bFed System

One issue many blenderized diet families face is the fact that modern tube feeding equipment has been entirely designed around formula use. In fact, by their own admission, the new ENFit system was developed with the recommendation in mind that commercial formula be the preferred product to feed through a feeding tube. In other words, when ENFit, the most recently developed system for tube feeding, was being designed, whether a blenderized diet could be fed through the system was never a consideration.

While this post is not about ENFit (I will be writing about ENFit in August), I am bringing this up to demonstrate how little attention the medical device industry is giving to the fact that more and more families are preferring home blenderized diets of real food over enteral formula. Parents are often turning to syringes designed for the feeding and rehabilitation of squirrels, for example, because the syringes designed for feeding food to squirrels are of better quality than the syringes designed for feeding food to children. The medical device industry is not keeping up with the times, that much is clear. And families have endured a lot of frustration because of it.LARGE_BOLINK_BOLEE_BAG

So, I was extremely pleased to hear of a couple of people experienced in the medical device industry who noticed this and wanted to offer something better to tube-fed patients, especially for those who are feeding pureed food. After working in the medical device industry for many years, Brian Johnson and Fred Reuning both saw the market changing more and more toward blenderized diets and more natural nutrition products. Yet, no new delivery options were being developed with this in mind. Believing in natural nutrition themselves, they knew they could create a delivery system that is better than what is currently available. And that is what they set out to do. They branched out on their own, launched their self-funded company, and developed the bFed System.

Earlier this year, their bFed System was launched. I am IN LOVE. All our frustrating days of dripping food everywhere with syringes can now be a thing of the past. Imagine just packing up pouches filled with your pureed food when you are going out for the day, connecting those pouches directly to the g-tube extension, and feeding. This is now possible, thanks to the bFed System.

One mom mentioned she really liked that she could fit an entire meal into one bag (a bag can hold up to 13 ounces), it was less messy than syringe feeding, and it was easy to clean, much easier than she had anticipated.

Some people have noticed that it was a bit difficult to push the food through the extension, particularly with thicker blends. However, other moms have noticed if you insure all of the air is out of the bag, this problem is alleviated. If you turn the bag upright so the opening is facing up and squeeze the food up to the opening to remove any air prior to connecting it to the extension, pushing food through becomes much easier. Alternatively, hold the bag upright, attach the extension and push all air up and out so only food is in the bag and extension. Then, attach the extension to the feeding tube (much like you would prime the air out of a bag on a feeding pump prior to connecting it).

It seems if there is a lot of air in the bag, you have to push it a lot harder because you are pushing large air bubbles around inside the bag rather than pushing the food directly through the tubing. Still, if you use very thick blends, you may want to try a small sample kit to see if this system is right for you. Some that use very thick blends had a hard time getting the final ounce of food out of the bag. It seems in most cases, however, blends go through just fine, and the response to the bFed System has been largely very positive.

SMLL_BOLINK_FEEDNG_TUBE_POUCH_3Another solution the bFed system provides is the ability to connect store bought baby food pouches directly to a G-tube extension. Many mothers, myself included, have sought out ways we could simply put a baby food pouch right into an extension, and we have gotten quite creative in the process. Throwing some shelf-stable baby food pouches into the diaper bag when going out for the day can be quite convenient. However, when you then have to squeeze all those pouches into a blender bottle, stir them up, suck it up with a syringe, drip food everywhere while moving the syringe from the blender bottle to the extension, and then, feed, that convenience pretty much goes out the window.

Now, you really can just attach a baby food pouch directly to the extension without SMALL_BOLINK_NO_CAPtremendous feats of improvisation. The bFed system has an adaptor that allows you to connect a baby food pouch directly into an ENFit extension. Also, if you do not wish to use ENFit, an adapter is available here that allows you to connect it to other extensions as well. Some people like ENFit and other people abhor it. I appreciate that this company offers both options so people can use whichever system they prefer rather than requiring everyone to use one system or the other.

If you use Nourish, Liquid Hope, or Real Food Blends, you can pour the product into a blender bottle with any liquid you would like to add, shake the bottle up to mix, and then pour it right into the bolee bag from the blender bottle for no-mess feeding.

What I am most pleased about with the bFed System is the selection and freedom of choice the company offers (something rarely extended to the tube-fed community), their acknowledgement that better systems are needed for people feeding pureed food through feeding tubes, and their desire and efforts to provide those better systems to the tube-fed community. The first generation of the bFed System was first shipped out in February of this year, and the second generation is already in development.

Their website is filled with pictures of wholesome, nutritious foods rather than sugar-laden beverages, and their slogan in their logo is, “Freedom to Choose.” In this way, they truly stand apart from other companies in the medical device industry.

I have personally spoken with Brian Johnson on multiple occasions, and I do feel he is genuinely interested in hearing consumer feedback so they can develop the best system possible. Home Care Supply companies can supply the bFed System as part of your monthly supply kit (they can bill it under the gravity billing code). You can also buy directly through their website here.

I give a two thumbs up to the bFed System and encourage you to give it a try and to support the efforts of this company to make tube feeding easier for all of us.

*I received no compensation, neither financially or materially, for writing this blog post.

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Crunchy Tubie Mama Teaches Science: Part 1

Hey, everybody! So, this is my first video in a series that I hope many of you will watch or listen to because I do think you’ll really benefit from it. I figured in the meantime, you’d enjoy some nice scenery while you listen in, so I’ve got some pictures of some really colorful foods and beautiful blends that were shared with me that really have nothing to do with what we’re talking about, but they’re nice to look at.

This video series is going to be all about how to research a subject you are interested in learning more about. I am going to teach you a really basic skill set that you will allow you to look up the scientific data on nearly any subject and find out what science has revealed about that subject.

I hear so often, “Oh, it’s so hard to figure out what is true and what is right when there is such conflicting information out there.” But, when you go straight to the scientific data, the nice thing is you don’t have to worry about who to believe. I’ve had conversations where I was sharing what scientific studies revealed about a particular subject matter, and I’d then be asked, “Well, why should I listen to you over my child’s dietitian?” for example. And my answer to that really is that you should not listen to me over your child’s dietitian. But, you also shouldn’t listen to your child’s dietitian over me. You should listen to the science.

Another question I’m often asked is what credentials do I have to lend support to what I’m saying. But, science is not based on credentials. It’s based on data. And if you have the right skill set, which pretty much anyone who is able to read can learn, you can look up that data for yourself and evaluate it. If you’re the parent of a child living with special needs or really if any member of your family is living with an illness or some sort of medical issue, I cannot overstate how invaluable this skill set will be for you. You are absolutely not at the mercy of someone’s credentials. And I’m not at all speaking against education because those credentials do mean something.

But, if someone is giving you advice that contradicts the scientific data that we have, that advice should be ignored no matter what credentials a person has. You have the ability to question what you are told and to do it in a way that is responsible and that makes you a more informed person.

Now, a lot of people find information like this to be a little overwhelming at first only because it is not an area that they have a lot of experience with. So, I’m offering this information in both a video that you can listen to, and I’m also going to post the transcript of everything I’m see here below as well. I know some people learn more easily through listening and some people learn more easily through reading. So, I’m offering both and you can choose which you prefer. Or choose both and read along as you listen. It’s up to you.

I hope by the end of this series, you will feel empowered question what you are told and to look up and evaluate the data for yourself.

So, for this video, I’m just going to give an introductory explanation about different ways of learning and the significantce of science when learning about the world around us.

So, there are different ways we learn information. And we’re going to go over those right now.

One way is called tenacity. Tenacity refers to repeatedly hearing the same piece of information again and again and eventually, coming to accept it as true simply because we have heard it so many times. To give an example of this, for years, the idea has been spread that humans only use 10% of their brains and that 90% of their brains just lie dormant. This is absolutely false. However, many people believe this to be true simply because they have heard it so many times. Likewise, there are many things taught to us by our parents as we are growing up and because we grow up hearing whatever it is they’re telling us over and over, we’ve just come to accept it as truth simply because we have heard it so many times.

The problem with this is that when that information that’s repeated to us is wrong, we have a tendency to believe something incorrect simply because it was said to us many times. We see this a lot in the blenderized diet community, actually. How many of us have had a dietitian or a medical professional just hammer onto us how super important complete nutrition is? And then we are pressured to insure virtually every single meal we feed our children is a perfectly concocted blend that accounts for every single nutrient in perfect proportion.

From our perspective, we come to see pretty easily that this is unnecessary and actually kind of silly. We see that no one really eats this way, not even the people telling us this information. So we realize this idea of complete nutrition really is incorrect. However, a lot of people trained in this area involving tube feeding have been told over and over and over about how important precision diets or complete nutrition is for tube-fed people. And even though there is no science to support that, they’ve just heard it so many times that they have come to believe that it is true regardless of how illogical it is and how unsupported it is.

So we can see how this is not really a very reliable way of learning, and it’s good to always evaluate our own beliefs and consider whether we believe something to be true because we have solid reasons to or simply because we have heard it many times.

Another way of knowing is through authority. We hear something from someone we consider an authority in that particular area and then, just accept it as true. We see this in the tube-fed community quite often as well. It’s really hard for a lot of us to go against what a doctor or someone with specific credentials say even if we are sure they are wrong based on really solid information. And this is because of our tendency to turn to authority.

