Like any parent having her first child, I had planned out the various ways that I might raise my son.  Thoughts of his bedroom, entertainment and nutrition were all part of the big picture.  Just like having children wasn’t supposed to put me in lock-down in my home, having a child with a feeding tube wasn’t going to change my nutrition plans if I could help it. 


I pumped in the NICU to provide him the milk that I intended him to have.  Although we were always trying bottles and then baby food, it was apparent at eight months that I had better start focusing on what my child with a feeding tube was going to be eating for the majority of his nutritional needs.  

Monitoring a child’s food needs is an ever-changing process, and at times I have certainly felt that giving the physician prescribed formula was just the easier way to go.  But when I have the time and energy to give it my focus, I know that giving him blended whole foods is something helpful that I am adding to his life.


The Transition to Whole Foods

Starting at 10 months, and after consulting the Amish and our supportive pediatrician, we gave raw whole milk.  This was an informed decision based on a lot of research that I knew was right for us, although not right for others.  

But this wasn’t the right choice for long.  I thought about other 12, 15 or 18-month-old children and they weren’t on all-milk diets.  A mother’s milk will actually change in its nutritional content as the child ages to meet the needs of that child and I wanted to be able to do the same with his food.  Of course, we were always continuing the work of our speech pathologist in food experimentations by mouth, but a large part of his calories came through his tube.  

We met with various nutritionists, and although they were helpful to a degree, I wasn’t getting the direction that I needed to make any decisions.  At one point I found a Yahoo group that allowed me to start considering a larger variety of foods in his tube, in addition to formula.  


Recipes

This is a misleading category because no recipes are actually needed.  The way I look at it, no matter what I give my child, he’s going to be eating better than most kids his age.  Toddlers are notorious for being odd eaters, and yet they still manage to get the nutrients they need.  This gives me the confidence that I can’t mess it up.  One nutritionist said that if the family is eating pizza, go ahead and give him pizza if that’s what you would do if he were eating with you. 

Your personal recipes will have to first take into consideration the food allergies and needs of your child, including their calorie needs, as whole foods can have a lower calorie content than milk or formula.  

Here are a few examples:

For our typical meals, a “good” meal would include cooked sweet potatoes, yogurt, a cooked green veggie, avocado, fruit juice for added liquid and a multivitamin if needed.

A “rushed” meal would be canned sweet potatoes, baby food peas and green beans, fruit juice, milk and a dash of olive oil.  

A great recipe will include a variety of foods that you would personally eat if you were trying to have a healthy, balanced diet.  Think in terms of your dinner plate to give you ideas.  

All blenders should do well with recipes such as these:

• Meal 1: Yogurt, canned peaches and overcooked instant oatmeal
• Meal 2: Peanut butter, banana and milk
• Meal 3: Canned or overcooked spinach, canned green beans, tofu and avocado
• Meal 4: Liver pate, baby wheat cereal premixed with water, canned whole tomatoes with seeds removed and fruit juice (straining suggested for this meal)

For these meals add 100% fruit juice, whole milk or the water from the vegetables to allow best consistency for blending.    

A powerful blender could allow you to use recipes such as these:

• Meal 1: Cooked oatmeal with flax seed, fresh berries and cottage cheese
• Meal 2: Kidney beans and brown rice with red peppers and spinach
• Meal 3: Cooked chicken and well-cooked wheat pasta with tomato sauce, corn and peas

Choosing a Blender

For blending whole foods, a heavy-duty blender is best.  The Vitamix is the king of blenders and has proven its name over the last 80 years, while the HealthMaster is a newer blender that some consider equally powerful.  For a comparison of several of the top blenders, see this article.

Vitamix will offer a discount if there is a medical need for the blender.  A physician’s note would be sufficient.  It is the most expensive blender available, but will blend more foods and should last a lot longer than any other.  

Bullet-type blenders are also useful, especially for smaller meals.  The Magic Bullet is known for its TV time but really is a great little blender to have on hand for making purees.  The personal size and upside down concept is easier for me than a typical blender.  The cup can be taken from the blender straight to the table for feeding.  I like not having to try to get all the food from around the metal blade as I do with a traditional blender.  The only downside is that a specific amount of liquid is required to blend, and if you use too little then it doesn’t work quite as well.  This could be a condition of my cheaper knock-off version.  The Magic Bullet has a more powerful motor and should not have this problem.  Mixes of a higher liquid content aren’t exactly a problem though since you are putting it in a tube!  Beware of substitutes parading as real Magic Bullets that won’t last as long.  I personally bought a knock off type blender from a department store just to see if it was what I wanted.  Mine cost me about $35, while the real thing, all gimmicks aside, will cost about $50.

