Homemade tube feedings - The basics - blender feeds

What is a homemade tube feeding formula?

Homemade tube feeding is a formula made with real foods. Ingredients may include:

• Baby foods
• Table foods
• Commercial formula

A blender is often used to mix these foods together. This is sometimes called blenderized or blended tube feeding.

Talk with your child’s doctor about homemade formulas. Ask if they are right for your child. Some medical conditions make these feedings very hard or impossible.

Homemade tube feeding is not recommended if:

• A J-tube or NG-tube is used for feeding.
• You have overnight feedings.
• The G-tube is smaller than 14 French diameter.
• You have continuous drip feedings.

Homemade tube feeding may be very hard if your child:

• Has many food allergies.
• Has a metabolic disorder.
• Has a weakened immune system.
• Has to avoid many foods.
• Is less than 6 months old.
• Has kidney disease.

Is homemade formula right for my child?

There are many things to think about before you choose a homemade formula for your child.  

• Homemade tube feeding is a commitment for you and your family. It takes more time, energy, and resources than using commercial formula.
• It may be easier to use commercial formula when traveling or if your child is ill.
• There are several commercial blended food formulas available on the market. Talk with your dietitian to see if this is a safe option for your child.

Think about the pro’s and con’s of blending your child’s tube feedings.  

Pro's:

•  Blending many different whole foods gives your child a more diverse diet. This may lead to better overall health.
• Homemade formula may cost less than what you pay for commercial formula.
• Your child may be able to help choose and blend foods.
• A homemade tube feeding may include foods from the table.  This makes their meal more like yours.  It may create more of a mealtime feeling. 
• Letting your child choose and make their meals may increase their interest in tasting foods.

Con's:

•  Homemade formulas may not have all of the nutrients your child needs. This depends on how much and which foods you use. Most often commercial formulas have enough protein, calories, vitamins, and minerals for growth.
• Commercial formulas are often covered by insurance. Homemade tube feedings are not.  
• A high-quality blender may be needed to get the best mix of the formula. 
• Making homemade formula can take a lot of time.  Commercial formulas are ready-made.
• Homemade formulas are made by hand so there is more risk of infection.

Homemade formula may only be made 24 hours ahead of time to keep formula from spoiling.  Otherwise it must be stored in the freezer. 

Talk with the dietitian about:

• What your child’s needs are for calories, protein, vitamins, minerals, and water.
• How to meet these needs with homemade tube feeding.
• You may need to give some commercial formula. This will help make sure your child gets enough protein, calories, vitamins and minerals for growth.
• How often to schedule appointments. At first, your child may need more visits.   

How do we start homemade tube feedings?

• Talk with your doctor and dietitian before starting.
• It is often best to start by blending strained baby foods with commercial formula.
• Start slow. Try one new food at a time.
• Add a new food every 3 to 7 days.
• You may try home cooked foods when you feel more comfortable.
• It can take weeks to months to make a complete change to homemade tube feedings. Homemade formulas are easier to give with larger size G-tube such as 16, 18, or 20 French. It is also easier when giving as bolus feedings by syringe.

How and when should the homemade formula be made?

• Make one batch at a time. A batch is enough to last 24 hours. It is important to use clean equipment and clean hands!
• If you have extra freezer storage, make extra batches and freeze immediately.
• Pour into separate containers for each feeding.
• Cover and refrigerate immediately.
• Let formula come to room temperature before feeding. If needed, you can run containers of this formula under warm water to bring them up to room temperature.
• Rinse tube with water flush after feeding. Follow the directions from your dietitian.
• Homemade formula should only stay at room temperature for 2 hours or less.
• Throw away unused formula after 24 hours.

How do I know if my child’s needs are being met?

Your dietitian will help you with recipes and a feeding plan. At each appointment, the dietitian will check your child’s:

• Weight and growth.
• Tolerance of tube feeding. The dietitian will make sure there is no vomiting, discomfort or diarrhea.
• Intake of calories, protein, fluids, vitamins, and minerals. Your dietitian and doctor will help you make plans to change or adjust feedings to best meet your child’s needs.
• For more information, you can read about homemade formula at http://mealtimenotions.com/HomemadeBlendedFormulaHandbook.htm. You can buy the Homemade Blended Formula Handbook at this website.

*Reference: Klein, M.D. & Morris, S.E. (Eds.). (2007). Homemade Blended Formula Handbook. Tucson, AZ: Mealtime Notions LLC. For other health and wellness information, check out this resource: https://kidshealth.org/ChildrensWi/en/parents