Now, this does not mean that people with credentials are always wrong and we shouldn’t care about what they say. We should certainly hear out their advice and consider it because they do have a lot of knowledge in their area of expertise. However, we also should not blindly follow them simply because they have specific credentials or something else that makes us view them as an authority. Because no matter how much knowledge anyone has, they can still make errors. They’re still humans, they still have their own biases, such as what I just talked about with tenacity as a means of learning. So, it’s always good to double check what we are being told.

That is why I always tell people you don’t need anyone’s permission to feed your child what you choose. Your child’s medical team is there to advise and recommend and, certainly, always hear out their advice and recommendations. However, it’s always important to be well informed and to consider that advice in the context of all the information that is available before making a decision. And the decision should always be yours, not just someone who is in authority.

Another way of learning is through experience. Now, you’d think that by experiencing something yourself, you’d fully understand that information you gained, right? But, this is not necessarily true. And that’s because your individual experience isn’t necessarily indicative of patterns that happen in a larger group. To give an example, have you ever heard of someone who was a really heavy smoker and lived to be in his 90s? That person’s experience may teach him that smoking actually does not cause cancer and will not shorten your life. But, we know from data collected on much larger groups, that that would be entirely incorrect.

Also, our own memory and interpretations are not nearly as accurate as we often seem to think. A big problem crime investigators, for example, run into when there are many witnesses to a crime, is trying to sort out the truth after talking to the witnesses. All of those people will have seen the exact same incident, yet have completely contradictory versions of it and information. Some will say the person of interest was wearing a red shirt, while others will insist it was blue. Even our own accounts can contradict each other.

I once witnessed a woman get hit by a bus while riding her bike. The bus company called me the next day to interview me. I didn’t hear anything about the incident for nearly 2 years when I was called in for a deposition and interviewed again by both the bus company’s lawyer and the woman’s lawyer. I answered questions that day that I was absolutely sure were correct and precise and exactly as I had seen that day.

When I finished talking, the lawyer for the bus company handed me a transcript with some highlighted sections and asked me to read those sections. I was just so embarrassed as I sat there at this table surrounded by all these people and read statements I had made the day after the accident that were completely the opposite of what I had just said there in the room moments ago. When asked which account was correct, I told them I had no idea.

Experience is definitely useful. In fact, that’s how we know most of what we know as individuals. However, there are definitely many doors for error even when knowledge comes from our own first-hand experience.

Another way of learning is through reason and logic. When we know one piece of information is true, we can use that information to deduce other information. Now, this is a very helpful way of learning. But, the big problem with this way of learning is that the original piece of information we deduced from may not be correct. So, if we say we know a piece of information is true because an authority told us or because we have heard it so many times and then, we deduce a conclusion from that information, our deduction will be incorrect if it turns out that the original piece of information was not correct.

I can give an example of this that I’ve seen happen in the medical community regarding blenderized diets. Abbott Nutrition and Nestle Health Science did some really poorly done research, which we will learn about later in another part of this series, that basically was used to tell dietitians and doctors that blenderized diets have really high levels of bacterial contamination.

Now, it’s important to know that those studies were done extremely poorly and their data did not at all support that conclusion. However, many people in the medical community, one, see these pharmaceutical companies as authority and believe what they say for that reason without doing any double checking. On top of that, Abbott Nutrition and Nestle Health Science know full well about the information I’m presenting here. They know if someone hears something often enough, they’ll believe it. So, they harp on this over and over again.

And so, through tenacity and authority, much of the medical community has come to wrongly believe that there is a lot of bacterial contamination in blended food. That piece of information that they have accepted as true is actually not true. But, let’s say they then take that information and because they believe it is true, they make a deduction from that. And one deduction they make is that because blended food has so much bacterial contamination in it, blended food cannot be safely fed through a J-tube because there isn’t as much protection in the intestines from pathogens as there is in the stomach with its higher acidity.

No study ever done has shown problems with feeding food into a J-tube. In fact, a couple studies have shown that feeding food into a J-tube is just fine most of the time as long as you’re taking the proper precautions. But, because they’re not looking at more solid evidence and instead, deducing from a false premise, they end up giving poor advice that turns out to be entirely incorrect.

And if you’re watching this and going into a panic saying, “Oh, you just can’t feed food through a J-tube. It just can’t be done. Please don’t tell people that.” I ask you to consider how you came to know that. Was it because someone in authority told you that? Was it because you have just heard it a bunch of times? Because I can tell you I know a lot of people at this point who have been successfully feeding blended food through a J-tube for years with absolutely no complications. And in fact, their children have less nutritional deficiencies when compared to their bloodwork when they were J-fed formula, their health is more stable and they’re really just doing great. And as I mentioned, the couple times has been studied, it actually showed that blended food could be fed through a J-tube and that’s perfectly safe as long as you take certain precautions.

So, you can see here that while logic and deduction are useful tools, this way of learning can go awry if you’re starting point that begins your chain of logic was not even correct to begin with.

So, with all of these ways of learning and coming to know and gaining information, it’s not that there are no places at all for these way, but you can see there are just many doors open for errors to be made. So, they are helpful and useful, but they should not be entirely depended upon because if they are, we can end up wrong about a lot of things no matter how educated we are.

The final way of learning that we’ll discuss here is through science. Science is a way of acquiring knowledge that directly addresses the biases that we bring with us when we come to a subject of interest and removes that bias so that we end up with, assuming we have a good study design, a data set that is not influenced by our biases or preconceived ideas from these other ways of learning that I just described. It uses objective measurements and the experiment itself can be repeated by others to see if they get the same results. And that’s done actually all the time. There are many things we can do to make sure our own bias or expectations don’t affect our data.

For example, I worked in research for several years and at one point, my job on a particular project was to observe interactions of family members with one another that had been recorded on video as they were performing a task they’d been asked to complete. I was then measuring certain aspects of those interactions.

I was not allowed to know anything about the hypothesis in the study because those that designed the study wanted to make sure that my expectation of finding a certain connection would not then bias me to score those measures in a certain way even if I did not mean to. So, to make sure my biases did not impact my scoring, I simply had no idea what the study was ultimately about while I observed the videos and scored them with the measures I was given.

So, that is one really lovely aspect of the scientific process because it removes all of these open doors to error.

The problem is when people take advantage of the scientific process and use very poor study designs that aren’t aimed to find the truth and instead, are just meant to get data that will benefit the researchers financially. When people do this, what they are doing is not even science. It is instead an abuse of the scientific process. And, sadly, that is actually running rampant right now in the field of nutrition where we have different companies making enteral formulas or different companies in the food industries making different foods, and they’re concocting all this terrible “research” and then they’re passing that along to people that are in a position to promote their products. And as they pass it along, they present their data as though it is from valid, properly designed studies when in fact, it’s not.

This is why we cannot just hear “Well, a study showed such and such is true” because there are a lot of crappy studies out there. We have to look up the study ourselves, read them with a critical eye and determine if their study design was solid and whether they analyzed their data properly.

And in that way, that is really what I consider to be the most beautiful aspect of science. It is there for everyone to check out. You don’t have to be a registered dietitian to read research studies about nutrition and determine if the studies are done correctly and then combine the knowledge you get from that review to come to a really firm conclusion that is very likely to be correct. You don’t have to be a doctor to review what science says about a medication. You can look all of this information up yourself.

Now, some people have commented that I can get a little worked up when someone says something like, “Well, you don’t have any place to comment on that because you don’t have the specific credentials in that area.” And I do get pretty worked up. Not because of anything they’re implying about me, but what they’re implying about all of us. What they’re saying is that none of us can learn for ourselves and we are just at the mercy of every authority out there and we just have to hope that they’re correct and don’t lead us astray.

But, that is a very wrong assertion. We are NOT at the mercy of authorities when it comes to gaining new knowledge. We absolutely can question what we are told and research it for ourselves. Science is not just for people with specific letters after their last name. Science is for absolutely everyone. And when someone suggests it isn’t, it really puts a dagger right into the most beautiful component of the scientific process. The field of science is there for all to benefit and learn from.

If you are not very experienced in the world of science and your skills are in different areas, this can sound very intimidating at first. But, honestly, the foundational principles of science are really quite simple to learn. So, in this series, we are just going to hit one or two chunks of this information at a time for you to take in and process little by little and by the end of this series, I am certain you are going to feel so empowered. You are going to feel so capable and so confident to get out there and learn all you can. So, don’t feel intimidated. I want this to be an empowering journey for you that leaves you with a skill set that will allow you to become really well informed on nearly any subject about this world on which you wish to be well informed.

By the way, please notice just under the video a little button. There are costs associated with keeping this website going and available to everyone, so I do ask if at any point, if you have gained important information that you feel is helpful to you, please consider making a small donation to contribute to this website. In the meantime, be on the look-out for the next video, which should be up in a couple weeks or so.

Pediasure Harvest Part 2

I’ve already had plenty to say about Abbott Nutrition’s Pediasure Harvest here. If you’ve followed my blog for long, you won’t be surprised that I have more to say.

I know my blog posts have been lengthy recently. I usually strive to keep my blog posts nice and short. However, there is so much information that is extremely important for every family with a tube-fed family member to know due to the recent launch of two products from Abbott Nutrition and Nestle Health Science. These posts are not intended to be read in one sitting, but more like a book read in portions. For all of my posts on these products, visit here and here.

I’d like to show you a portion of the webinar Abbott put together for healthcare professionals about Pediasure Harvest and offer my commentary.

