Blended Diet 101

Whew. I finally finished this post. I started it over a million times because my methods keep changing. I keep finding new, simpler ways of doing things and I'm still trying to create a lasting method. I called it Blended Diet 101, because it's a beginning course. I will have a 202 class coming in a couple weeks after I master how to travel with blended foods.
It all started the end of January, just before Owen's 2nd Birthday. He was puking at least 5 times a day and I continued to pump Pediasure into his tummy. He needed to gain weight and that was what the doctors told me to do. I was to a point where I couldn't watch him suffer anymore. The puking was aggressive, he was exhausted and he wasn't developing well. I spoke with Avery (Bela's Mom) and she gave me the motivation and encouragement to try a blended diet. I will never be able to thank her enough!!

Fast forward 9 weeks and Owen is a different boy!! Very minimal puking and it is mild. He is pulling to a stand, crawling up stairs, only napping for two hours a day and playful the rest of the time. It makes us happy to see him finally feel good and I also have the satisfaction of knowing I am able to control his nutrition.

No more cans of Pediasure packed full of sugar. Can you imagine drinking a heavy, sugar filled "milkshake" all day?? Yuck. Now imagine eating salads, lean proteins, meats, fresh fruits and veges instead. We all know how great we feel when we eat a healthy diet! That was all I needed to hear to get started on a new diet for Owen.

I started off switching him 100% the first day. I knew that he had no food allergies and so the options were endless. I kept a journal of everything I fed him because I knew that his doctors and nutritionists would be curious and skeptical, to say the least.

I had no idea what I was doing or where to start. I knew that his body requires 1300 calories a day and around 30 ounces of fluids. I started there. I also know that we should get 40% protein, 30% fats and 30% carbohydrates for a balanced diet. I am not a nutritionist by any means, but I know what foods are good and what foods are not.

I measured everything out during the first month to ensure that he was getting enough of each food group. Now, I just eyeball it. You have to read a lot of labels and I kept the laptop handy when I needed to look up nutrition info on produce and meats. I have learned more than I ever wanted to know. :)

I had a blender already, but it's a pain to clean. I went to Costco and purchased the Magic Bullet and I love it!! It has been good to us and I rarely have to strain chunks out of Owen's foods before injecting it into his Gtube. You do have to use soft foods, steamed veges and warmed fruits... it's a "magic" bullet, but it does have limitations. I still haven't figured out how to blend up some rices and meats yet. More on that in a minute. It works great, it's easy to clean and I will be taking it on vacation soon.
Because the Magic Bullet isn't able to do everything and I am definitely committed to blending Owen's food long term (until he has enough energy to orally eat), I figured I would go ahead and order the Vitamix. This is the Granddaddy of blenders. They do roadshows at Costco and I have seen them throw in some crazy stuff and it pulverizes it. Amazing. The good folks at Vitamix also offer a medical discount which takes a little sting out of the $400 price tag. I am looking forward to getting our new blender soon and I'm sure it will change the way I blend many things... that will also be in my next blended diet post.
Before I start on the foods that I am feeding Owen... I will share with you a couple resources that might be helpful. I personally started with neither of these, but I am a risk taker like that. The first book is written by Marsha Dunn Klein. She is a doctor/nutritionist based out of Tucson and is a big supported in blended diets in tube fed kids. The book is a bit pricey, but can be found here. Another heart mom gave me this book a couple weeks ago and it has some great recipes and tricks to blending foods. The information in this book is for making homemade baby food using your blender which also applies to tube feeding. You can control what's in the foods and also the textures of them. When feeding your kiddo by tube, you have to make sure there aren't chunks or pulp in the foods or it will clog it. Nothing a little shot of Coke won't unplug, but still, not idea.
It's time to bring on the food! It's really so simple, but I will just share some of the foods that I use daily. I use TONS of fruits and veges!! Avocado and Bananas seem to have the most calories, while berries and dark greens pack a nutritional punch. I usually steam the veges and hard fruits (apples, broccoli, squash, pears) before blending so they are soft. Soft fruits and veges go straight in the blender (bananas, avocado, strawberries). I am not against using frozen fruits and veges as well. You need to blend up the foods with a little liquid, but instead of using water, I like 100% fruit juices. It adds calories, and the more calories the better!! I will throw in a cup of Apple Juice with a few heads of broccoli. Or a cup of Orange Juice with a blend of zucchini and squash. I love the Simply Juices because they don't have additives and I also like the Naked Juices. When I blend up fruits and veges... I do big batches and pour them into ice cube trays and freeze them. I then store them in Ziploc freezer bags and they are readily available when I need them. Just pull about 4 cubes of different fruits and veges out of the freezer, defrost them in the microwave for 20 seconds. Since produce doesn't have enough calories for an entire meal, we need to add some goodies.
We all need lots of complex carbohydrates for energy. I love to use oatmeal.. this is our favorite kind! We eat it all the time and I always have leftovers for the blender. I am just figuring out how to use Barley, Quinoa, Whole Wheat rice and Lentils in the blender so that it doesn't clog his tube. Any advice on this? I usually just cook these items, blend them up with some whole milk and strain them if needed. I'm sure the Vitamix will help grind these grains a little more than the Bullet does and this process should be easier. I usually throw in about 1/3 cup of oats, lentils, barley.. any of the above mentioned..in with the produce I just defrosted.
We also eat a ton of beans around here. It's so easy to open up a can of beans and throw a cup in the blender with some whole milk, some fresh produce or frozen cubes (from above) and a cup of whole milk. Lunch is ready within minutes.
Owen needs nuts and proteins, just like the rest of us. Blending nuts is probably not the best idea if you're going to inject them into a tube. It might work but I haven't tried it. I use nut butters because the hard work is done for me. This is about keeping it simple. We love the organic peanut butter and the almond butter from Costco. A tbsp of either of these packs tons of protein and fats. It's also 1/2 the calories he needs for his entire meal. Awesome staple in blending!
Honey is another ingredient I use daily. One tbsp has 60 calories and natural sugars. It's a great way to sweeten the food without using sugar. You know.. in case Owen decides to eat one of his meals. My newest discovery this week is Coconut Milk. It has 140 calories in 1/3 cup and 14 grams of fat! Owen needs a lot of (healthy) fats and this provides just that. There are also no sugars in this product which I love. This is also great for kids that have milk allergies.
Eggs are a great source of protein and other great stuff, totally not a nutritionist here. I'll scramble up a few eggs or throw some leftovers in the blender, add some whole milk, a cup of blueberries and a tbsp of honey. Breakfast of champs.

