Exploring dietetic attitudes and experience of recommending tube feeds containing real food ingredients to paediatric patients

Abstract

Blended tube feeding for patients requiring enteral nutrition involves the provision of pureed food administered via a gastronomy tube⁽¹⁾. It is relatively new in dietary practice, with several clinical and perceived benefits, which was partly driven by the large prevalence of enteral nutrition intolerance in paediatric patients⁽²⁾. In response to patient and dietitian preferences, as well as challenges of blended diets, medical nutrition manufacturers have developed commercial tube feed products containing real food ingredients (RFI). There is very limited published literature on these types of tube feeds.

The aim of this study was to understand the attitudes and awareness of dietitians towards recommending tube feeds containing RFI. This was done through investigating the indications behind recommending this type of product, what conditions they are recommended for, and the main barriers and benefits of recommending tube feeds containing RFI to paediatric patients.

A twelve-item online survey was distributed via Irish Nutrition and Dietetic Institute (INDI) and Irish Nutrition Jobs Facebook group to collect data from registered dietitians over six-weeks. Frequencies and Cross-tabulations were performed to analyse categorical variables using IBM SPSS V29.

From the total sample of 23 paediatric dietitians, those who currently recommend tube feeds containing RFI (n = 14) reported that the two main disorders to use this product are, gastrointestinal disorders (n = 13, 93%) or neurological disorders (n = 12, 86%). A primary indication for recommending these products is to improve tolerance (n = 12, 86%), with the main feeding method being bolus pump (n = 13, 93%). Key benefits reported are improvements to GI symptoms (n = 13, 93%) and improved weight gain (n = 5, 36%). Of the total sample, prime barriers found to recommending this type of feed is the low energy dense profile (n = 7, 30%) and insufficient amount of natural ingredients (n = 3, 13%).

This study shows a positive response towards tube feeds containing RFI and gives an insight into the potential benefits that using these innovative tube feeds can have for patients and carers. More case studies using these products are required, for dietitians to fully understand the main benefits and drawbacks of recommending these feeds to their paediatric patients.