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Here, they show a brief history of tube feeding. They are quite incorrect about what exactly happened during the 1960s and 1970s. I give a much more detailed history, based on what can be seen in the medical literature, in my book, Stand for Food. There were not significant concerns about bacterial contamination of pureed food back then. All tube-fed patients were fed pureed food up to that point. They were not showing higher rates of food poisoning or related illnesses than orally-fed people.

In fact, initially, doctors were vehemently against the use of these formulas. You can find multiple articles in medical journals from 1950-1980 written by doctors describing how much more poorly their patients were doing on these enteral formulas compared to when they were fed food. They found patients that were formula-fed had much more severe GI complications and did not recover from surgery or illness as well.

The idea of contamination is specifically mentioned in these articles, in fact, and it is said that they were not observing any problems in that regard. Blended food was placed on ice, and this was very effective according to the medical literature. Doctors who had seen day in and day out how tube-fed patients did while being fed pureed food did not like these formulas for years after their introduction because they observed the decline in their patients’ health when they were fed formula.

You won’t find any articles written by doctors praising enteral formulas and the supposed benefits Abbott and Nestle Health Science claim they brought. The only articles you’ll find with those such claims were written by the companies that produced the formulas.

In time, the companies making these formulas marketed to hospital heads…people that don’t have much, if any, direct interaction with patients. They emphasized cost savings. It was less expensive to have a nurse pop open a can of formula than it was to pay kitchen staff to puree food. That is ultimately why things changed.

Abbott Nutrition and Nestle Health Science will have you believe that physicians saw these formulas as some sort of heaven-sent miracle. Nothing could be further from the well documented truth. Again, I give much more details about this history with citations in my book, Stand for Food, which you can read about here. Today, this history has been lost from much of the medical profession.

What really happened is that patients were fed formulas that were making them sick because it was cheaper to do so. Patient health became secondary to profits. And Abbott Nutrition and Nestle Health Science saw this as an opportunity to make millions upon millions of dollars, the patient’s health be damned.

And now, in their own way, Abbott Nutrition has admitted as much.

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I want you to look closely at the comment in blue about these benefits they list of blenderized diets (BTF = Blenderized Tube Feeding)…you know…under the sentence with the big typo…since that is how much effort they put into this webinar. “Overwhelming evidence that diet high in fruits, vegetables and healthy fats and low in sugar and processed food decreases chronic disease.” Yes, there are some more grammatical errors there. But, I digress.

Let me tell you what Abbott is saying here. “The formulas we have been making and pushing onto doctors and dietitians…and therefore, parents and patients…have been making tube-fed children and adults sick for decades.”

Next: “Improved feeding tolerance” and “less constipation and reflux.” In other words, again, “The formulas we have been making and pushing onto doctors and dietitians…and therefore, parents and patients…have been making tube-fed children and adults sick for decades. Our products have been causing people to suffer from reflux and vomiting unnecessarily for many years. We have ignored that fact all this time.”

Next: “Faster progression to oral feeds.” In other words, “The formulas we have been saying are so wonderful for children with oral aversion have actually been slowing their progress toward oral eating.”

And Abbott, please stop saying the word “feeds.” Our children are not a herd of cattle. We feed them meals, breakfast, lunch, snack, dinner, and so forth. I really doubt when you sit your child down at the table for a meal, you say that you’re giving your child a “feed.” While we are on the subject, I also doubt you’re giving your child a can of Pediasure Harvest for their meals every day, either. Or any of the formulas you’ve worked so hard to push onto us.

Why the movement back to blenderized diets? Because the formulas made by this company and others have been making tube-fed people sick for far too long, and the tube feeding community has had enough.

Here are some more:

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More and more studies showing how much patients improve when they are fed real food just like they had been for millenia until greed got in the way. What Abbott doesn’t mention is that as they’ve been seeing dollar signs this whole time, countless numbers of children and adults who have already had more than their fair share of obstacles as it is have been made sick by their products.

None of this research Abbott is presenting is new or groundbreaking. As you can read in my book, Stand for Food, which can you learn about here, studies have shown from early on, as far back as the 1970s, that patients do not do nearly as well on these formulas as they do on pureed food. Volume tolerance is worse with enteral formula, including elemental formula. More reflux, diarrhea, and constipation are seen with enteral formula. Patients that had handled bolus feedings of pureed food just fine suddenly required continuous feeding with a feeding pump when they were tried on enteral formula.

Abbott mentions that there is overwhelming evidence that diets high in various real foods are associated with better health outcomes as if this is an idea that was just discovered a year ago. We have known this for decades. Abbott has known this for decades. Nestle Health Science has known this for decades. But, they did nothing. They changed nothing.

They continued cranking out their formulas and getting rich from making people sick. I don’t understand what kind of a person could knowingly make young children sick and then laugh all the way to the bank with their bags of money. While you expect the industry to change as science discovers more, this change did not happen because of a new scientific discovery. We have had access to this scientific data for over 40 years.

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“Often differentiated in the research literature.” As they should be. Diets of real food with all of their natural vitamins and fiber, enzymes, cofactors, and more are not comparable to the concoctions of sugar, oil, protein powder and synthetic vitamins these companies make.

I want to emphasize here that synthetic vitamins are not the same as those naturally found in food. Vitamins naturally found in food are absorbed better and provide benefits the synthetic version of those same vitamins do not. We know this to be true, and we have known this for quite a long time. When these formulas are called things like “nutritious,” that is really an incorrect statement. Sugar, oil, protein powder, and synthetic vitamins are not nutritious, especially in the context of products like these being fed for a person’s entire diet.

Enteral formula and blenderized diets are completely different and not comparable on any level. They absolutely should be differentiated because they are very, very different.

On that note, let’s play a game. Did you grow up watching Sesame Street? Remember this game?

One of these things is not like the others. Which one doesn’t belong?

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The medical literature differentiates between enteral formula and blenderized diets. Absolutely correct. We do, too.

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The third bullet point from the bottom makes a pretty strong statement, though I don’t think Abbott Nutrition realized this at the time. Of those feeding food rather than formula, only 25% worked with a registered dietitian. This means 75% of families using pureed food for tube feeding have chosen to not see a dietitian.

I can explain why. At first, parents, caregivers, and tube-fed patients were told the reason so many tube-fed people were vomiting and having terrible digestion problems was because that is simply how it is when a person is tube-fed. It is a consequence of the feeding tube.

In time, people started to figure out it really wasn’t the tube. It was what was being fed through that tube. These enteral formulas were making people sick. So, they stopped using the enteral formulas and began feeding blenderized diets of real food. More and more people were learning about what these enteral formulas really are made of and their impact on health. As a result, more and more people were choosing blenderized diets.

Abbott Nutrition and Nestle Health Science saw this threat to their profits. Every meal that a caregiver or tube-fed patient blends up in a blender at home results in a profit loss for the makers of enteral formula. Profit margins are extremely high on enteral formula. Their ingredients are dirt cheap, but the products are sold at a substantially inflated price. They weren’t about to sit back and watch their sales go down the toilet.

So, Abbott Nutrition and Nestle Health Science both began conducting very flawed research with extremely poor study design. Abbott went to Iran, for example, to hospitals already well documented to have kitchen food that is heavily contaminated. They tested the pureed food from those kitchens and then, spread the claim to the medical profession that, supposedly, blenderized diets have been shown to have high levels of bacterial contamination, never mentioning the context in which these studies were conducted.

Both Abbott and Nestle Health Science spread baseless and unfounded fears that people on blenderized diets would be at a very high risk of getting food poisoning. They said enteral formula was “complete nutrition,” and people being fed blenderized diets could become dangerously malnourished. After all, food has variable levels of nutrients (notice this did not stop those working at Abbott and Nestle from eating food themselves with all of this nutrient variability that they claimed was so dangerous).

Their idea was to make blenderized diets look dangerous…a liability. They wanted doctors and dietitians to be frightened of blenderized diets. Then, the medical profession wouldn’t recommend blenderized diets to patients, enteral formula would be used instead, and the money would keep rolling in. That was their plan.

Their success was only partial. They were actually quite successful at instilling fear into much of the medical profession. To this day, most of the medical profession remains grossly misinformed about blenderized diets and enteral formula. My son’s dietitian told me, “Ohhhhhh…what you’re doing is just so, so dangerous….ohhhhhh…I just…ohhhhhhhh…I’m so worried.” My experience is not uncommon. So, in that regard, Abbott and Nestle Health Science were very successful.

However, they did not accurately predict the response from the tube-fed community. When doctors refused to approve of blenderized diets and prescribed enteral formula instead, we just stopped using the formula and didn’t listen to the doctors. When dietitians argued against real food, favoring enteral formula, we just stopped seeing them at all.

And who can blame us? When enteral formula caused my son to be debilitatingly ill and miss out on such important developmental windows, something that still affects him to this day, and when it became so clear to me that the enteral formula was truly the cause of the severity of my son’s digestive issues, would any reasonable person expect me to continue to feed him enteral formula?

Well, the dietitian did. She was completely against a blenderized diet in spite of the benefits it had brought my son. She still insisted I feed him enteral formula, a diet that had landed him in the hospital more than once. She was so fearful of blenderized diets that she thought a diet that was making my child so ill that he was being repeatedly hospitalized was the safer option.

She gave these very reasons pushed into her mind by Abbott Nutrition and Nestle Health Science. She told me he could get food poisoning. She told me I had no way of knowing whether it was complete nutrition. After enough arguing on the subject, I just stopped speaking with her, just as any mother do would in my shoes. That is why only 25% of parents feeding real food to their children see a registered dietitian.

