How common is BTF ?
In the ' 50s and ' 60s , BTF was used in hospitals as the sole source of enteral nutrition . That changed in the ' 70s when commercial formulas were created as hospitals placed more emphasis on aseptic techniques . Now , the tables are turning again , and some recent surveys have found :
• A high proportion of tube-fed patients report BTF comprises more than 50 % of their daily enteral nutrition
• Around 40 % of HEN services report patients use BTF as an alternative to some or all of their enteral nutrition
Clearly , BTF is out there . The odds of a dietitian ’ s patient using it and not disclosing it ( and potentially following up with a nondietitian ) are rising , so we need to get on the bandwagon . I ’ m pro presenting the option and pro patient choice . Just like we offer choice with the type of feeding regime to suit a patient ’ s lifestyle ( bolus vs . continuous ), we should offer choice with the type of formula , too .
When would you not consider BTF ?
People needing continuous pump feeding would find it tricky to use homemade BTF as it shouldn ’ t hang for longer than 2 hours unrefrigerated .
I would also exercise caution for those :
• With a smaller feeding tube ( i . e . < 14 french )
• Receiving jejunal feeding
• Who are medically unstable
Otherwise , I would try to work around things to support my patient if they want to try BTF .
Dietitians are the experts in food and the experts in tube feeding – so let ’ s take ownership of safe , nourishing and effective BTF .
What are the common myths associated with BTF ?
1 . Myth : BTF increases the likelihood of tube blockages . Fact : It does not if it is done with the correct particle size , type of blender used and duration of blending . Tube blockage is more likely to occur with infrequent water flushing and syringing several medications down the tube .
2 . Myth : BTF increases the likelihood of food contamination . Fact : Regular food handling guidelines still apply when you ’ re cooking for BTF :
• Keeping up with hand hygiene
• Washing equipment
• Separating cutting boards for meats and vegetables
• Refrigerating blends until used and between feeding
• Discarding any leftovers after 24 hours
© Dietitian Connection 28 Infuse | October 2022