then blend again on the evening of the 2nd day. I’ll make 2-4 recipes and repeat those for the 2 days.
I usually do a fruit oatmeal based recipe for breakfast, alternating what fruits I use depending on what I have/what’s in season. For the mid-morning feed, I do scrambled eggs and toast, or an egg omelette, or more of a lunch recipe like a sandwich and milk, soup, etc. For the late-afternoon and dinner feeds, I usually do more dinner-type food (BBQ chicken thighs, rice, veggies or pasta and veggies, or veggie options like butternut squash soup, etc).
I store the blends in 500ml glass Mason jars, about 400ml worth which is enough to feed both boys (plus a bit extra as some gets lost pouring, stuck to the sides, etc).
Now that I’ve got the hang of what works for our family, it’s easy and fun to blend meals for them! Not always easy to fit in the time to cook the items in the first place (lol), but I’m making it work.
Do you do a blended diet? What’s your style or go-to recipes?