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Blend S Episodio 8 ~REPACK~


Once a child reaches a year of age, nutrient needs change and the child is ready to advance beyond infant formula. By the time a child is a year of age, there are a variety of formulas to choose from, as well as pre-made real food blend options or home blends




Blend S Episodio 8



Whole food blend options have been a focus in nutrition research within the past several years. Multiple studies have pointed to the benefit of whole food blended diets and improved feeding tube tolerance. Specifically, one study focused on providing a pureed by G-tube diet in children post fundoplication to reduce gagging and retching.3 The exact mechanism of why the puree by G-tube diet (PBGT) helps to reduce retching and gagging is unknown, but it is suspected that the thicker blend (higher viscosity) allows for slower emptying of the stomach. There are several commercial options on the market for blended whole food formulas. Some blends provide a thicker viscosity which is helpful for retching and gagging, while others are thinner. The literature points to moderately thick and extremely blends being important for improving the retching, reflux and gagging symptoms, but whole food blends in general have been shown to help with overall GI tolerance. Below are the commercially available whole food blended options.


The product is free of gluten, corn, and lactose. The protein source is chicken, milk protein and pea protein. The blend is considered thin.4 The recommended delivery method is through an 8 French or larger feeding tube via gravity feed or pump.


The product is free of dairy and the protein source is soy. The blend is considered slightly thick.4 The recommended delivery method is via syringe bolus feeding or gravity feeding. The blend can be fed via pump in a continuous feed (including overnight


The product is free of dairy, tree nuts, gluten, soy and corn. The protein source is brown rice protein, quinoa, garbanzo beans and green pea. The blend is considered mildly thick.4 Nourish can be used with tubes that are a 6 French or larger. It can be delivered at room temperature through a pump or gravity bag and the hang time is 12 hours. Infinity brand pumps may be more suitable for delivery in comparison to Joey pumps.


The product has two options: chicken garden blend or plant-based. Both products do not contain dairy, soy or corn. The chicken garden blend protein source is chicken and pea protein. The plant-based blend protein source is pea protein and rice protein. The blends are considered moderately thick.4 The blend can be delivered via syringe bolus or pump-assisted (Enteralite Infinity Pump System) feeding with a 12 French feeding tube or larger. The hang time is 8 hours. Gravity feeding is not recommended related to the viscosity of the formula.


A high-powered blender (Vitamix or Blendtec) will provide the best product when blending at home in order to ensure the blend is smooth and will not clog the tube. Home blends can range from mildly thick to extremely thick. There are several factors that can attribute to the thickness of the blend including amount of liquid included in the recipe as well as added later during feeding as well as the freeze/thaw cycle.4 Defrosting a large batch of home blend can reduce the thickness. In order to maintain the viscosity of the blend, it is recommended to give water 1-2 hours post feeding to avoid dilution of the blend.


Once a feeding tube type and a formula or whole food blend is selected, establishing the feeding schedule is an important final component of completing the enteral nutrition plan. There are several options for creating the tube feeding schedule, and caregivers, registered dietitians and GI doctors can work together to determine the best plan for the child.


Decades ago, it was not unusual for table food to be blended and given to patients though their G-tube. But, as commercially-prepared formulas were introduced that were nutritionally complete, sterile and easily delivered, feeding shifted to giving these formulas to tube-fed children of all ages.


The challenge was how to make sure children received the correct number of calories and the correct mix of macro- and micronutrients to promote optimal growth and development. So began the creation of a spreadsheet that would act as a road map for families who wanted to give their tube-fed children a homemade, blenderized diet that met their specific nutritional needs, as well for healthcare providers who could support this practice.


The wire frames were used to obtain feedback from both CHOP dietitians and families who were using or considering using a blenderized diet for their child. The response was overwhelmingly positive and we began looking for a commercial partner with the resources to build the application and market it widely.


This notice lists acceptable substitutes for HCFC-22, HCFC-142b, and blends thereof for end uses in refrigeration and air conditioning, foam blowing, aerosols, and sterilants. The determinations all include substitutes previously listed as substitutes for other ODS or as substitutes for HCFC-22 alone.


This notice expands the list of acceptable substitutes for end uses in refrigeration and air conditioning and foam blowing. The determinations concern new substitutes. In addition, this document informs the public that the refrigerant blend previously found acceptable under the name KDD5 has received the ASHRAE designation R-438A and has the trade name ISCEON MO99.


This notice expands the list of acceptable and pending substitutes and clarifies information on refrigerant blends R-410A, R-410B, and R-407C that EPA previously added to the acceptable substitute list. This notice lists acceptable substitutes in various and uses in refrigeration and air conditioning, foam blowing, fire suppression, explosion protection, solvent cleaning, aerosols, adhesives, coatings, and inks. There are also pending substitutes, n-propyl bromide and HFC-4310, listed in aerosols and solvent cleaning.


Description:This notice expands the list of acceptable substitutes for end uses in refrigeration and air conditioning and foam blowing. The determinations concern new substitutes. In addition, this document informs the public that the refrigerant blend previously found acceptable under the name KDD5 has received the ASHRAE designation R-438A and has the trade name ISCEON MO99.


Description:This notice expands the list of acceptable and pending substitutes and clarifies information on refrigerant blends R-410A, R-410B, and R-407C that EPA previously added to the acceptable substitute list. This notice lists acceptable substitutes in various and uses in refrigeration and air conditioning, foam blowing, fire suppression, explosion protection, solvent cleaning, aerosols, adhesives, coatings, and inks. There are also pending substitutes, n-propyl bromide and HFC-4310, listed in aerosols and solvent cleaning. 041b061a72


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