I realize with Timmy & his blog, some things slip through the cracks. When we first start down a new direction, we are often overwhelmed and may not post many details. Later, when we are getting the hang of something, it seems so 'old-hat' that we don't post. We wanted to give you just a small glimpse into life at our house feeding a child with a tube.
When we first came home from the hospital, Timmy was being fed breast milk and formula. Over the months of limited sleep and all the energy needed to care for Timmy, his diet changed to all formula. After turning a year old, we saw a nutritionist that switched Timmy over to a formula using real food for children over a year old. Through all of this, we noticed that any formulas we had used were harder for Timmy to digest than the breast milk had been. It meant a struggle to get the recommended amount of food in him each day. The nutritionist set a goal of 650 ml of food (formula) a day - and it was not looking promising.
Fortunately, we had been doing some research and reading about blended diets for 'tubies' (people fed through a g-tube, ng, or nj tube or some other variety of tubes). After deciding on a handful of foods to try first (as they must be tried one at a time to check for allergies or processing problems) we dove into blending. We had a decent blender, but 2 brands kept being suggested as being able to process foods into small enough pieces to go through a 12 french tube (about 4 mm diameter). We purchased a refurbished Blendtec and got to work.
Using the Blendtec and adding raw or cooked foods (depending on the food) and water with a little bit of Olive Oil to reduce frothing, we make a puree that is about the consistency of a stage 1 baby food. The high power of the blender makes it look almost like a liquid while it is moving, but it comes out with a nice thickness to it. If I remember right, this is a batch of avocados.
The blended mixture is then poured into ice cube trays to facilitate measuring and defrosting the food, covered with plastic wrap, and put in the freezer for 12-24 hours to harden up.
When the cubes are frozen, we remove them from the trays and pack them into freezer bags in the freezer. Here we have: Avocado, sweet potato, prunes, peas, blueberries, bone broth, green beans, broccoli, chicken, eggs, peaches, apples, and garbanzo beans.
Each week, 7 bags are made up of a variety of the foods that we have. 16 or 17 cubes get put in a bag, and set in the freezer with about a days worth of food for Timmy.
Each day, we take the bag out, put the contents in a pot, and defrost Timmy's food.
Once defrosted (or cooked if cubes are still frozen), it is blended again to get rid of any bigger pieces leftover from blending a large batch, and then it is strained through a sieve to make sure we remove and 'chunks' that could clog Timmy's tube.
To thin it out a little more, we add a few ounces of formula and mix it together. Some molasses is also added to help with nutrition, calories, and constipation.
We pour the food into a Squeasy bottle (on left) which makes it easier to load the food into the waiting syringes.
Syringes are loaded, capped, and set in the refrigerator to take care of the next feeding. This is Timmy's 'dinner' - his food that he will get in 2 doses around 5:30-6:00. Timmy gets 150 ml of food at dinner out of the 540 ml of real food he gets during the day. We also give Timmy 200-220 ml of formula during the day for a total of 740-760 ml of food a day. (Currently, this changes slightly from time to time as we tweak and add volume to his routine.)
At feeding time, Timmy gets a small shot of water through his tube about 15 minutes ahead to help get his tummy ready for a meal, and then the food is pushed with the syringe through the g-tube. At present, he gets his food at a rate of about half an ounce every minute and a half. Now if we could just get him to help push the syringe at the appropriate intervals. :)
Tube feeding is definitely a different world than we had ever experienced with our first 8 children. It has a steep learning curve, but hopefully one we are staying ahead of as best we can. We have found that many children have feeding tubes for many different reasons. Some won't eat, some have oral aversions, some have illnesses that cause digestive issues, some have problems getting the food to go into their stomachs instead of their airways, and some, like Timmy, have to work too hard to get food in orally (can't breathe, eat and function properly at the same time). We are grateful that this one 'small' adjustment has allowed Timmy to grow and thrive and let his heart and body work easier when his heart defect already makes things hard enough. We do not know how long this stage will last for Timmy, but step by step and day by day it continues to be a great adventure we will enjoy with him.