Crunchy Tubie Mama

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 questions 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.

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.

I had heard of a product called Squeasy Gear that 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.

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.

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.

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.

*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!

 

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.

Page 1:

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.

Page 2:

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.

Page 3:

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.

Page 4:

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.

The cover:

“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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I sometimes witness a debate in the blenderized diet community. The question is asked, “If a child has a feeding tube, is it ok to feed treats and desserts through the feeding tube?”

The answers I see to this question generally fall into one of two ways of thought:

1. Having a feeding tube doesn’t change what a child can be fed. If a child would be eating treats and desserts orally, he/she can have them through a feeding tube.
2. I want to take advantage of my child’s feeding tube by feeding the most nutritious and healthful diet possible. So, I would not waste calories on junk food since my child cannot taste the food anyway.

I tend to fall somewhere in the middle. I, like those that answer according to the second way of thought, wanted Bradley to have a super nourishing diet through his feeding tube. I saw his tube as something to take advantage of. On the other hand, feeding some special snacks and treats can normalize tube feeding for both the parent and child (as well as for the adult tube-fed person). And that is no small thing.

Eating food is an emotional process whether we want to admit it or not. Because of this, feeding our children brings about various emotions, too. A parent can receive joy from feeding his/her tube-fed child a special treat. It can also bring joy to children as well as they watch their family members enjoy indulging in a special treat and get to participate with them. All of these factors have value in and of themselves. Moreover, tube-fed people do sometimes taste the food they are being fed.

But, I also say, why can’t we have it both ways? Can we have special treats that also nourish the body? Why does a special treat inherently mean junk food? Does it have to? I don’t think it does.

I submit this chocolate-y, lemon-y brownie batter cake as my proof. I know, I know. That is one long name. But it is the best name for this cake. It’s texture is like an under-cooked brownie (and who doesn’t love those?). With a light chocolate flavor and a touch of lemon, the cake is divine. The lemon frosting finishes it off. Ever had lemon and chocolate together? Probably in most foods, this wouldn’t pass. But, if done right, it can be a delicious combination.

Check out the nutrition profile below. These babies are loaded with healthy fats, protein, fiber, and plant-sourced iron (this source of iron will not constipate like other forms do). While the cake portion isn’t as sweet as your typical brownie, the frosting brings the richness you want in a dessert. And with an ingredient list that is nothing to feel bad about and lots to feel good about, indulge! Blend a brownie up in a little dairy alternative, and let your tubie enjoy it, too.

Added bonus? These brownies are both gluten and dairy free, which many tube-fed people require. While many children living with motility issues have difficulty with banana causing constipation, such a small portion of banana ends up in each piece, I don’t think this would be an issue.

To make the batter,

Ingredients:

• 1 medium banana
• 4 cups red beans, cooked (NOT kidney beans…actual red beans, typically found in Asian markets or onilne…if you cannot find red beans, you can replace with black beans, but note that the iron content will be reduced)
• 2 Tbsp maple syrup
• 1/2 cup date paste *(directions below at the end of the recipe directions)
• 1/3 cup cacao powder
• 1/2 cup raw cashews
• 1/2 cup unsweetened coconut
• 1/4 cup chia seeds
• 2 cups old fashioned oats (not the quick cook kind)
• 1/2 Tbsp baking powder
• 1/2 Tbsp baking soda
• 1 cup dairy alternative
• Zest and juice of 2 lemons

Directions:

Preheat oven to 350 degrees. Line a 13×9 cake pan with parchment paper and set aside.

In a food processor, add the banana, red beans, maple syrup, date paste, cacao powder, cashews, coconut, and chia seeds. Process until relatively smooth, but will still be a little lumpy with some cashew pieces remaining. Set aside.

Add the oats, baking powder, and baking soda to your blender, and blend until ground into a fine consistency. Add this to a large mixing bowl. Empty the contents from the food processor into the mixing bowl as well, along with the dairy alternative and the lemon juice and zest. Stir until well combined. Transfer the mixture into the cake pan covered in parchment paper. It’s thick, so don’t worry about it being nice and pretty. Frosting will cover the top anyway! Bake in the oven for 45 minutes or until a sharp knife comes out clean.