This fear mongering is still part of their plan, as you can see here.

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“Unsure nutrient intake” and “higher level RD education” for home blends vs “Known nutrient composition” for formulated products. In truth, children have repeatedly shown blood levels relevant to nutrition far better when on home blends than formulated enteral products. Higher level education for the registered dietitian? Did they seriously just say that registered dietitians aren’t educated enough to figure out what food to feed a child? If that is true, that is a really alarming statement about the nutrition programs currently available in our universities.

After the recipes I’ve seen parents come to me with that were given to them by registered dietitians, I can’t entirely disagree with Abbott’s statement here. I have seen recipes filled with foods well known to be difficult to digest and not tolerated by most children with feeding tubes. When the child then doesn’t do well, the dietitian says they do not tolerate a blenderized diet when in reality, the child did not tolerate the ridiculous recipe given to them by the dietitian. I have developed starter blends for countless parents to feed to their children who were vomiting on the dietitian’s recipe. When they changed to my recipe, the vomiting stopped because my recipes are based on the knowledge I’ve gained about foods that help digestion rather than worsen it.

I have seen recipes from dietitians that are completely absent in grains and instead, include table sugar for all of their carbohydrates as well as other glaring problems. Dietitians are not often taught about real food. That much is clear. While I ultimately blame our nutrition programs for these occurrences, it is time for dietitians to stand up and begin demanding more proper education on these matters. Dietitians are attending nutrition programs, not Formula University.

“Lower risk microbial contamination” for formulated products and “higher risk microbial contamination” for home blends. In fact, a survey showed the incidence of food poisoning in children fed home blenderized diets is quite low, substantially lower than the incidence of food poisoning in the general population. Studies have also shown formulas to have pretty shockingly high amounts of bacteria in them when you consider the high heating they’ve been put through.

Hang time for home blends is not 2 hours. It is if you’re just allowing the blended food to sit at room temperature. However, with ice packs properly placed around the feeding pump bag, home blends remain at a safe temperature for 12 hours. Yes, we’ve tested this. We’ve tested this because that is what us moms have had to do since the healthcare industry is not doing these tests. We’re doing our own research and collecting our own data. We are the ones that have brought science back to the tube-fed community, something that should have never been taken from us to begin with.

Abbott Nutrition and Nestle Health Science have worked very, very hard to make blenderized diets terrifying. The medical profession may have fallen for it, but moms know better. We see the difference in our children. And despite Abbott’s claims that we don’t think our children are worth the time and effort of going to the grocery store and cooking them food, which you can read about here, they’re wrong again.

Their plan pretty much blew up in their faces, and sales continued to decline in spite of their best efforts. Now, suddenly, after campaigning against real food for tube-fed people for years, after writing manuals (link here) about food being very dangerous while citing very poorly designed research, after all of that, they’re now going on and on about the benefits of real food that we’ve known about for decades as they market their first real food product (and by the way, the product still totally sucks, but I’ll get to that).

Look at what they say.

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First, let’s jump to the third statement in this graphic. Blenderized diets are safe if they’re monitored by experienced registered dietitians. Oh? According to the data presented in this very webinar, it appears 75% of families choosing blenderized diets are doing just fine without this monitoring.

Let’s jump back up to the first statement. Sorry to anyone that doesn’t appreciate my language choice here. But, I have no other way I can express this. Abbott Nutrition, you are a pharmaceutical company that is a part of the medical industry. You are not supposed to be getting your knowledge from “patient demand.” You are supposed to be getting your knowledge from SCIENTIFIC DATA, you dumbasses.

And that data has been available to you for a very, very long time. You have completely ignored it because that data wasn’t part of your financial interests. Food has far reaching implications beyond macronutrient properties, you say? Are you going to pretend like you’re just now figuring that out? This isn’t news. You haven’t cared about this information because patient health was never a part of your equation.

Products like Pediasure Harvest are what happens when patient health is not a part of the equation. There are several reasons I dislike this product, but I’ll touch on only one here in this post. The very first ingredient in Pediasure Harvest is banana. Most of you with children with feeding tubes will understand how ludicrous that statement is. BANANA. If Abbott had taken the time to do the slightest amount of research on this subject, they would have known that the vast majority of tube-fed children do not tolerate banana in any quantity, let alone as the most abundant ingredient in their diet. Even if that was not true, no one should be eating more banana in their diet than any other ingredient. This is not a well balanced diet.

So why did Abbott choose banana as it’s primary ingredient? Clearly, it was not because they wanted to make a product specially designed with the health of tube-fed children in mind. They chose banana because bananas have a lot of calories and because they’re cheap. They saw cheap calories and jumped in with both feet and with their eyes closed, which is exactly what they’ve always done.

They’ve never ran proper clinical trials on their products before deciding whether people should be fed these products. They’ve never done research to find out the truth about any of their products before making claims about them to the medical profession. For example, they’ve told doctors and dietitians for years that elemental formulas are very gentle on the digestion system and easy to digest. They’ve told doctors and dietitians their elemental formulas leave the stomach faster and are perfect for patients with reflux and problems with gastric emptying.

Abbott Nutrition has never done a single study to even see whether that is true. Others have, though. And every time elemental formulas have been studied, they have been shown to worsen reflux, to delay gastric emptying, and to slow motility. They have been shown to completely obliterate the gut microbiome, something absolutely vital to good health, in as little as 21 days. We have known for over 40 years that elemental formulas significantly increase the risk of NEC in premature and low birth weight infants, though you will have a hard time finding a doctor or dietitian that is aware of this connection. Now that we know these formulas completely wipe out their gut microbiome, we have a better understanding of why. When gut bacteria is wiped out, opportunistic infections can, and often do, occur.

This issue hits close to home for me. My son was placed onto elemental formula due to a dairy allergy when he weighed only three pounds. I had doctors and nurses telling me this was such a great formula because everything was broken down. It was so good for his digestion, they said. Back then, I was the mom in shock who had given birth to her less-than-two-pound baby and sat through the additional shock of being told her baby has a congenital heart defect. I should not have had to look up medical journals to verify everything the NICU staff was telling me. It was their job to know these things.

One month after being fed an elemental diet, 36223213_10155374815287414_8896504036124000256_nmy son developed NEC. This led to scar tissue accumulating in his large bowel, which caused a total bowel blockage. He then needed two surgeries on his bowels at a time when he was very medically fragile. While doctors and dietitians sing the high praises of these elemental formulas and their impact on the gut, the large surgical scar that runs from my son’s chest all the way to his belly button has a different story to tell about these elemental formulas. The science about them has a different story to tell as well.

My son’s motility was and forever will be impacted by those surgeries. It is very possible that none of that would have ever happened had his dietary decisions been based on the scientific data about these elemental formulas rather than what the pharmaceutical companies told the staff at a steak dinner. One of Bradley’s NICU nurses, after learning all of this information, said to me, “You’re right. We do just listen to what the pharmaceutical reps tell us.”

This is why claims should not be made in the field of medicine without the proper research done to back up those claims. Life altering, irreversible mistakes can be made when that happens. In science, which is what the field of medicine is supposed to be based on, a person cannot just stand up and declare something to be true. They have to provide scientific data that has been properly collected and analyzed to support that claim. Otherwise, they are just making stuff up. This isn’t a field that can afford to just make stuff up.

These companies have been making kids terribly ill with these formulas, and doctors are scratching their heads saying, “I don’t know why they’re vomiting these formulas. They’re gentle and easy to digest.” No study anywhere has ever shown these formulas, elemental or not, to be gentle and easy to digest.

Tube-fed patients were being fed pureed food and thriving on it. Then, everything changed to enteral formula without any research first to even see if that was a good idea. To this day, no study exists observing the long-term use of enteral formula. It has never been studied a single time. Yet, claims continue to be made that these formulas are safe and effective as a sole source of nutrition for years and years.

Now, even short-term studies have shown that tube-fed patients should have never had real food taken away from them. Multitudes have suffered greatly and needlessly because of this mistake.

Now, after causing so much harm to the tube-fed community, Abbott Nutrition has the audacity to come onto the scene and claim they’ve come up with a “novel” new formula? Yeah, they’re actually calling it that when they talk to the medical profession. There is nothing novel about feeding food to tube-fed people. People have been home blending for an extremely long time. Companies already exist that make prepackaged real food products for tube feeding.

Developing a formula that isn’t properly researched, isn’t focused on the health of the patient, and that is focused on profits only is also not novel, sad though that reality may be.

Just like the fear mongering Abbott Nutrition has done for years, it appears many dietitians are eating all of this up as well without doing their own adequate research. Just this weekend, I received an email from a parent asking about Pediasure Harvest. She explained she had told the dietitian she would like to try Nourish, made by Functional Formularies, with her child.

The dietitian refused to approve of Nourish telling the mother that Nourish had too much protein. Instead, she wanted the child fed Pediasure Harvest. It took me 2 minutes to look up the protein content of each of these products and calculate their protein content. I want to emphasize that again. It took me two minutes.

Nourish has 14 grams of protein in 400 calories. Pediasure Harvest has just over 15 grams of protein in 400 calories. The dietitian told the mother that Nourish has too much protein for her daughter and then suggested a formula that has even more protein instead. I don’t need to explain how illogical that is.

Dietitians, I know there are good ones of you out there, but far too many of you are paying virtually no attention to any details about the products you’re recommending and not recommending. I don’t know how many times I’ve heard a parent tell a story in which they asked very basic questions about the ingredients or sugar content of a formula their child’s dietitian was recommending to them, and the dietitian sat there with a blank face because they did not know the answer to such simple questions about the very products they were recommending.