I love applesauce and we always have it in our fridge. It's packed with calories and sugars (usually natural if you get no sugar added). I will throw in a 1/2 cup of this, with some black beans, a tbsp of flax oil and some whole milk (maybe even coconut milk).

I used to use the fatty Yoplait yogurts but realized how packed full of sugar they were. I switched over to this Yoghurt and love it!! It's totally gross if you are eating it because it's not sweetened, but great for tube feeds! It's thick and creamy, full of calories 180cal per 1 cup, and Owen gets it every morning for breakfast with fruit and whole milk.

I love using oils in Owen's diet! I only use Flax Oil or Olive Oil because they have tons of Omega fats (healthy fats) and they pack a lot of calories in 1 tbsp. I use them daily, in at least one meal.
While I am talking about Flax.. I LOVE this flaxseed (again from Costco). I use it in our foods as well. It's packed with GOOD stuff for you.. protein, fiber, omega 3s. I think meat is optional, but we are meat eaters around here. Beef, chicken, fish, and pork is where we get the majority of our protein. I have been blending up fish (mostly Salmon) for Owen and it works great. The other meats, I just can't get to liquefy enough in the Magic Bullet. Bummer. I have been purchasing these Organic chicken and turkey meals from Super Target.. they are made be Happy Baby. It's the same concept of pre-cooking, using an ice cube tray and freezing your meals... only the work is done for you! Also, you can buy the baby food meats because they are pureed for you as well. Whatever you do, make sure your little one is getting enough protein!! Owen requires a lot of fluids due to his heart condition. I try to maximize his fluid intake at every meal by flushing his tube with at least 2 ounces of water after each meal. This gives him an additional 8oz throughout the day. I know it's empty calories, but we all need lots of water. I also make sure to use Whole Milk as his base on all his foods. I have tried Soy Milk and Almond Milk as well.. and Coconut Milk has been a new addition to that trend.

I think that pretty much sums up the foods that I give Owen. I'm pretty sure he eats healthier than any other orally eating toddler out there. Kamryn lived on chicken nuggets and pb&j's and turned out great!! I love that I am the one controlling his nutrition. If Owen was a normal oral eater and gaining weight, there would be no question as to what foods he was eating. Even though he'd probably be eating a lot less healthy diet than I am providing him now. The biggest challenge we faced with doctors was that they don't like the fact that they can't read a label on a can to make sure he's getting his nutritional needs met. That is why I kept a food journal in the beginning. I also consulted with several nutritionists, at both Stanford and PCH. I faxed them his food journal and we made adjustments accordingly. Now, all the doctors are on board and they are amazed at how well he is developing!!

Another HUGE issue that nutritionists and doctors had was sanitation. I usually throw all the syringes into a sink of HOT water with some dish soap. I clean them several times a day and lay them out on a towel to dry. You can throw them in the dishwasher but they do warp too. I get a box of 30 syringes a month from home health care and I just rotate them.

When the rubber on the syringe starts to stick from washing them... you can use a spray of Crisco on the rubber and it slides like silk through the syringe. Just a little tip ...I learned the hard way!!

That wraps it up!! If you have any questions, email me at andreanicolesimmons@hotmail.com

Also.. ALL TIPS ARE WELCOME! I am not a pro at this. I can use any and all advice you have to offer. We are leaving for Stanford in a few weeks and I am trying to figure out the best way to travel with blended foods. I thought about preparing his meals in advanced and freezing them in cubes and then putting them into individual freezer bags. I don't know how well it will work though.

If I can help one mom or one kiddo... this post was worth it!! :)