*To make date paste, blend 1 cup of pitted dates with 1 cup of water until smooth. This is a great natural sweetener (I always keep some in the fridge) and a nice low volume boost for a blend.

For the frosting,

Ingredients:

• 2 cups dairy alternative
• 5 Tbsp tapioca flour
• 6 Tbsp freshly squeezed lemon juice
• 1 cup cashews
• 2 tsp vanilla extract
• 1/4 cup maple syrup
• 6 medjool dates, pitted

Directions: Wait until the cake is done and out of the oven before making the frosting. If you don’t, all is not lost, but this frosting will be more difficult to spread if left to sit. It is much easier to whip this up when the cake comes out of the oven and pour right onto the cake.

Add all ingredients to a high powdered blender (such as a **Vitamix or **Blendtec) and blend on high for several minutes until it thickens. You will hear a change in sound from the blender when it thickens. When you hear this, turn it off immediately and pour onto the cake, spreading it as needed.

**If you do not have a high powered blender, you will need to soak the cashews in very hot water for an hour prior to blending. Add everything to the blender, and blend until smooth. Transfer to a medium pot and heat over medium-heat, stirring often until it thickens (this will take some time).

Allow your creation to sit and rest for 30 minutes prior to serving. Yeah, I totally ate a piece before taking a picture of my cake. I have no regrets.

Makes 20 servings

1 serving =

• 177 calories
• 27 carbohydrates
• 5 grams fiber
• 7 grams fat
• 5 grams protein
• 3 mg iron

 

I’ve had a lot of people contact me asking what I think about Nestle’s announcement regarding their soon-to-be-released “real food” pureed food for enteral feeding. I have a lot of thoughts on the subject matter. But, to sum it up in one word: NO. A big, fat NO.

Why do I say this? Is it because of the ingredients? Actually, no. This goes far deeper than that. I’d like to show you the booklet Nestle Health Science is passing out to dietitians in preparation for this product’s release. But, first, I’d like to tell you a story.

Once upon a time, there was a company named Nestle Health Science. They made enteral formulas that they claimed were wonderful for children. They went on and on about how gentle and “easy to digest” their formulas were. In truth, Nestle Health Science hadn’t conducted a single clinical trial using their formulas to learn whether they actually were gentle and easy to digest. They had no data whatsoever to support these claims about their formulas. And their formulas were absolutely loaded with sugar, unhealthful oils, and other nasty things that are terrible for digestion as well as virtually every system in the entire body.

These formulas, because of their terrible ingredients, were making many children very, very sick. Many children vomited excessively (many times per day), including my son, Bradley. Even for those that did not vomit while fed these formulas and appeared to be thriving on them, time was the real test. I have had a very large number of parents reach out to me with children who, after several years of being fed these formulas, had developed type 2 diabetes, high blood pressure, high cholesterol, cardiovascular problems, renal problems, and more from these “gentle” formulas of “complete nutrition.” And this isn’t surprising since diets extremely high in sugar are strongly associated with these very health issues.

Nestle Health Science absolutely did not care about any of this. The ingredients they chose were cheap. That is why they chose them. This did not mean their formulas were sold at a cheap price. On the contrary, they are very expensive for consumers. This meant an extremely high profit margin for Nestle Health Science. In other words, in their development of their formulas, the health of the children being fed these formulas was never a significant part of their decision making process. The health of our children was irrelevant. What mattered to them was money, our children be damned.

Nestle Health Science sent representatives to doctors and dietitians to tell them how wonderful their products are. These representatives failed to mention to any of these medical professionals that they’d done virtually no scientific research to determine whether their claims were even true. And the majority of doctors and dietitians swallowed everything the Nestle representatives fed them without ever bothering to check whether these claims were true. These enteral formulas became the normal, default diet for tube-fed children and adults. As these children and adults often vomited and suffered severe complications while being fed these formulas, the medical profession scratched their heads, wondering how this could be happening since these formulas were supposedly so gentle and easy to digest. Still, few approached these formulas with an appropriate level of skepticism.

Mothers will only tolerate this for so long. So, eventually, we started to figure out that these formulas simply were not what we had been told. They actually were not gentle and easy to digest. They were not healthful and nutritious. They had an enormous amount of sugar. They were making our children sick. And so, slowly, over time, more and more mothers and fathers began to see that they had been misled and stopped using enteral formula. Adults with feeding tubes began doing the same. They themselves noticed how much better they felt when being fed real food.

