Tag Archives: Bolus Feeding

Meet Raiden

Working with Raiden’s mom was an amazing experience. She was highly motivated which was crucial in taking on a blended diet for Raiden. A blenderized diet takes time and commitment and we were working together with 3000 mile and 2 time zones in between us. The fact that we both owned a Vitamix made it easier for me to create a blend for her and have her repeat it seamlessly step by step. My joy comes from seeing little ones with g-tubes grow and thrive on real food and helping other families experience the same success. So, without further ado, here’s Raiden’s story:

Raiden at 1 year

Brechae and Raiden’s Testimonial:

My son Raiden has been tube fed since he was 4 months old. He was fed breast milk fortified with formula for extra calories. As he got closer to a year old and my milk supply began to decrease I sought out his options for nutrition. I spoke to his G.I. and he wanted to put him on Pediatric Compleat. I’m the kind of person who does her research, especially with regard to my child, so I looked up the formula. Upon reading the ingredient list I quickly discovered that the product was mostly sugar. I didn’t want that for him. I remembered reading about a blended diet in a feeding tube group on Facebook. At the time I had no idea what it was but I wanted to learn more. I was directed to “Blenderized RN” group on Facebook and that is where I met Tina!

We bonded over both having tubie sons who also have Down syndrome. She helped/taught me to slowly start the transition from fortified breast milk to real food through his tube. Raiden doesn’t have dietary restrictions/sensitivities or G.I. issues. His aversion to food is mostly sensory so I was able to trial all kinds of baby food, baby cereal, eggs, whole milk, etc. with no problem. Once we learned what he tolerated, Tina created a breakfast blend just for Raiden (Raiden’s Breakfast Blend)! It had oatmeal, eggs, an apple and whole milk. It was my go to meal and gave me the confidence to create blends for him on my own with my Vitamix.

Initially he was fed via Infinity pump and could only handle small amounts at a time. I was worried it would always take hours and hours of him being connected to his feeding pump to get him to grow. Tina assured me that based on his medical history we would one day be able to bolus feed via syringe and that he would be able to handle more volume and she was right! When I started blending Raiden was 18lbs. Now he is 27 lbs! We are two years into our blenderized diet journey and I can honestly say that it has been one of the best decisions I’ve made for my son. Tina’s wisdom and guidance along the way has been such a blessing!

Raiden at 33 months

Mooie!

enteral-feeding
Night Feeding Via Pump

Ok it’s been a while since I been able to add a new recipe so here goes.  I’m dedicating this to 2 young tubie warriors.  This ones for you, kiddos!

Three years ago, right before Matt had his hip surgery, his digestive tract started giving him problems again.  I was trying to avoid putting him on laxatives so I developed a green smoothie that I had hoped would help him.  I originally put fruit in it and offered it to him to drink.  He liked it (sort of) but he only drank 2oz.  I knew that was not enough to work so I went back to the drawing board.  Then it dawned on me.  He has a g-tube!  He doesn’t need to drink it so I can remove the fruit and add more greens!  It worked.  The added greens allowed me to add more fiber without fighting with him about the taste.  Now when I give him a bolus feeding or hang his bag for his night feeding he smiles and says, “Ooh! Mooie!  Yup.  You got it.  That’s where the name came from.

image4-3
Bolus Feeding

Since each child and adult that are g-tube dependent have different issues, I caution you to check with your doctor before changing a feeding regimen and, if you get the ok to to try this, add small amounts at first and watch for adverse effects.  I do not recommend making this smoothie with anything else but a Vitamix.  The Vitamix blends the greens so finely that there are little or no leave particles to get caught in the filter of the feeding bag.  If the filter gets clogged that feeding stops and the alarm goes off.  It’s less of a problem for bolus feeding but, if there is difficulty in breaking down solids, it could cause issues. All of the ingredients are added to the Vitamix container by weight. That way there is no measuring so it comes out the same every time. It also makes for a quicker blend. Just put the Vitamix container on a food scale and add the ingredients. No more measuring cups and spoons to wash.

Ingredients:

  • 3oz + 5oz of peppermint or chamomile tea
  • 6oz of greens (your choice)
  • 2oz of fresh Aloe Vera gel (optional)
  • 3oz avocado (or 2oz of avocado + 4 tsp of organic olive oil)
  • 1oz Organic apple cider vinegar
  • 8oz DIY “Ripple” (split pea milk)

Directions:

  1. In the 32oz Vitamix container add 3oz of the tea, the greens, the Aloe Vera gel (if you are using it) and the avocado and secure the lid.
  2. Select variable 1.
  3. Turn the machine on and quickly increase the speed to variable 10, then to High.
  4. Blend for 1 minute.
  5. Turn the machine off, return the switch setting to Variable and the dial setting to 1 then remove the lid.
  6. Add the remaining 5oz of tea, the vinegar and the DIY “Ripple” (split pea milk) and secure the lid.
  7. Turn the machine on and increase the speed to Variable 6 and blend for 10-20 seconds or until all the ingredients are combined.