This is beyond unethical. A36188863_10155374120972414_6389590234572521472_nnd I know why it’s happening. It’s happening because Abbott Nutrition and Nestle Health Science keep taking these people out to lavish steak dinners. They faun over their unresearched products as they wine and dine the doctors and dietitians. Nearly everyone has a great time, believes every word said to them without doing any double checking, and out the door they go, ready to be sales people for Abbott Nutrition or Nestle Health Science rather than being doctors and dietitians whose practices and recommendations are based on facts and data. This needs to stop.

And it is going to stop. Can you guess what that mother did whose dietitian was pushing Pediasure Harvest while giving completely wrong information about its protein content and the protein content of Nourish? She stopped seeing the dietitian. The more that dietary advice is based on steak dinners rather than science, the less parents, patients, and caregivers there will be that are willing to bother with hearing that dietary advice, let alone following it.

There really is only one thing Abbott Nutrition and Nestle Health Science could do at this point to win any favor with me and the many parents of tube-fed children I’ve come to know. And this would be nothing less than what the tube-fed community fully deserves from them. What they really owe us is a public apology.

They owe us an apology for ignoring patient health for so long. They owe us an apology for their recklessness. They owe us an apology for every infection that was not fought off well, every seizure, every vomit, every reflux episode, every stomach ache, every killed gut bacterium, every C. diff infection, every NEC infection, every case of SIFO, every case of SIBO, every type 2 diabetes diagnosis, every high blood pressure diagnosis, every cardiovascular problem, every kidney problem, every developmental delay, every blood test result showing a nutrient deficit, every experience of constipation, and every experience of diarrhea that has been directly caused by the use of their enteral formulas over the years.

Just like Nestle Health Science’s Compleat Organic Blends, what Abbott has done here is far too little, far too late. Just say no.

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Nestle Compleat Organic Blends Part II

I wrote already here why I do not support Nestle’s new Compleat Organic Blends. I wrote of how aggressively Nestle Health Science (along with Abbott Nutrition) has campaigned against feeding food to tube-fed people and the extremely flawed “research” they willfully conducted and/or spread to medical professionals. They were poorly conducted studies leading to poorly collected data to begin with, and then, this data was presented to healthcare professionals completely out of context. Their reason was to coerce and deceive the medical profession to turn away from real food for tube-fed people favoring their enteral formulas instead.

This practice is an assault on science. It is an assault on the field of medicine. It is an assault on tube-fed people. The entire purpose of science is to remove human bias from data collection. When studies are purposely designed to get the answer one desires, that is not even science. And these kinds of studies have absolutely no place in the healthcare profession.

I would like to give an example of one of these studies and then, share a story of the harm recently done to a child as a direct result of these practices. Sadly, there are many more such stories like the one I am writing in this blog post that I could share with you. It’s not an isolated or uncommon incident.

A study conducted by Nestle Health Science, titled “ILSI Task Force on enteral nutrition; estimated composition and costs of blenderized diets”  can be found here. The investigators went to Brazil and state that enteral formula is available in Brazil, “permitting safe and reliable enteral nutrition therapy with quality control, both in the nosocomial and the home environment. Nonetheless, blenderized or homebrew tube diets (BTD) are still popular, especially for home use after hospital discharge as well as during home care by specialized health providers.”

They then continue to explain that blenderized diets have been shown to have high levels of bacterial contamination and basically, that a person cannot get the nutrients they need from food if they are fed through a feeding tube. In truth, no valid study has ever shown blenderized diets to be at a high risk of containing pathogenic bacteria. You can learn more about the studies they are referring to here and why they are not valid studies in this video.

Further, studies have shown that commercial enteral formulas used in hospitals have similar levels of bacteria as blenderized diets. I expound on this in much more detail in my book, Stand for Food. To state it simply, no properly conducted study has ever shown blenderized diets to be at a high risk of bacterial contamination, and the data we do have actually shows that tube-fed people that are fed a blenderized diet have a lower incidence of food poisoning than the general, orally-fed population. In other words, what Nestle Health Science says here is a lie.

They continue on, saying there is little control over osmolarity (which essentially means how many particles of substance there are in a specific unit of volume). They claim this lack of control means blenderized diets are inefficient and contribute to complications. No study ever conducted has yielded data that supports this statement. In fact, all studies on this subject consistently show patients do dramatically better on blenderized diets than on commercial enteral formula. Thus, what Nestle Health Science is saying here is another lie.

They explain, “It is worth mentioning that nutritional value of foodstuffs depends on geographical origin, ripeness, season of the year, and methods employed during processing, storage and cooking.” For once, Nestle Health Science says something that is true. The nutrition in food varies. The nutrition in one orange will not be exactly the same as the nutrition in another orange. No, the nutrients in blenderized diets are not precisely controllable.

Here is something else worth mentioning. That doesn’t matter. Can Nestle Health Science find any evidence in scientific studies that show that the nutrients fed to tube-fed people absolutely must be precisely controlled? In case you are wondering, the answer is no. Do the people who wrote this article drink nothing but commercial enteral formula because, otherwise, they don’t have any precise control over their nutrient intake? I would bet dimes to donuts that in spite of this variance in food, the authors of this article choose to consume food rather than formula.

Even if we are speaking of tube-fed people in the hospital, everything they are saying here would apply to orally-fed people in the hospital as well. One could not possibly precisely control the nutrient intake of patients eating the plates of food served by the cafeteria for the very same reason one could not precisely control the nutrients in a blenderized diet. Yet, hospitals everywhere continue to serve orally-fed patients food without panicking about a “lack of control” over the patients’ nutrient intake.

When you are writing a scientific article, you aren’t allowed to just make stuff up. You have to cite legitimate research for absolutely every claim you make in the article. This article does not do this. They claim that tube-fed people will have health complications if their nutrient intake is not precisely controlled. Yet, they cite no scientific study to support this. You know why? Because there aren’t any studies to support this. As I have mentioned, however, there are studies that show patients do dramatically better when they are fed real food along with all of its variations in nutrient intake than when they are fed commercial enteral formula with its precisely calculated nutrients.

The idea of “precision diets” first became a thing a little over 50 years ago. The makers of enteral formula, who invented this idea of precision diets, said that patients fed these precise diets would live to be 150 years old. Needless to say, they were incorrect, and precisely controlled diets don’t seem to have done people’s health any favors.

Here is some more information worth mentioning. The ridiculous formulas these companies push contain ingredients that are very well documented to contribute to medical problems, such as increased inflammation, decreased immune function, cardiovascular problems, liver problems, cardio-renal problems…does this sound like a diet that would be beneficial to someone sick enough to be in the hospital? Who cares if the carbohydrates are right at 55% if those carbohydrates are coming from terrible ingredients known to make people sick?

Nestle Health Science seems to enjoy talking percentages, so let’s talk percentages. According to basically every major health, dietary, and medical organization in the entire world, the percentage of calories gotten from sugar and ingredients like brown rice syrup, corn syrup, maltodextrins, and such should not exceed 10%. You’ll find that in these “precisely controlled” commercial enteral formulas, the percentage of calories from these ingredients is roughly 50%, 5 times the recommended limit.

We also know that synthetic vitamins, which are the only kinds of vitamins enteral formulas have, do not provide near the same benefits as those naturally found in food. For example, taking a vitamin C supplement will prevent you from developing scurvy, but it will not provide the benefits shown to be gained from a diet rich in foods high in vitamin C. Diets rich in foods high in vitamin C have been shown to provide strong cardiovascular protection among other benefits. Diets high in vitamin C supplements do not show the same benefits.

I could write pages and pages of examples just like this one. Synthetic vitamins do not provide near the benefits as those vitamins naturally found in food. A person with a micronutrient intake derived only from synthetic vitamins will not be as well nourished as a person with a micronutrient intake derived from real food. We also know that synthetic vitamins are not absorbed as well as those found naturally in food. Food has cofactors, enzymes, etc. that increase absorption of vitamins and minerals. Commercial enteral formulas have absolutely none of these things.

In the scientific literature, we find that people fed blenderized diets have blood levels relevant to nutrition in the normal range. They are not malnourished. I have personally seen, from the thousands of people I have met that feed a blenderized diet, children that routinely showed deficiencies in their nutrition-related blood levels while fed commercial enteral formula that were quickly corrected after changing to a blenderized diet.

Commercial enteral formula has no phytonutrients, which are found only in plant foods. Phytonutrients are absolutely vital for a person to experience optimal health.

Taking all of this in, it is shocking to read the statement these authors make that the idea of feeding blenderized diets should be considered  “within the context of the rights of each patient to receive optimal nutritional care at all times, and the responsibility of the society and specialized health organizations to provide high quality nutrients, in order to foster health and correct malnutrition.” Absolutely none of the enteral formulas manufactured by Nestle Health Science provide high quality nutrients. Diets of sugar, unhealthful oils, protein powder and the equivalent of a Flinstones vitamin are absolutely not in any way providing “high quality nutrients.”

Sadly, many in the medical profession have fallen for these tactics utilized by Nestle Health Science. They use phrases like “lack of control” and “risk of complications” to frighten healthcare facilities into rejecting blenderized diets even though the scientific data does not in any way support these claims.