Less and less tube-fed people were purchasing these enteral formulas, favoring pureed meals made at home instead. Less people purchasing the enteral formula meant Nestle Health Science’s profits were going to decrease. Wanting to avoid that, Nestle Health Science developed a new formula called Compleat. They advertised and marketed this formula as a formula made of real food. However, this was entirely untrue.

Compleat was loaded with sugar and unhealthful oils just like all of the other formulas. It contained only trace amounts of food. Their goal was not to actually make a healthful enteral formula made of real food. Their goal was to make a product that was still very cheap to produce that looked like it was healthful and made of real food so that people would be fooled into buying it. They told dietitians and doctors about their wonderful real food formula and many parents were told (myself included) by medical professionals that Compleat is made of entirely real food.

Apparently, most dietitians and doctors never bothered to check the ingredient list to see if what Nestle Health Science was saying is true. A simple look at the ingredient list will tell you this is not a real food product. The most abundant ingredient in Compleat was corn syrup. OK, so corn syrup is technically a “food,” but the cans of Compleat have pictures of fruits and vegetables on them. They don’t show a picture of a bottle of corn syrup. I suppose they realized that wouldn’t be nearly as appealing if their marketing gave a realistic view of what this formula contained. And when we are talking about a diet of real food, we are absolutely not talking about a diet of mostly corn syrup. Can you imagine if the most abundant ingredient in your diet was corn syrup? How do you think you’d feel if you ate more corn syrup than any other ingredient day in and day out?

For a while, this strategy worked. Parents fed Compleat believing they were providing a better product to their child because dietitians and doctors told them it was better because Nestle Health Science had told the dietitians and doctors it was better.

After a while, parents began noticing the ingredient list and realized this was not nearly as healthful of a product as they’d been told. Less and less people were willing to use these products with concerns about such excessive corn syrup.

So, Nestle Health Science, according to them, “listened to parents’ concerns.” They changed the corn syrup in the Compleat to brown rice syrup. Nestle Health Science was banking on the idea that parents would see the words “brown rice” and believe it was better than corn syrup. However, the reality is that brown rice syrup is a terrible ingredient. It has one of the highest glycemic indices of any ingredient known to man. Brown rice syrup is made by taking everything good in brown rice and removing it, leaving only the sugar behind. This sugar is then concentrated into a syrup. And by the way, lots of brown rice syrup has been shown to contain levels of arsenic above the levels deemed safe for children to consume.

Some people were excited about the change to brown rice syrup, but most parents didn’t fall for it. And those that did were learning the truth about brown rice syrup and Compleat as time passed.

In time, Nestle Health Science could see what was coming. If this trend continued, profits would suffer. So, along with Abbott Nutrition, Nestle Health Science launched a very aggressive campaign against feeding food to tube-fed people. Abbott Nutrition conducted some very ridiculous studies that Nestle Health Science was only too happy to promote and share. In these studies, Abbott went to places such as Iran and Saudi Arabia. There, they went to hospitals already well documented to have kitchens full of bacterial contamination. They tested the pureed food made in these highly contaminated kitchens. Because the pureed food had high levels of bacterial contamination, as any food made in a contaminated kitchen would whether pureed or not, they concluded “blenderized diets have been shown to have high levels of bacterial contamination.”

Abbott Nutrition and Nestle Health Science passed along these findings to doctors and dietitians without ever mentioning the location of their data collection. If you Google Abbott Nutrition and blenderized diets, you can find a manual they make standing against blenderized diets because of how dangerous they supposedly are, citing this extremely poorly done research. I dare not even refer to it as scientific research because science isn’t really what is being done when a team of researchers skew their study design to get the results they want. You can see Nestle Health Science making these claims in an email from them here. You can read more about the poorly done research conducted regarding the use of blenderized diets and enteral formula in my book, which you can order by following the instructions here.

Nestle Health Science continued their campaign against real food for tube-fed people, citing their formulas as the perfect and more safe substitution. They described blenderized diets as difficult to digest and full of bacteria that would surely make those being fed them sick. They strongly advocated for dietitians and doctors to refuse to condone or recommend blenderized diets. In the medical profession as a whole, this has largely worked. It is shockingly rare for the parent of a tube-fed child to find a medical profession that supports blenderized diets.

