G120(P) The use of a blended diet via gastrostomy

Abstract

Aims There is growing interest in families of enterally fed children regarding the use of blended diet via gastrostomy as an alternative to commercial formulas. Reported benefits include reduced reflux, constipation and general systemic improvement. There are also numerous concerns including possible tube blockage and bacterial contamination. Liquidised feed is discouraged by BDA, ESPHGAN and EPSG. This had led to barriers to implementation in many areas of the UK and loss of the therapeutic alliance between healthcare professionals and carers. This study aimed to assess patients already commenced on a blended diet in a district general hospital. Methods Six patients were identified as being on a blended diet via gastrostomy. One patient was excluded due to poor engagement and care mainly residing in tertiary services. The BDA Practice Toolkit for liquidised diet by gastrostomy was adapted; medical and dietetic notes reviewed and questionnaires sent to families. Results All of the children had a complex neurodisability with ages ranging from 4%–16. 60% had a 14Fr and 40% had a 12Fr gastrostomy. Families started a blended diet due to poor tolerance of feeds including vomiting and retching non-responsive to medications; increased seizures; constipation; and weight loss. None of the patients had a risk assessment prior to commencement. Diets were augmented to varying extents with commercial formulas/supplements. Families encountered barriers including lack of policies and lost respite days. Information was obtained, not from healthcare professionals, but instead personal research including Facebook. Benefits included reduced reflux, constipation, chest infections and hospital admissions. An improved quality of life for their child was perceived. Sparse records of nutritional indices were found, only weight was recorded which either improved or was static. Nutritional status bloods weren’t taken although incidental blood tests were normal. There was no change in the frequency of button changes and no tube blockages nor diarrhoeal illness were reported. The study was limited as it was a small study group, without wider nutritional details or costings included. Conclusion This group experienced positive changes in using a blended diet for their children but further research is warranted.