Because of these tactics, many healthcare facilities have made policies that forbid patients from being fed a blenderized diet while in the hospital. To state it more clearly, because of Nestle Health Science, many healthcare facilities have made policies that forbid patients from being fed a blenderized diet while in the hospital.

Many, many times, these policies have caused direct harm to patients. To state it clearly again, many, many times, Nestle Health Science caused direct harm to patients.

I have met family after family after family who were literally forced to feed their child in the hospital enteral formula that made their child vomit day and night because the hospital insisted this was the safer option. Why? Because Nestle Health Science and Abbott Nutrition told them it was safer without providing any real scientific data to back that up.

I want to emphasize this very strongly. There are hospitals that have a policy that states that it is safer for a child to be fed a diet of nothing but sugar, oil, protein powder and synthetic vitamins and that is causing the child to vomit repeatedly while they are already sick enough to be in the hospital than to simply feed the child food. Nestle Health Science and their horrifically and appallingly unethical tactics are largely the reason for these policies.

Who do these healthcare facilities think they are? They dictate to a parent what they can feed their child? The mother of the orally-fed child in the room next door can bring her child a happy meal, but the mother of the tube-fed child is forbidden from feeding her child whole grains and vegetables? And Nestle has the audacity to reference the “rights of patients”?

Just this past week, I met a mother with a daughter who was in the hospital for a scheduled open heart surgery. This child has thrived on a home blenderized diet. The hospital, however, does not allow blenderized diets. They forced this mother to feed a diet that makes her child sick while she was recovering from something as extreme as an open heart surgery. As the child vomited and risked aspiration and other complications, and as the mother fought with hospital administrators, the hospital continued to insist that a blenderized diet was a dangerous option and that enteral formula was the safe option.

After a short time, the child began to experience GI bleeding because of the hospital’s feeding requirements, and this caused the child to experience serious complications. She required blood transfusions and her hospital stay was substantially extended, which means her risk of contracting an infection were also increased since every day spent in a hospital increases that risk. Not to mention the unnecessary pain and suffering.

The mother put her foot down and began feeding her usual home blenderized diet in spite of this policy while threatening to consult a lawyer regarding the damage this hospital had done to her child. The vomiting stopped. The GI bleeding stopped. All of the complications this child was experiencing stopped.

It became clear that if this child had just been allowed to be fed food, LIKE ORALLY-FED CHILDREN ARE ALLOWED TO BE FED FOLLOWING OPEN HEART SURGERY, none of those complications would have happened, and she would be home now. Today, this child is still in the hospital recovering from everything cast onto her by this hospital policy that is not in any way founded upon legitimate science.

This child’s doctor had to face this mother after seeing the damage they had done. He said, “Sometimes, we doctors like to control everything, and it’s not always the best way.” That seems to be the closest to an apology she is going to get. I hope he will be more wise moving forward.

This doctor would have done well to listen to Florence Nightingale as she said, “You cannot diet a patient from a book, you cannot make up the human body as you would make up a prescription.”

Take all of this in. And then listen to the video at the bottom of this link that Nestle Health Science made about their Compleat Organic Blends. They called this “Project Love.” Seriously. This was actually “Project We Tried to Force People to Feed our Cheap Products that Were Making Children Sick, but More and More Parents were Figuring Out that our Products Make Children Sick, so Sales were Declining and We Had to Try a Different Strategy.”

There is only one project Nestle Health Science could do that could truthfully be called “Project Love.” And that would be a public confession of the terribly unethical practices they have willfully engaged in for so many years and a public apology for the many children and adults harmed by these practices.

I implore you to refuse to use these products. Nestle Health Science and Abbott Nutrition both need shut out of the world of enteral nutrition. They have harmed too many tube-fed people. They have lied too many times. They have launched too many assaults on the scientific process and the integrity real science requires. They have shown too often that profits are always the bottom line, even if it means making people sick.

This Compleat Organic Blends is just too little too late.

The best thing all of us could do for tube-fed people everywhere is to refuse these products and let them bomb. It is our way of showing that companies that use these tactics are not going to continue to experience success. We have the power to send that message. We just have to say no. With every package of this product that a tube-fed person uses, we communicate the opposite message and relinquish that power.

Interested in real food, but want to refuse this product? You can feed a home blenderized diet, visit Functional Formularies, or visit Real Food Blends.

I have only touched on what science as a whole says about this issue in this blog post. For more in depth information, check out my book, Stand for Food.

If you have found my blog helpful, please consider making a small donation here to cover the expenses associated with keeping this blog available for everyone.

Kate Farms

It is not uncommon for me to hear from a parent of a tube-fed child, “I talked to my child’s dietitian/doctor about doing a blenderized diet. The dietitian recommended a real food formula called Kate Farms. What do you think of this product?”

Kate Farms is another formula growing in popularity. Let me be clear about this. Kate Farms is not in any way a real food formula. It is one of multiple formulas that are posing as real food while not actually using real food. Like Nestle’s Compleat Pediatric and Abbott’s soon-to-be-released PediaSure Harvest, Kate Farms is a formula consisting of primarily sugar, and children consuming this formula will be consuming multiple times the recommended daily limit of sugar for children.

A single can of Kate Farms formula contains more sugar than a child is recommended to have in an entire day. After water, the first ingredient listed is a syrup blend of brown rice syrup and agave. Kate “Farms” gives the impression that it is full of food grown on farms. I have yet to come across a farm that grows brown rice syrup. Both brown rice syrup and agave have an extremely, extremely high glycemic index and should thus be consumed in extreme moderation (in fact, I would contend brown rice syrup shouldn’t even be consumed at all). These ingredients should most certainly not be the most abundant ingredients in your diet, but for a child living off Kate Farms, that is exactly what is happening.

Looking at the ingredients of Kate Farms, it can be seen that this formula contains an extremely small amount of actual real, nutritious food. If you look at Kate Farms’ advertising, they boast of all the fruits and vegetables their formula is supposedly loaded with.

The volume of real food ingredients in this formula are less than the volume of the synthetic vitamins. Think about that for a moment. Envision a Flinstones vitamin. It’s small, right? A can of Kate Farms contains a smaller volume of these foods they boast about than the volume of that tiny vitamin. No where anywhere in the world will you find a health, medical, or dietary organization recommending children consume a volume of fruits and vegetables equal to the size of a fingertip.

The ingredients alone are reason enough to stay away from this formula. However, there are even more reasons to avoid this company all together. I have personally witnessed Kate Farms engage in unethical and dishonest practices. When you’re making a product for consumption by children, there is no room for these practices whatsoever.

I have seen the founder of Kate Farms comment on many posts in various tube feeding groups on Facebook with comments such as, “I tried Kate Farms and loved it! I hear they are coming out with a new flavor soon!”

We are talking about an owner of a company posing as a satisfied customer. This is entirely unethical. I have yet to witness any other company use such strategies for advertising. It is highly unethical and comes from a place of deceit.

Further, as I am actively engaged in multiple Facebook groups relevant to tube feeding, I have seen many posts such as “Has anyone tried Kate Farms? I’m thinking about trying it. I love that it has all natural ingredients!” Regular group members don’t make posts like this. While I cannot make a definitive statement with proof like the statements I will be making below, it is near certain that Kate Farms has people make posts such as these to advertise their products. Again, I have never seen a company that makes enteral products engage in these kinds of practices. And this is not to mention that Kate Farms does not use all natural ingredients in the first place. So, yeah…double whammy.

Even worse, I have seen parents pose questions33312921_10155307179812414_5481250444409831424_n to Kate Farms regarding concerns about their extremely high sugar content. Kate Farms, without fail, replies with thestatement, “We use brown rice, which has a low glycemic index…” and gives some bizarre explanation about how agave and brown rice work together to prevent blood sugar spikes.

First, ingredients with a high glycemic index never provide an “offset” that improves the general healthfulness of a product as they are claiming.

Secondly, as you can see, Kate Farms claims they use whole brown rice. A simple review of their ingredient list shows whole brown rice is not used in their products in any quantity. Kate Farms uses brown rice syrup, which is entirely different than brown rice. 33147969_10155307183687414_3622433309310582784_n

The CEO of Kate Farms reached out to me in efforts to convince me that they do indeed use whole brown rice in their formula. He was insistent. Yet, their own ingredient list determines these claims to be false. Shortly afterward, not surprisingly, Kate Farms blocked me from commenting on their advertising since I had been correcting their false statements based on their own ingredient list and calling them out.

As I’ve explained in other posts, the process of making brown rice syrup involves removing absolutely everything good from brown rice, leaving behind only its sugar, which is then concentrated into a syrup. Brown rice syrup, while it may sound healthful at a glance, has one of the highest glycemic indices of any ingredient in existence. Its glycemic index is substantially higher than that of table sugar. There are also concerns that the arsenic naturally found in brown rice may remain in the syrup. While the small amount of arsenic found in whole brown rice is nothing to worry about because you could never consume enough brown rice to consume toxic quantities of arsenic (you would get far too full first), concentrating that arsenic into a syrup is very concerning, especially for young children.

So, Kate Farms says they use brown rice, which has a low glycemic index when they actually use brown rice syrup, which has an extremely high glycemic index. This company tells blatant lies to consumers about the ingredients they use and the properties of their ingredients.

Mixing together an ingredient with an extremely high glycemic index, such as brown rice syrup, with another ingredient with an extremely high glycemic index, such as agave, does not magically create a product that does not spike blood sugar.

