Tips for Transitioning to a Blenderized Diet
The following information was written by Rachael VanDyke, mom of Kabuki kid Elijah. Elijah battled many gut issues, sugar instability and immune system problems which delayed his development and caused many hospital stays. Rachael began to research homemade blenderized diets and the benefits of doing such a diet. After doing the research, she implemented what she learned. The transition resulted in vast improvements in Eli's immune system, sugar stabalization and developmental growth.
As she says the handout she created, she is not a doctor. She is simply sharing her experience and the research she has done in an effort to give other kids a better option for food given through a tube. All Things Kabuki did not assist with creating content below, and we recommend (as does Rachael) that you consult with your child's physician before implementing a plan.
The Top Things I Wish I Knew When I Transitioned My Son to a Blenderized Diet
By: Rachael VanDyke
Disclaimer: These are my thoughts and opinions that stem from my personal experience transitioning my pediatric tubie from PediaSure® to a blenderized diet... and then to Liquid Hope. I am in no way offering medical advice, but am offering suggestions to things I experienced or learned on our journey making the transition. It is always recommend to be followed under a physician’s care and to refer to your Registered Dietician for the recommended food guidelines that are tailored to the specific needs of your tubie.
Changes we saw in our son with Kabuki Syndrome with switching from traditional commercial formula to a blenderized diet with real food (including the use of Nourish and Liquid Hope):
-Significantly reduced GI symptoms (reflux, vomiting/retching resolved; more normal BMs; was able to stop all GI medications)
-Blood sugar levels became more within normal range (Prior to switch, blood sugars would drop as low as 20s-30s… after switch, blood sugar levels ranged from 60s to low 100s WITH NO MEDICATION)
-Within the first couple of weeks skin color improved (not so pale), increased energy (started taking steps then walking), increased expressive language, hair started coming in thicker, head circumference was showing improved growth rate, just overall improved cognitive function.
-Improved immune system (went from multiple ear & respiratory infections, pneumonias, kidney infections with multiple hospitalizations… to NOT ONE hospital in over 2 years)
-Became more interested in oral eating… with less oral aversion
First and foremost… to prevent headaches and hearing the dreaded, annoying beeping sound of your tubie’s feeding pump reading “NO FLOW IN/OUT” … you need a very high powered blender. The best blender recommended by most individuals in the blenderized diet community is either a Blendtec blender or a Vitamix blender. Both companies have programs available for either discounts (for people using the blender for blenderized diet via feeding tube) or a possible donation of a refurbished blender if income meets criteria. For more information with their discount programs… contact Blendtec @ www.blendtec.com / 800-253-6383… OR contact Vitamix @ (www.vitamix.com / 800-848-2649 / firstname.lastname@example.org.
Other blenders may be used, but you may have to cook foods to soften them (which you may lose some nutritional value during the cooking process). You will also likely have to strain your blends to go through a feeding pump. Typically with Blendtec or Vitamix blenders, you don’t have to pre-cook foods to soften them. Obviously you cook foods you would normally cook, but you can put in raw or frozen fruits and vegetables and it will blend to a smooth consistency… no straining required!
The best pump for blenderized food seems to be the Zevex Entralite Infinity pump. The worst one seems to be the Kangaroo Joey for blenderized food. When using a pump for G or J-Tubes you have to play with the setting and flow rate to see what works for each individual.
When using the Zevex Infinity pump, if your feeds are on the thicker side, you may need to modify the bag. Here is a video explaining.
When transitioning from “tradition commercial formula” (Ex. PediaSure®)… to a homemade blenderized diet, you may find you need to increase the amount of calories for your tubie. For example, a 2-year-old requiring 960 calories of PediaSure® (4 cans/day), may need more l like 1200-1300 calories per day to continue to gain weight. That is what we discovered with our son… BUT every child will be different. You will probably have to use trial and error method and monitor weight to find out what works for your tubie.
FREE WATER IS IMPORTANT!! It is vital, and not only to keep your tubie hydrated. It helps with motility, especially those with slow gastric emptying. It is also a must to help prevent constipation. Most give free water by simply giving it by gravity… 30 minutes before a feed. Even most volume intolerant tubies tolerate free water to gravity, but you can use a pump if you need to. Here is a Facebook post from Blenderized Food for Tubies Facebook page that gives different suggestions of how much and when free water is given.
Another article helpful to some is Fluid Requirements for Children. You can use it as a possible guideline to how much free water your tubie may need per day based on weight. The 2nd and 3rd pages address tubies… Remember, part of the fluids you use for your base in your blends can also count toward the recommended daily amounts of fluids… but it is still important for digestion, motility, etc., to do some of it in free water prior to meals.
Constipation issues…. You may find when making the transition to a blenderized diet that your tubie may start to have firmer stools or even have periods of constipation. There are many options to help with this problem. THE FIRST IS MAKING SURE YOU ARE GIVING ENOUGH FREE WATER!! One of the most popular go-to’s for constipation is BLACKSTRAP MOLASSES… such as this option. Blackstrap molasses is different than regular molasses and has many benefits including: rich in iron, high in calcium, magnesium, potassium, manganese and a good source of Selenium and Vitamin B6.
Each individual requires different amounts of Blackstrap Molasses for desired results. I would recommend starting out with 1 tsp (5mls)… and work up to 1 Tbsp (15mls) added to a blended meal. Increase or decrease as needed. You can give with each meal until you get desired results. Some individuals require daily use of Blackstrap molasses, while others only require on occasion when stools start to become more firm than desired. Other options that tubies use for constipation are prune juice, coconut oil, aloe vera juice, flax oil, etc.