Healthcare systems began making policies based on Nestle Health Science’s aggressive campaign that forbid tube-fed patients from being fed food while in the hospital. Parents were threatened to be removed from the hospital away from their child if they did not agree to feed their child a formula that made their child vomit 10 times per day instead of the pureed food that their child did not vomit with at all. Yes, it has truly gotten this bad. And the unscientific and unethical practices of Abbott Nutrition and Nestle Health Science are why it has gotten this bad. They will do anything to keep profits high even if it means sacrificing our children’s health. They’ve consistently proven this through the decisions they’ve made.

In spite of these policies, in spite of doctors telling parents they would no longer provide treatment to their child if they fed a blenderized diet, in spite of it all…mothers knew best. More and more moved toward a diet of real food as they realized food is what everyone in the entire world eats, including the very people campaigning so strongly against it. We saw how much better our children and loved ones were doing on real food. There was simply no comparison between real food and enteral formula. We took a stand and demanded real food for our children. One mother, in spite of hospital policy forbidding the feeding of food to tube-fed people, stood at the door of her child’s hospital room and refused to allow anyone to enter the room that had any formula. She won. Mothers were paving the way.

Meanwhile, two companies began that made enteral products that actually were made of real food. One was a company called Functional Formularies. The founder of Functional Formularies developed an enteral product called Liquid Hope after she was so horrified and appalled at seeing the options made available to tube-fed patients when her father was ill and required tube feeding. Eventually, they developed a product intended for pediatric use called Nourish as well. Both products are entirely plant based, organic, and non-GMO.

Another company was started by the parents of a child with a feeding tube. They, too, found that the formulas made their son very ill and switched to a blenderized diet. Wanting an option suitable for travel or just other times that blending isn’t possible or desired, they began a company called Real Food Blends. They offer a variety of basic meals similar to common meals people eat, such as juice, roast beef with spinach and other veggies and a breakfast blend of eggs, oatmeal, and apples.

Many doctors and dietitians have refused to prescribe these real food products, citing a “lack of research” on the products as their reasoning. They would then turn to products by Nestle Health Science and recommend those products instead in spite of the fact that those products have never been scientifically researched, either. The bias has been obvious and appalling. While Nestle Health Science has taken doctors and dietitians out for lavish dinners and won their hearts that way, Functional Formularies and Real Food Blends have instead invested their funding into developing products that are actually made of real food. Sure, it costs more to make and profit margins are lower. But, unlike Nestle Health Science, that was a sacrifice both companies were willing to make.

Nestle Health Science representatives began telling doctors and dietitians that Real Food Blends and Nourish were dangerous. They claimed kids were doing poorly on them. They claimed insurance would not cover them, so not to bother prescribing them. None of these claims were true.

With more and more people turning to Functional Formularies and Real Food Blends for ready made enteral products as well as making their own pureed food at home, Nestle Health Science saw what was going to happen next. In spite of all their efforts to keep us from feeding our children food, they were failing miserably at doing so. With less and less people interested in their enteral formulas, and the prediction of drastically falling profits, Nestle Health Science…the same company that had spent years spreading poorly done research and so very aggressively campaigning against food for tube-fed people…developed an enteral product of real food.

They looked at Liquid Hope, Nourish, and Real Food Blends…the same products they’d claimed were so terrible for children…and copied them. Knowing all of this information and knowing how aggressively Nestle Health Science has campaigned against food for tube-fed people, look over the booklet they are making to promote their product.

Have we moved to a different planet? This company that has claimed literally for years that real food is not suitable for tube-fed children and will make them very sick…this company that has claimed that high sugar diets are healthful for children and their sugar-loaded formulas are so easy to digest…as soon as profits are threatened, now, they’re saying, “Real food. A real difference.” “Real food can make a real difference for your patients.” “Served with LOVE.” “A healthy eating pattern includes a variety of vegetables and fruits, especially whole fruits.”