If you have read much on my blog at all, you’ll see I have a very strong dislike for Nestle Health Science due to its appallingly unethical practices. When it comes to Kate Farms, it seems that Nestle Health Science had a baby. It’s another formula with terrible ingredients falsely being marketed as real food when it is nothing of the sort.

The combination of terrible ingredients and severely unethical practices leads me to offer a resounding no to this product. Even if Kate Farms were to improve their ingredient list, there simply is not room for such dishonesty in the field of medicine or nutrition. There is a certain level of trust a company must earn before I’m willing to place one of their products into my son’s body. This company has burned its bridge with me.

Sadly, many doctors and dietitians are turning to marketing schemes rather than a true, critical evaluation of these products in their decision of whether to recommend enteral products to their patients and their patients’ families. The mother of a tube-fed child mentioned to me recently that her daughter’s GI doctor recommended Kate Farms instead of a blenderized diet, speaking rather excitedly about the product. The reason he gave for thinking so highly of the product was that he saw it on the cover of a GI Magazine.

Is this what things have come to? When it comes to tube-fed people, science and data are no longer relevant? Advertising and marketing schemes are the foundation of recommendations now? Magazines are trumping peer reviewed medical journals?

Dr. Michael Greger, founder of Nutrition Facts, says in his book, How Not to Die, “During my medical training, I was offered countless steak dinners and fancy perks by Big Pharma representatives, but not once did I get a call from Big Broccoli…the power foods to affect your health and longevity may never make it to the public: There’s little profit motive…As corrupting an influence as money is in medicine, it appears to me even worse in the field of nutrition, where it seems everyone has his or her own brand of snake-oil supplement or wonder gadget. Dogmas are entrenched and data too often cherry-picked to support preconceived notions…I thought the answer was to train the trainers, educate the profession…I’m realizing it may be more effective to empower individuals directly.”

Moms, dads, caregivers, and tubies, be empowered. More and more tubies and their families are realizing the magnificent power of a diet of real, whole foods. One blender full at a time, we are changing lives for our own children and setting an example that will change the lives of tubies everywhere.

*If you haven’t already done so, check out my new children’s book series, Foods that Grow from the Ground!

If you have found my blog helpful, please consider making a small donation here to cover the expenses associated with keeping this blog available for everyone.

Squeasy Gear

I had heard of a product called Squeasy Gear 32286526_10155286620822414_4123984467557613568_nthat many tubie mamas have mentioned using and loving. Needing a solution to some annoying problems I was having with feeding Bradley pureed food, I decided to give it a try. I have to concur with others. I love them!

Feeding pureed food is…messy. Annoyingly so. Especially on the go. When Bradley had a feeding tube, I would bring his food in a thermos or blender bottle. When it was time to feed him, I needed an easily accessible surface to set his food on because drawing the food up with a syringe required 2 hands. Such surfaces aren’t necessarily always available. And this is not to mention the difficulty at times with finding a place to store the container’s lid during feeding, which is often covered in a layer of pureed food. More mess potential.

Add to this is the fact that you have to put the syringe into the pureed food to draw it up. This means food is dripping on everything from the syringe. It’s not an easy process.

Now that Bradley is eating by mouth, but still requires pureed food, he can only eat from food pouches or bottles with a similar mouth piece as food pouches. I had found I needed to bring along what feels like a million small containers with his food and drinks. I was fed up.32253706_10155286620587414_1849848977097228288_n

So, I tried Squeasy Gear. What is wonderful is that they have a large, 16 oz container. On a long shopping trip, I was able to create 1 blend of 16 oz that included all the fluid and food he needed for the duration of the trip in one container. I packed it in a lunchbox with an ice pack. Easy peasy!

As we went to several different stores, Bradley slowly drank his blend little by little, mess free! I have worked out some blends for him in which he can receive his entire day’s nutrition and fluids with two 16-oz bottles and one 6-oz bottle. This makes packing up and bringing along his food if we will be gone from morning to night so much easier.

The snap lid on the top stays closed between uses in my experience. And, since the lid remains attached to the bottle when opened, there is no need to find somewhere to keep a food covered lid during feeding. When the snap lid is opened all the way, it remains in the opened position rather than falling forward and getting in the way when the bottle is turned upside down. Seriously, they thought of almost everything.32257864_10155286620422414_3729974170801405952_n

And if your child eats food through a feeding tube, this eliminates many problems as well. One BD mom noticed that the opening to Squeasy Gear bottles perfectly fits the tip of a 60 ml syringe. This means no need for a surface to put the food down on and no drips to worry about. Woo hoo!

As an added bonus, the opening of the Squeasy Gear bottles is large enough to easily pour directly from the blender right into the bottles. When Bradley was using food pouches, I would have to transfer the blend into a liquid measuring cup and then transfer it to the pouch. And who wants to wash extra dishes? And speaking of washing dishes, Squeasy Gear bottles are very easy to clean with a bottle brush. 32252968_10155286620517414_8698137526994468864_n

If you prefer smaller bottles, Squeasy Gear comes in 3.5-oz and 6-oz sizes in addition to the large 16-oz bottles. They are made of silicone and are dishwasher safe. While I have not personally tried it, I believe Squeasy Gear bottles would work great with Nourish, Liquid Hope, and Real Food Blends as well.

I will mention that those that use very thick blends may have trouble with Squeasy Gear as it would be difficult to draw it out of the bottle. My only “negative” to report about my use of these bottles is my wish that they would have a 9-oz bottle as well rather than jumping from 6-oz bottles all the way to a 16-oz bottle.

Squeasy Gear was so delighted when they heard that their products were of such help to the tube-fed community, they offered a special discount specifically for tubies and their families. Nice! Contact the company to ask for the discount code when ordering.

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*I was not given any financial compensation for providing this review nor was I asked by Squeasy Gear to review their products.

If you have found my blog helpful, please consider making a small donation here to cover the expenses associated with keeping this blog available for everyone.

**If you haven’t done so yet, check out my new children’s book, Tom Turnip’s Plant Foods Adventure!

 

Abbott’s Pediasure Harvest

I have already written on a new product coming out made by Nestle. Abbott has a new product coming out, too. There is plenty to say about this product, but first, I’d like to share some important information about Abbott as a company.

Abbott, like Nestle, has aggressively campaigned against home blended diets. If tube-fed people started making their own food instead of consuming the sugar loaded formulas made for tube feeding, Abbott would stop making money. So, of course, they’ve done what they can to discourage the use of blenderized diets and encourage the use of their own products instead.

In so doing, Abbott conducted some very shady “research” (I use quotations because the studies they did hardly pass as legitimate research). For example, Abbott went to Iran to a handful of hospitals already well documented to have kitchen food contaminated with large amounts of pathogenic bacteria. They tested their blended food prepared for tube-fed patients. Of course, since the food being blended was prepared in a kitchen full of contaminated food, the bacterial content of the blended food was not surprisingly rather high. Abbott has conducted other similar studies.

Abbott then sent pharmaceutical reps to doctors and dietitians to explain how horribly contaminated blended food has been shown to be, never mentioning where these studies were conducted. They made a ridiculous document explaining how dangerous consuming food is (the cover of this document ironically contains pictures of people eating food). There is a great video that talks more about this here.

In the document, Abbott makes multiple false and/or unsupported claims about enteral formulas and blenderized diets. For example, at the very beginning of the document, they claim that new formulas are improving tolerance and patient outcomes. There is no data to suggest this, especially in comparison to diets of real food. First, the formulas have changed very, very little since their introduction in the 1950s. In truth, every time blenderized diets and enteral formulas have been compared through case studies or research studies, the data enormously favored blenderized diets showing dramatic reduction in GI complications in over 90% of participants when they began a blenderized diet instead of consuming enteral formula. You can read more about these research studies and many others in my book, Stand for Food.

Abbott references “specialty formulas” that have been manufactured in the past decade, yet, they fail to mention that essentially none of these specialty formulas have ever been a part of a single clinical trial. Meanwhile, they continue to make their claims about how dangerous blenderized diets are, citing their flawed research in the process. Let me be clear. Blenderized diets have absolutely never been shown to increase the risk of infection or other health complications in a single properly conducted scientific study. Ever.

A survey, which you can learn about toward the end of this video, showed that less than 3% of respondents reported any incidents of foodborne illness in their child while feeding a blenderized diet. This is very far below the incidence of foodborne illness experienced by the general population, according to data from the CDC.

Abbott claims in their document that it’s unsafe to feed a person blended food with a feeding pump because the food is sitting at room temperature. A fellow BD mom friend of mine who is trained in food safety and sanitation and is even certified to teach classes on the subject, feeds her son a blended diet on continuous feeding not just through a g-tube, but through a j-tube and has done so successfully for a long time. She has tested the temperature of her son’s food in the feeding bag when it is surrounded by ice packs and the temperature of the food after it passes through the pump line and comes out of the extension tube and found that for a full 12 hours, the food remained at a safe temperature using this method.

Has Abbot even tested these things? Of course not. They just made this stuff up to keep themselves relevant in a market where people are losing interest in their products more and more as time passes. But, we BD moms are testing things all the time, and we are consistently finding the claims made by Abbott are simply untrue. Trustworthy company? No.

Now, let’s move on toward the actual product, PediaSure Harvest and the marketing pamphlet they are passing out to dietitians.

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They note that 59% of parents of tube-fed children feed their child a home blenderized diet. Abbott, of course, does not like that because it means we aren’t buying their products. They then list 6 steps a parent must go through to feed their child a blenderized diet in their attempt to make it sound utterly dreadul.