You can use different liquids for the base for your meals. All depends on what your tubie’s needs/tolerances/intolerances are.
-Homemade bone broth is a GREAT base for blends. It has many nutritional benefits and gut healing properties.
-If your child does NOT have issues with dairy, Vitamin D milk will give you 150 calories / 8oz.
-Other NON-DAIRY options: Almond milk, rice milk, hemp milk, bone broth, etc.
Most are trying to make blends/meals that are high in calories, but low in volume… so using a base liquid that is healthy and high in calories can be key to getting optimal calories in.
Don’t make the process too complicated when coming up with recipes or making meals!! Think of what a typical oral feeder would eat at that age and tweak it to the right proportions for recommended daily allowances of carbs, protein, fats, fruits, vegetables, etc.… making sure you are in the ballpark for the amount of calories your tubie needs to either maintain weight… or gain weight if still growing.
***Speak to your Nutritionist/Registered Dietician for what is recommended for your individual tubie’s needs.
***Many families have found going dairy-free and gluten-free have had many beneficial results.
***Many families have also found great results with the following diet plans: GAPS diet, Paleo Diet, and Keto diet.
***Please keep in mind… if attempting a Keto diet, you should be followed by a trained professional such as a doctor and nutritionist.***
REMEMBER… This is your opportunity to feed your tubie the healthiest of foods without them complaining that they don’t like the texture, taste, etc. Use this to your advantage to feed them the healthy options like kale, spinach, numerous nutrient dense packed vegetables, garbanzo beans, etc. Some ideas for healthy FATS are: avocados, flax oil, coconut oil, almond butter. Use this opportunity to skip or cut out the junk that comes in processed foods or foods that are high in sugar or have sugar added.
If making homemade blenderized food is just too overwhelming…
I highly recommend Nourish (for Pediatric population) or Liquid Hope (for older children or adults) –both made by Functional Formularies - as an alternative to homemade blends. For starters… it makes doing a blenderized diet easy and doable for those that live crazy busy lives filled with Dr.’s appointments, therapies… list goes on and on.
Nourish, or Liquid Hope are about the most nutrient complete, well-balanced meal you can get that is pre-made, has a shelf-life of 2 years, and a hang time of 12 hours. It is the only 100% organic real food only, non-dairy, non-GMO, and gluten free, nutrient complete meal that is on the market.
Nourish ingredients include: organic garbanzo beans, organic green peas, organic whole grain brown rice, organic carrots, organic extra virgin olive oil, organic sprouted quinoa, organic whole grain brown rice protein, organic sweet potato, vitamin blend[Calcium Citrate, Sodium Chloride, Potassium Chloride, Potassium Phosphate, Acerola Extract, Choline Bitartrate, Magnesium Glycinate, Mixed Tocopherols, Zinc Gluconate, Folic Acid, Cholecalciferol, Niacinamide, Calcium D-Pantothenate, Copper Amino Acid Chelate, Biotin, Pyridoxine Hydrochloride, Riboflavin, Chromium Picolinate, Methylcobalamin], organic broccoli, organic kale, organic flax oil, organic turmeric, organic ginger, organic alaria (seaweed)
Liquid Hope ingredients include: Filtered water, organic garbanzo beans, organic green peas, organic carrots, organic whole grain brown rice, organic flax oil, organic whole grain brown rice protein, organic sprouted quinoa, organic sweet potato, organic miso, organic broccoli, organic almond butter, organic kale, organic garlic, organic turmeric, organic rosemary, organic ginger, organic wakame (seaweed), vitamin blend [thiamine mononitrate(B1), riboflavin (B2), niacinamide(B3), pyridoxine hydrochloride(B6), cyanocobalamin (B12), ergocalciferol(D2)].
KEEP IN MIND!!! WHEN CALCULATING DAILY FLUID INTAKE
NOURISH AND LIQUID HOPE BOTH STATE “12 OZ” ON PACKINGING… THIS MEANS THAT THE MEALS WEIGH 12 OZ.
WHEN IT COMES TO VOLUME…LIQUID HOPE AND NOURISH ARE ACTUALLY 10 FLUID OZ not 12 OZ!!!
There are now other companies on the market that have the option of real food tube-friendly meals. The reason I personally prefer Functional Formularies’ Nourish/ Liquid Hope over these other brands is for a couple of reasons:
Nourish/ Liquid Hope is 100% organic….
Nourish/ Liquid Hope do not have any form of added sugar, nor do they use juice concentrates in their meals
Blenderized Food for Tubies Facebook Page : Great resource for asking any questions you may have… and receiving answers from individuals around the world that have lots of experience with blenderized diet.
Kathy Reed’s Blog (Kathy is a fellow Kabuki mom, she has numerous posts regarding dietary intervention)
Homemade Blended Formula Handbook – 2007 by Marsha Dunn Klein M.Ed. OTR/L (Author)
The Heal Your Gut Cookbook: Nutrient-Dense Recipes for Intestinal Health Using the GAPS Diet Paperback – September 9, 2014 by Hilary Boynton (Author), Mary G. Brackett
(GAPS Diet) Gut and Psychology Syndrome: Natural Treatment for Autism, Dyspraxia, A.D.D, Dyslexia, A.D.H.D, Depression, Schizophrenia Revised & enlarged Edition by Natasha Campbell-McBride