Blenderized tube feeding for children: an integrative review

Schmitz, Érica Patrícia Cunha Rosa; Silva, Eliziane Costa da; Lins Filho, Ozeas de Lima; Antunes, Margarida Maria de Castro; Brandt, Kátia Galeão

doi:10.1590/1984-0462/2022/40/2020419

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Revista Paulista de Pediatria

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Review Article • Rev. paul. pediatr. 40 • 2022 • https://doi.org/10.1590/1984-0462/2022/40/2020419 copy

Blenderized tube feeding for children: an integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To analyze scientific evidence on the use of blenderized tube feeding in children regarding nutritional composition, family satisfaction, and health outcomes.

Data source:

Survey was conducted in the PubMed, Scopus, Embase, and Virtual Health Library (VHL) databases using the following search terms: blenderized tube feeding OR blended tube feeding OR homemade OR pureed AND enteral nutrition AND enteral tube. The methodological quality of the selected articles was evaluated using the Critical Appraisal Skill Programme and Hierarchical Classification of Evidence.

Data synthesis:

After analysis, 11 articles were included in the present review. Most studies demonstrated improvements in health outcomes and greater family satisfaction after replacing the commercial enteral feeding with blenderized tube feeding.

Conclusions:

When guided and monitored by the healthcare team, a blenderized tube feeding ensures an adequate nutritional composition. The use of this method is also associated with positive health outcomes such as reductions in gastrointestinal symptoms and hospitalizations. Moreover, a high frequency of family satisfaction was verified.%

Keywords:
Food, formulated; Child nutrition; Enteral nutrition; Patient satisfaction; Child health

Author, year	Sample	Main findings	CASP AHRQ
Batsis et al., 2020	23 children aged 1 to 18 years	BTF was well tolerated. Gastrointestinal symptoms, such as gagging, nausea, and vomiting, improved in most children.	A VI
Trollip et al., 2020	12 children aged 1 to 14 years	Improvements in overall health, emotional and social well-being, and gastrointestinal symptoms after using the BTF.	A VI
Hron et al., 2019	70 children aged 1 to 18 years	Better clinical results in children who were offered blenderized or commercial feeding with real foods. The total number of emergency visits, hospital admissions, and admissions due to respiratory complications was reduced.	A IV
McClanahan et al., 2019	10 children aged 2 to 8 years	PBEN was well tolerated, with improvement in the observed symptoms, and can improve the health of microbiota in children with chronic diseases using an alternative feeding route.	A IV
Gallagher et al., 2018	20 children aged 1 to 16 years	Participants needed 50% more calories to maintain their BMI while using the BTF. Bacterial diversity and richness in stool samples significantly increased.	A IV
Johnson et al., 2018	433 parents of children fed by probe	Reasons for using a blenderized tube feeding and/or commercial enteral feeding with real foods included the desire to offer whole foods, having family meals, or the fact that they did not like the commercial feeding.	A VI
Orel et al., 2018	37 participants aged 2 to 26 years	After six months of intervention, the Z-scores for weight-for-age and BMI, as well as the percentages of fat and lean mass, were higher in the commercial feeding group than in the blenderized feeding group.	A IV
Epp et al., 2017	125 children with mean age of 5.4 years	Of the patients, 89.6% used a blenderized feeding for an average of 71% of the total daily nutrition intake; 83% reported that the diet represented > 50% of their energy requirements.	A VI
Samela et al., 2016	10 children aged 1 to 6 years	90% of children were successful in the shift to a diet formulated with real foods. There was also an improvement in their feces patterns.	A IV
Klek et al., 2014	456 children; 142 of whom with a mean age of 8.7 years	CEF allowed for weight gain and reduced the incidence of infectious complications, the number and length of hospital stays.	A IV
Pentiuk et al., 2011	33 children with a mean age of 34.2 months	52% of children reported a reduction in gagging and vomiting, and 57% of children reported an increase in oral intake after the introduction of BTF.	A IV

Author, year	Blenderized tube feeding n (%)	Commercial enteral feeding with real foods n (%)	Commercial enteral feeding n (%)	Mixed diet^* * Commercial+blenderized feeding or blenderized+commercial feeding with real foods; n (%)
Batsis et al., 2020	15 (65.2)	4 (17.4)	––––	4 (17.4)^b b blenderized+commercial feeding with real foods;
Trollip et al., 2020	4 (33.3)	––––	––––	8 (66.7)^a a commercial+blenderized feeding;
Hron et al., 2019	11 (15.7)	14 (20.0)	28 (40.0)	17 (24.3)^a a commercial+blenderized feeding;
McClanahan et al., 2019	––––	10 (100.0)	––––	––––
Gallagher et al., 2018	20 (100.0)	––––	––––	––––
Johnson et al., 2018	134 (31.2)	20 (4.6)	213 (49.5)	59 (13.7)^b b blenderized+commercial feeding with real foods;
Orel et al., 2018	20 (54.0)	––––	17 (46.0)	––––
Epp et al., 2017	84 (75.0)	1 (<1.0)	––––	27 (24.0)^b b blenderized+commercial feeding with real foods;
Samela et al., 2016	––––	10 (100.0)	––––	––––
Klek et al., 2014³ 3 all participants initially used the blenderized tube feeding and later shifted to the commercial enteral feeding.	456 (100.0)	––––	456 (100.0)	––––
Pentiuk et al., 2011	33 (100.0)	––––	––––	––––

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[1] *Corresponding author. E-mail: erica_rosa@live.com (E. P. C. R. Schmitz).