Step 1: Shop for the right ingredients. In other words, the parent must go grocery shopping, an activity that parents of orally-fed children around the world must do. I don’t see Abbott trying to market this product to replace food for orally-fed children so parents no longer have to go to the grocery store. Are they suggesting tube-fed children are not worth the effort of going to the grocery store?

And what are the “right” ingredients? Both Abbott and Nestle have tried to make it sound like blenderized diets require lots of specialty ingredients and weird concoctions of 34 perfectly measured ingredients in order to attain “complete nutrition.” Bradley has had pancakes, tacos, spaghetti, sandwiches, soup and much more through his feeding tube. I did not calculate every single nutrient to make sure his diet was “complete.” No one eats this way. A blenderized diet is not an attempt to make a formula out of food. It’s just feeding food like all other humans everywhere eat.

Step 2: Rinse and clean the food. Yes, if you buy fresh produce, it must be rinsed and cleaned. Just like all orally-fed people do. Eating orally doesn’t mean you don’t need to wash fresh produce. Everyone needs to do so. They are suggesting again that this effort is worth it for an orally-fed child, but that tube-fed children simply are not worth the same effort.

Step 3: Measure everything. Just like everyone does when preparing a recipe, whether they are preparing food for oral consumption or through the tube. Apparently, they are under the impression that tube-fed children are not important enough to bother with measuring food while orally-fed children are. Preparing nearly any meal requires most people to measure their ingredients.

Step 4: Blenderize. Yeah, you put food in the blender and turn it on for 2 minutes. This literally takes less than 5 minutes. Sure, you don’t have to do this for orally-fed people, but seriously. It’s 5 minutes. Our children are worth 5 minutes of effort.

Step 5: Divide into serving sizes. When my best friend made a pot of soup for her family the other day, she had to divide the soup into serving sizes in bowls. This was not cause to stop feeding her family food and to begin feeding them cans of formula instead. Yet again, the implication here is that tube-fed children are not worth the same effort given to orally-fed children every day.

Step 6: Clean equipment for next use. Just like everyone else must wash their dishes after preparing a meal for their children and feeding it to them. I spent a month in Cambodia once. I will never forget sitting alongside the river and watching a man carry a bin of dirty plates and cups and washing them in a river less than 10 feet from where someone else was bathing in the river. He had no soap. Just a scrub brush. Like many living in Phnom Penh, Cambodia, that river was the only source of water he had.

If he can manage to wash dishes, at least as well as he can, in such circumstances, surely the average parent of a tube-fed child living in an industrialized country is capable of washing dishes in their kitchen sink or in their dishwasher. Besides, the only additional equipment that needs to be washed is the blender, which is the easiest dish to wash if you have a high powered blender (and most people that feed a blenderized diet do). You simply fill the blender jar with water with a dab of soap and run it briefly before dumping the soapy water out and rinsing it. Occasionally, I have to take a bottle brush and scrub the sides, which takes very little time. Some like to do a second run with water and vinegar or even water and a touch of chorine for added measure. Though most do not do so.

After this horrifyingly offensive statement that Abbott doesn’t think tube-fed children are worth the same energy and effort as orally-fed children, it claims that their PediaSure Harvest is a good source of antioxidants. It has a little asterisk next to that and lists vitamin C, E, and selenium as the antioxidants. This is a “good source” of antioxidants? Hardly. There are so many antioxidants and phytonutrients that can be found in abundance in a varied diet of real food that PediaSure Harvest does not offer. Yet, they call this “nutritionally complete.” Just…no.

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Here, we find pictures of spinach, mango, broccoli, and such. Ironically, after making a big deal about how hard it is for parents to find the “right ingredients,” they then list ingredients in their formula, and all of those ingredients are easily found in almost any grocery store. Who has a hard time finding bananas at the grocery store? To get these products into a form that works in their liquid-y formulas, a lot of processing has to be done. As does super heating to make it shelf stable. This destroys much of the nutrients that can be found in this food. I notice they fail to mention this.

They mention their protein source is from soy, chicken broth, and rice. I have to wonder how much research Abbott did when developing this product. I’ve spoken with thousands of parents of children with feeding tubes and/or GI disorders. While soy is a great source of protein for many people, it is an ingredient that children with digestive disorders commonly have difficulty with. This was a very poor choice of a protein source for a product designed for tube feeding children.

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First of all, the title of this page is “Real Food Formula Nutrient Comparison.” Yet, neither of the formulas listed here are actually real food formulas. These are both formulas with a little bit of food added to them. They’re still loaded with sugar like every other enteral formula. These are absolutely not real food formulas. This is important to keep in mind because as Abbott and Nestle are making these terrible products and claiming they are the same as a blenderized diet, when children try them and have complications, dietitians and doctors may tell parents their child “failed” at the trial of a blenderized diet and should return to a more traditional formula. This would be entirely incorrect because a real blenderized diet is what would likely reduce or even eliminate the symptoms.

This page is just a comparison of PediaSure Harvest to Compleat Pediatric, made by Nestle. This is hardly a product to be comparing your product to. It has an enormous amount of sugar in it with really only trace amounts of food. Nestle markets this as a real food product, but it has ingredients that are terrible for health.

Nestle used to use corn syrup as their primary carbohydrate source in their Compleat Pediatric, but after enough complaints from parents, they switched to brown rice syrup. They did this because brown rice syrup sounds healthier. This is sadly not reality. Brown rice syrup has an extremely high glycemic index, far higher than even table sugar. It also can contain levels of arsenic inappropriate for a pediatric population. It is not a healthful ingredient, yet it is the most abundant ingredient in Compleat Pediatric after water. They don’t care if their product actually is healthier. They just care if it sounds healthier so people will buy it. Abbott is doing the exact same thing.

When we talk about a diet of real food, we are talking about food that people actually eat. No one sits around drinking glasses of brown rice syrup. If they did, they’d get sick. Abbott is showing that PediaSure Harvest is similar to Compleat Pediatric here. Not exactly a positive endorsement of PediaSure Harvest. I notice as much as Abbott talks about the “dangers” of bacteria in home blenderized diets, they never mention the dangers of long term high sugar diets (which virtually all of their enteral formulas consist of). Diets with these ingredients are strongly correlated with decreased immune function, increased inflammation, poor gut function, cardiovascular problems, and much more. These formulas are far from safe and their long term use has never been studied in a single clinical trial.

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This page continues the comparison to Compleat Pediatric. Notice rice maltodextrin is a carbohydrate source in PediaSure Harvest. This, like brown rice syrup, has a high glycemic index and isn’t going to do anyone’s health any favors.

The source of fat for PediaSure Harvest isn’t something that’s going to promote health, either. Tuna oil in every can? Is it even safe for children to consume fish oil over and over again every single day? I can guarantee Abbott has not checked prior to adding this to their product. They added it because, as you can see, Compleat Pediatric has no DHA in it, an extremely important fatty acid necessary for brain growth and development (so much for it being “complete nutrition”). Abbott wanted this upper hand on Compleat Pediatric.

While adding DHA to a child’s diet is a very good thing to do, adding fish oil every single day is in complete contradiction to the nutritional recommendations for children due to its potential for mercury content and blood thinning effects. Many children with heart defects have a feeding tube and are also on blood thinning medication due to their heart defect. I have serious concerns about any child being fed fish oil all day every day, but I am even more concerned for children with heart defects that are on blood thinning medication being fed this ingredient.

A far better source of DHA would have been from algae (in fact, the only reason fish contain DHA is because they either eat algae that has DHA or they eat other fish that have eaten algae with DHA). This is a much more safe source of DHA to be consuming on a daily basis. But, it is also more expensive and this would mean decreased profit margins for Abbott. It seems while they harp on the extreme “dangers” of blenderized diets and express such terrible concern for our children’s health, that concern stops quite abruptly as soon as it starts affecting their profit margins.

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“Real food parents want, nutrition children need. Now you can give them both with new PediaSure Harvest.” Parents that feed their children a blenderized diet have been giving their children both of these things for decades. Real food has the nutrition children need, and it has been giving children the nutrition they need for a very long time. And freshly blended food has far more nutrition in it than any canned preparation ever will. Now we can give both? We’ve been giving both all along.

If they want to imply that tube-fed children fed real food all this time haven’t been getting the nutrition children need, they are seriously misinformed. In fact, a study showed that children fed blenderized diets have perfectly normal blood levels relevant to nutrition. Our children are absolutely thriving on blenderized diets, and they are far more nourished than children being fed PediaSure Harvest could possibly be.

They think this has the “real food” parents want? No. It absolutely does not.

I’d like to end this with a quote from my book, Stand for Food:

“Stemming from this general recommendation is the question many parents of tube-fed children have been asked by medical professionals: why go through all the trouble of making food when you can just feed formula? No medical professional would ever ask the mother of an orally-fed child, ‘Why do you bother making  your child food? Why don’t you just feed formula?’ Yet, parents of tube-fed children are asked this question regularly.

“So, I will answer this question for anyone wondering. We don’t “just feed formula” because the ingredients in commercial enteral formula contribute to chronic illness and poorer health outcomes. Our children deserve natural fiber. Our children deserve carbohydrates from actual grains, fruits and vegetables rather than sugars. Our children deserve phytonutrients, natural enzymes, cofactors, beneficial bacteria and all of the other wonderful benefits real food brings that cannot be found in commercial enteral formula. And our children are absolutely worth the effort to provide this for them. That is why we don’t ‘just feed formula.”

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