It is truly sickening. This shows quite clearly they have known all along that there is absolutely nothing wrong with feeding a tube-fed child food, but just said so to keep the money rolling in while they made droves of children unnecessarily ill. Even more infuriating, dietitians are pressuring parents to switch from Nourish or Real Food Blends to these products even though these products aren’t even on the market, yet. They’ve told parents for years that they don’t like Real Food Blends or Nourish because of a lack of clinical trials, but they’re without hesitation jumping to recommend this product even though it not only has no research done on it, it hasn’t even been used in the tube-fed population yet to see if there will be any issues from it.

Shame on any doctor or dietitian for pushing parents toward a product like this made by such a dishonest and untrustworthy company while discouraging the use of products that have been used with great success by thousands and thousands of people. Shame on any doctor or dietitian that has refused to recommend or prescribe Nourish, Real Food Blends, or a home blenderized diet, but is jumping to recommend and prescribe a Nestle Health Science product that is literally a direct copy of these very products.

Nestle Health Science, you have burned your bridge with me. You have shown my child’s health absolutely does not matter to you. He was never even the tiniest part of the bottom line for you. You’ll do whatever makes you money, even if it means making children sick. You have not earned the trust required for me to place anything made by you into my son’s body.

So, I don’t need to look at their ingredient list. I truly don’t care if it actually is made of entirely real food. I only need to see who it is made by to say a resounding no. We already have two very good options for premade pureed food that are made by companies proven to actually care about the people being fed their products and desire good health for the tube-fed community.

Add to this, I believe a homemade blenderized diet is the best you can give your child or loved one living with a feeding tube even though I fully support the use of Real Food Blends, Liquid Hope, and Nourish. And here is the reason why. Enteral products are required to go through a heating process to make them shelf stable. The companies making these products have no other option, so this is not saying anything negative about the companies themselves. When food is heated in this way, many natural vitamins in the food are destroyed. These vitamins must then be supplemented with a multivitamin of some kind. Functional Formularies adds a vitamin blend back into the product. People using solely Real Food Blends add a multivitamin each day.

But, this is not the same as consuming these vitamins and minerals directly in food. For example, a study showed diets high in foods that contain lots of vitamin C provided a great protective component to the cardiovascular system. Diets low in foods containing vitamin C, but supplemented with high amounts of vitamin C from a man-made vitamin did not provide the same cardiovascular benefits. This shows that while supplements can be a great help, they don’t provide the full benefits of vitamins and minerals naturally found in a whole food with all of that food’s enzymes, cofactors, and more. There are many other examples of this in the medical literature. Real Food Blends created a free recipe booklet that includes freshly pureed food blended into their meals for those that wish to do so for this reason.

Nestle Health Science, I’m sure, will promote their product as the perfect alternative to a home blenderized diet, claiming it is more safe as they cite the ridiculous studies cited by Abbott claiming home blenderized diets are dangerous. These products by Nestle Health Science are absolutely not superior to a home blenderized diet. And for those that truly cannot blend either some of the time or all of the time, there are already products made with real food made by people who are far more trustworthy. They stood for real food from the very beginning and endured the attacks of Nestle Health Science. Both companies were inspired by the love of a close family member in need of something better than the sugar-laden formulas made by Nestle Health Science and other companies.

I can only speculate regarding Nestle Health Science’s long term plan. But, I’ve already made a guess, based on their history. While I may be completely wrong, my prediction is that Nestle Health Science plans to do what they can to put Functional Formularies and Real Food Blends out of business by either purchasing them or squashing them…whichever works. If they were to succeed (and since I know the owners of Functional Formularies and Real Food Blends both, I can assure you, that is a big IF), they will have eliminated their competition. Then, they’ll do what they can to get people to use Compleat as much as possible because Compleat, with its very cheap ingredients, offers a substantially higher profit margin. Perhaps they’ll work with insurance companies to require Compleat to be used first, turning only to the Compleat Organic Blends if Compleat isn’t medically possible for one reason or another, regaining their high profit margin from their Compleat.

Whatever their plan is, I don’t care except in what ways this will impact the tube-fed community. There are many reasons to not support Nestle in general. While I’ll always recommend a home blenderized diet rich in plant foods first and foremost, I do strongly support both Functional Formularies and Real Food Blends for those that choose to go that route. But, I will never support any product made by Nestle Health Science no matter what they come up with.

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I was watching Michael Pollan’s “In Defense of Food,” and I found myself quite struck by a particular portion of his movie. While he was not in any way speaking of diets for tube-fed people, what he said was so relevant to this topic.