 
Hand or stick blenders are a surprisingly good option.  I laughed at this concept when someone suggested it, but when I tried my mother-in-law’s Cuisinart stick blender I was amazed at the results.  I could put in very little liquid and get a consistent blend without chunks.  It also offered the ability to not have to work food from around the blade.  You can use it in any cup or container that it fits in, allowing it flexibility like the bullet blenders.  It will be my next purchase, seeing as many models cost between $35 and $50.

The standard household blender that you will find at a box store for $20 to $50 might not be worth your time.  We broke many and the setup was less than ideal.  If you do choose this type, try to find one that has all metal components.  If one part of the mechanism used to turn the blade is metal and the other is plastic, or worse, if both are plastic, your repeated use can strip the plastic and render it useless.  Cleaning is a chore and small batches are hardly worth the time and mess, but it will work until you can find something that fits your needs better.  It works well if you always do large batches with very soft foods only.  


Clogs

If you venture away from formulas using a blender other than the Vitamix, you WILL get clogs.  A tomato skin, vegetable seed or clumps of thicker foods will clog the tube up when you least expect it.  The easiest way to avoid this hassle is to cook and blend thoroughly, and to pass the puree through a mesh strainer before using.  A clog can occur in the tubing or extension set of your feeding system, or in the mechanism in the belly, the button or long tube.  For the most part they are handled the same way.

Here’s my method of clog removal. 

1. Remove extension set from the feeding tube and go get an empty extension and syringe.  
2. Get a cup of warm (not hot) water and some rags while you’re at it, because in a frustrated state you are likely to make a mess.  I’ve done this with just air in the tube/syringe but water seems better.  
3. Fill the extension tube with water.  Some can be in the syringe as well, but not very much, 1 ounce or less.  
4. Now use the syringe plunger to try to force the water into the belly, pushing the clog in.  
5. Pump the syringe while holding tightly to the connection between the syringe and the tube.  The force could cause it to separate, requiring the use of those rags.  
6. If this doesn’t work then remove tube and empty all water.  Put syringe plunger all the way into syringe and reconnect tube to button.  
7. Try to remove plunger, pulling clog up and out and into the syringe.  Give a few attempts.  I’ve started with this method before the water but I also think the water method could help dissolve a clog.

You might feel like you are doing it too hard and your child might be crying, but this is not hurting him or her.  Your child likely will sense your frustration, or be scared since you’re messing with the tube in an unfamiliar way.

Other forms of removing a clog that I have found online include using carbonated beverages, whose efficacy hasn’t yet been proven, and special digestive enzymes that a doctor could give you.  The best thing is to try to avoid the clog.  My worst clogs have taken up to 20 minutes to clear, but I’ve been lucky to only have a few bad ones in the year and half I’ve done this.  


The Benefits of Whole Foods

I love using whole foods because I can imagine that it’s food that my son would be trying to eat if he could.  It’s well known that vitamins and other health supplements don’t work quite as well as naturally obtaining the same nutrients from  whole foods.  I go with his hunger cues and fill in the rest, both nutritionally and calorie-wise by tube.
 
My son is a very healthy looking two-and-a-half-year-old with good color to his skin.  He is almost never sick.  I don’t how much of that is helped by his nutrition, but I feel that it certainly doesn’t hurt.  We’re lucky that he has no food allergies or reflux issues as long as he is going to the bathroom regularly, allowing us to bolus feed him a whole food mix.  However, from what I’ve read, you need not feel excluded if these issues pertain to you or if you prefer to use a pump.  Do some research and consult your doctor, and you, too, might find that a whole foods approach to tube feeding can have great benefits.    


Chelsea Webber is a Virginia mom to two boys, the oldest with a diagnosis of spastic quad CP.  She recently created a website for families living with cerebral palsy called cerebralpalsymentor.com to try to fill that gap in information that she has felt raising her son.  She enjoys researching treatment methods and health information and hopes to share it with others.