Makes 2 14oz smoothies. Matthew’s night feeding is 500mls so I rinse the container with enough filtered water and add it to the feeding bag to ensure he gets the full dose. I have also added 1 tsp of fresh pureed ginger when Matthew’s stomach was more upset than usual.  Feel free to experiment with different greens.  Sometimes I will buy the large bag of Power greens or spinach from Costco along with Romaine lettuce hearts.  I also keep a close eye on the local farmer’s market for greens that are on sale.  Parsley is great because it helps settle the stomach.

Nooooo!

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So what do you think happened here?  Was it:

  1. The baby threw up.
  2. The syringe malfunctioned.
  3. The med port popped open.

If you guessed #2, you were right.  Sticky syringes can be annoying if not down right disastrous.  Has it happened to you or is it just me and the mom of this baby?  I have had to clean walls, ceilings and floors because I forced a syringe filled with medication or oils.  You know the drill.  You use a syringe, wash it, let it dry and forget about it until it’s time to reload it.  When bolus feeding a blenderized diet it can cause a sticky syringe within in 1 to 2 uses.  We all know tossing our syringes after so few uses is out of the question. You have to use those syringes 5-6 times a day minimum for up to a week so what do you do?  The answer:  Lubricate the plunger.

I use coconut oil for 2 reasons: 1) It was recommended to me by another Tubie mom and 2) when I used olive oil it still got stuck.  So here’s the process:

  1. Starting with a dry syringe and plunder, dip the plunder into a bowl containing slightly warm coconut oil.
  2. Make sure to coat all surfaces of the plunger.
  3. Insert the plunger into the syringe and move the plunger up and down inside the syringe several times while turning the plunder.
  4. For the 60cc syringe, I sometimes use my finger to lubricate the inside in addition to the plunger.  This is helpful if the blend is fairly thick or the syringe has been reused a number of times.

Now you are ready to load your feeding.  It is very important to give the feeding immediately after loading it. It has been my experience that, if you set the syringe down and come back to it, the plunger will be stuck.  And what happens when you have a syringe full of a blend and you try to force into the extension tube?  Refer to picture 1.

If you are feeding on the go, I suggest you carry the coconut oil with you in a small vial.20170130_091230  It is solid at and below room temperature so you will want to keep it somewhere that is fairly warm.  If you can’t do that, you can still use it on the plunder but you have to do step #3 until the friction in the syringe melts it.

I would love to hear what works for you.  Please leave a comment.  The more information we have the fewer, “Nooooo!” situations we will have.

Matthew’s Green Smoothie

ATTENTION: Make sure to get clearance from your doctor before trying any blenderized diet.

My Helper
My Helper

1 cup of peppermint or chamomile tea
2 oz of Avocado
2 oz of fresh Aloe Vera (optional)
3 cups of greens
Makes 2 cups

Bolus Feeding Syringe
Bolus Feeding Syringe

1. Place all ingredients into the Vitamix in the order listed and secure lid.
2. Select Variable 1.
3. Turn machine on and quickly increase speed to 10, then to High.
Blend for 1-2 minutes or until very smooth (no visible leaves).

Night Feeding Via Pump
Night Feeding Via Pump

Food Tip: When using this smoothie in the enteral feeding pump, it is vital that there are no leaf particles. Because the bag tubing, extension tubing and g-tube are all small in diameter, small bits of leaves can get caught and cause the pump to alarm and stop the feeding due to “No flow out”. Green smoothies do not work well without some type of fat in them. Outside of the health benefits, that’s why the avocado is added.Also, if formula is normally given, it is best to combine the smoothie with the formula and mix well. It has been my experience that straight green smoothies without the formula mixed in tend to separate. The pureed greens are lighter than the water so the water will go though the pump leaving the greens stuck in the feed bag.  If Aloe Vera is used it must be food grade.  Do not use fresh Aloe Vera unless you know how to properly prepare it.

Time Tip: How much smoothie to give depends on total volume and tolerance. It is best fresh within 2-3 days so I store the remaining smoothie in a container that allows me to shake it up before pouring.

Money Tip: Since they are going to be blended, buy greens in bulk and freeze any portion you do not use within 3-5 days. That way there is no waste from greens gone bad in the refrigerator.  Fresh frozen greens such as kale and spinach break up easily once frozen allowing for easy measuring and blending.