You can see the portion I’m speaking of here (and pardon the sound of Bradley playing with his cars in the background…this is life, lol):

The most common feedback I receive from parents about feeding their tube-fed child a blenderized diet (a diet of pureed food through a feeding tube instead of the more typical tube-fed diet of enteral formula) is their extreme fear of “messing it up.” What if they miss a certain nutrient? What if they can’t figure out the correct amount of fats and carbs? Likewise, they get concerned about how time consuming they are told blenderized diets are because it supposedly requires so much calculating.

I explain in my book, Stand for Food, that these fears are unfounded. Those who have gotten to know me well through the online blenderized diet community know one of my most frequent statements: “It’s just food.” Don’t make it more complicated than it is.

During the 60s, science was seen as much more capable than it actually is. We were going to solve virtually all problems with science, we believed. And don’t get me wrong, I love science. Scientific data is so important as our guide to truth. However, the claim was made back then that through science and technology, we could masterfully piece together a diet far superior to what nature provides. This claim was entirely wrong.

During this time period, enteral formula was invented. Prior to this time, virtually all tube-fed people were fed pureed food. Enteral formula came along with claims that because it had an exact and predictable amount of carbohydrates, fat, synthetic vitamins, etc., it was superior to a diet of food. Outrageous claims were made that people living on these formulas would be so healthy, they would live to be 150 years old. As we have seen, that was entirely incorrect.

Enteral formulas have changed very little since then. The vast majority of carbohydrates come from forms of sugar. They contain only synthetic vitamins. Even the fiber in most enteral formulas is entirely synthetic. They contain absolutely 0 phytonutrients, which are essential for long term optimal health. Whole food contains cofactors and other components that allow our bodies to better absorb the natural vitamins found in the food. Enteral formulas contain none of these components. I am sure there is much more to food than we’ve come to learn and understand at this time, which is all the more reason we cannot create a diet superior to the food nature provides.

In spite of these very significant negative aspects of enteral formula, most doctors and dietitians continue to press enteral formula onto tube-fed patients and their caregivers, explaining it is far better, and they discourage the feeding of food to tube-fed people. Why? How can this possibly be the case?

I believe in Michael Pollan’s explanation of what he calls Nutritionism, we find the answer to this question. The nutrition of tube-fed people has been approached with the idea that a precise calculation of specific nutrients is best and that a tube-fed diet consists of nothing more than a sum of various nutrients, whether synthetic or otherwise. Interestingly, the very people telling many of us that it is so vital to have precise control over nutrient levels do not eat this way themselves. They just eat food. They feed their children food. And never do they sit down to calculate whether they are eating or feeding precisely 55% carbohydrates, etc. With tube-feeding, they have been told by the representatives of companies that make enteral formula that this precise control is extremely important. Yet, no data anywhere supports this claim.

I assure you, such precision is not necessary. I met a mom a while back who was told she had to feed her child enteral formula overnight with a feeding pump because the child had a congenital illness that caused him to be unable to manage his blood sugar level well. Thus, he needed fed throughout the night through a feeding tube as he slept to keep his levels steady. The dietitian told her it was essential this mother use enteral formula to accomplish this because it gave very precise control over carbohydrates. While this mother could count carbohydrates in food, it would not be super precise and therefore, was not recommended. Yet, in spite of this precision found in enteral formula, the child’s graph showing his blood sugar levels throughout the night displayed wildly out of control blood sugar levels with multiple spikes and drops that reached dangerous extremes.

She decided to try feeding a blenderized diets instead. In spite of all of its non-precision, the child’s graph showed a beautiful, stable line with only very small rises and falls in blood sugar level all night long the very first night. Not once did his blood sugar reach a dangerous high or low. He has continued this pattern for months on a diet of real food rather than enteral formula.

This idea of Nutritionism not only has led medical professionals to favor enteral formula, but it has led them to be quite fearful of blenderized diets. The most common question a parent that feeds her child a blenderized diet is asked by medical professionals is, “How do you know your child is getting everything he needs?” Terror that the child will become horribly malnourished in one or more nutrients is sown, and parents hesitate to feed their tube-fed child food instead of enteral formula as a result.

