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A.
Determine How Many
Calories are Needed
Each Day/How Much to Feed
This is an essential step you cannot skip this. Your
goal will be to eat the proper number of calories per day, so
you must take this step to determine your goal.
Ask your doctor or dietician or use a calorie calculator (Mayo
Clinic Calorie Calculator) to estimate the number of
calories needed for the person who is tube feeding's height, weight and sex. (I have also
used this
other calorie calculator
which is especially useful for calculating calories needed for
weight gain.)
Now, track every calorie you eat until you are sure you know
how to meet your calorie goals. If you use my recipes,
I've helped you out by calculating the calories. As you
develop your own recipes, use this database to help you figure
out how many calories a food has:
http://www.thecaloriecounter.com/
Whatever you do, take advantage of the knowledge of your doctor
and/or dietician. If you can, run your ideas for menus by
them and make sure you are on the right track.
(FYI because of our particular health situation and
allergies, all the recipes on this site are relatively high in calories,
dairy- free and do not mix milk and
meat products - you should tailor your diet to your own needs)
B.
Understand Healthy Diet
Basics
There are many approaches to putting together a healthy diet.
Again I find the Mayo Clinic guidelines helpful.
Using a Food Pyramid
Food Group and Serving Size List
Use these or other guidelines for estimating the minimum
ingredients to create a balanced liquid diet just like you would
a regular food balance diet. Depending on individual
needs you may make revisions in this plan for example to gain
weight, increase iron, etc.! We also used a pill grinder
to include a daily vitamin in the liquid diet.
C.
Get the Right Equipment
At minimum you will need the following tools:
1. A food processor or blender.
A Vitamix blender is the top choice and with that you only need a
blender. If you can't afford the Vitamix then a food
processor and blender are best but you can do it all with the food processor
(we sure did!). The food processor is great for
everything you make except something that is almost all liquid. The blender
is designed for liquids and handles them well but does not
handle a significant volume of solids very well and won't
process meats any many vegetables to a fine enough consistency
for the feeding tube. The blender is also very helpful
though when the feeding tube gets taken out and you are making
the transition back to swallowing food. Many people have written
in to say that Vitamix is the best but very expensive. An
Osterizer blender is an inexpensive but effective choice but
very loud when operating.
2. A strainer.
I suggest at least an eight inch, single mesh strainer (for
example this
strainer.)
3. A large, light-weight mixing bowl for straining
prepared food into. It should be deep and just wide enough
for the strainer to sit on it comfortably. For example this
mixing bowl might work.
4. A flexible spatula.
To cut down on dishes, I like to use one that is silicone and
heat resistant. I also use it for scrambling eggs. I like this
spoon spatula.
5. 4-6
sealable containers that work well for pouring liquid
into the g-tube. I like the
Zyliss Shake 'n Go Containers that I found at Sur la Table
and some supermarkets.
They are very sturdy and don't spill if they are tipped over.
Use 3 for food and, if needed, 1 for a bit of water for flushing the tube
before and after meals.
6. 6-10 re-sealable, reusable
containers
to store liquid food and refrigerate or freeze.
I like the Ziploc brand
Twist 'n Loc containers in
the 4 cup size (holds enough for 2 liquid servings). They seal
well with liquids and don't even spill when tipped. You can find
these in your local supermarket or
online here. 7. Rubber gloves.
I found that doing so much washing with very hot water
(important to reduce any chance of bacterial contamination)
caused dry, sore hands. It's much quicker to cook and clean
up after this type of liquid food using a pair of
gloves.
D.
Cooking Techniques
So, truthfully, making feeding tube food is not as easy as
throwing food in a blender and pouring. You've probably
figured that out by now and that's how many folks make it to our
site. It's important to know a few basics. And once you have mastered the basics, making homemade liquid nutrition
isn't really that complicated. Anyone can do this!
We suggest you try using
the basic techniques and equipment below with our recipes and then,
go ahead get creative and create your own
favorite recipes.
Liquefying food often (but not always) boils down to a few
simple steps:
1. Cook the food well (a
slow cooker for 8-12 hours is ideal for softening meats and poultry;
I don't recommend
ground meats (i.e. ground hamburger) since they have too much gristle
and won't liquefy well.)
2. Process or blend solids first
until they are as ground up as possible and the fine
solids begin to
clump on one side of the bowl. If you're going to overdo
it on processing time, this is the time to do it.
3. Then add a very small amount of
liquid and continue to grind up.
Liquids such as broth or clear juices are the easiest to use and
don't create as much froth or foam as, for example, soy milk.
Listen, watch and test with a spoon to check the size of the
food particles. Do not over process as this may create a foaming
which makes it excruciatingly slow or impossible to pour down
the tube.
Remember, usually keeping calories up is important. Try to
use a liquid with calories.
When you have a very fine consistency,
gently hand stir or pulse in the rest of your liquid to create the
desired consistency.
I can usually get almost a pound of lean beef liquefied into
just a little bit more than 16 oz.
For a cup of chicken, I use about 2 cups of liquid.
4. If necessary, but not for meats,
poultry or fish, use
a single mesh sieve (see buying information
below - double mesh is too fine)
to take out larger particles that would be difficult to get
through the feeding tube.
If you try one or two of our recipes, you'll catch on quickly.
But, and this is a big "but", liquefying food
doesn't always work perfectly even if you follow the recipe very
well. So always, be prepared to redo and check your methods if the
consistency isn't right.
5. Serve foods at room temperature or
slightly warm. Remember this food is going
directly into the digestive system. So very hot foods
would be a dangerous idea and very cold might be a bit of a
shock to the system. We have a very low power microwave and I
microwave everything for between 1 and 2 minutes to bring it to
room temperature or warmed after being refrigerated.
E.
Keep Everything Super Clean Remember, everything that goes into
the tube goes directly into the body. It is important that
you keep your equipment very clean - use soap liberally and hot
water. Avoid any possibility of food contamination.
Wash all fruits and vegetables served raw very well. Also,
keep prepared foods covered and refrigerated for a maximum of 2
days. If you'd like to store food for longer, freeze and
then thoroughly reheat to boiling almost and then cool before serving. Don't leave food on
the counter unrefrigerated. And, watch those sponges, dishrags and towels -
notorious breeding grounds for bacteria. Every day either
change them or zap for 2 minutes in the microwave or run through
the dishwasher. Definitely toss sponges at least once a month.
F.
When in Doubt Test or
Write Me Sometimes even when the consistency
and particle size look right on a spoon, the liquid won't go
down the tube at a reasonable rate. This can be due to
foaming, viscosity of the liquid or any number of factors.
So, when in doubt, just try a small amount your recipe down the
tube to check what happens. |