However, these fears are never cast onto parents of orally-fed children. Look at the nutrition advice given to parents of orally-fed children. They are never told to insure their child receives X amount of vitamin A and Y% of calories from fat. Instead, they are shown a plate with the various food groups and their relative recommended proportions. The focus is not on individual nutrients, but overall amounts of various groups of food. In other words, nutrients are never even brought up. The focus is instead on actual food.

Parents, this is how tube feeding can be approached as well. Count calories if you need to. Otherwise, monitor food group ratios to make sure they are reasonable. This is all you need to do. It’s what parents around the country and the world are advised to do every single day with their orally-fed children. Having a feeding tube does not change the way nutrition should be approached. You are not going to mess it up, mama. It’s just food.

Of course, there are those with special dietary needs that do require more precise calculating. For example, children on a ketogenic diet must have their carbs calculated. This frightens many parents away from a blenderized diet. Yet, there are many orally-fed people with these same dietary needs, and they consume food. They do not sit around drinking enteral formula all day. From what I’ve seen anecdotally, by the way, children on a ketogenic blenderized diet do much better than children on a ketogenic enteral formula.

While there are conditions that require more precise calculating in one’s diet, having a feeding tube in general is not one of those conditions and there is no reason a tube-fed person would need more precision in their diet than an orally-fed person.

It can be hard to let go of what I have called “formula thinking” when it’s been so pressed onto us tubie parents that very, very precise calculating is necessary for our children’s diets. I like this phrase of “nutritionism” better. Do not fall into this thinking.

A blenderized diet is not an attempt to make a formula out of food. A blenderized diet is a rejection of the idea that tube-fed people require a formulaic diet in the first place.

A blenderized diet is just food.

Constipation. Chances are, if you have a child with a feeding tube, constipation is an issue you are quite familiar with. Many children require a feeding tube because they have low tone muscles or problems with motility. These issues also make constipation a chronic issue. Bradley has always struggled with constipation due to motility issues caused by 2 bowel surgeries he required as a baby. It can be very frustrating!

What works miracles for one child’s constipation may do little to nothing for another child’s. So, there is indeed a process of trial and error in figuring out what will work with your child. While some kids do require intervention with medication, many children do wonderfully using a more natural approach.

The good news is that there are lots of natural foods to try that can greatly help with constipation (and a few of these suggestions help with diarrhea as well!). The list below is a compilation of suggestions* by fellow tubie mamas from around the world, and I hope the answer for your child can be found in this list! Of course, many of these ideas can be used simultaneously.

Water

I know, this seems incredibly obvious. But, one of the first questions to be asked if a child is constipated is whether the child is receiving a sufficient amount of water to move stool. Some children require a little extra water to keep things moving. So, step one, unless there is a medical reason not to do so, increase free water a little and see if that helps.

All of the remedies listed below ultimately work because they hold water in the bowel resulting in a softer, easier to move stool. If there is not enough water being given, however, these remedies will not work and will actually cause constipation to worsen as they will make the stool very hard and difficult to move through the bowels.

Fiber…or not

Fiber gives stool bulk, which helps with moving it through the bowels. Giving a high fiber diet with extra water can be a game changer for many children. It also feeds the good bacteria in the gut, which further helps with constipation. However, this is not true for everyone, and extra fiber can actually have the opposite effect and worsen constipation for children with specific issues. Some children with low muscle tone simply cannot move a lot of fiber through the gut. Therefore, when increasing fiber, I always recommend doing so slowly to give the gut time to adjust and to test whether this will be a solution or a disaster.

Foods like blueberries, spinach, cabbage, kale, dates, cherries, kiwi, brown rice, oatmeal, whole grain bread, and quinoa can help with constipation by providing higher fiber.

Prunes

The simplest solution for many children’s constipation is prunes. Prunes are both rich in fiber and high in sorbitol, which is a natural laxative. Sorbitol holds water in the bowel, which results in a softer, easier to move stool. For Bradley, I blended prunes at a ratio of 2 prunes to 3 ounces of water and gave a serving equal to the 2 prunes daily followed by an additional 4 ounces of water. For example, I’d make a large blend of 20 prunes and 30 ounces of water and freeze this into 10 portions. I would then give one portion along with an additional 4 ounces of water.

This worked beautifully for him. However, adding prunes to his blended food did nothing to help. Prunes worked most effectively when given with plenty of water on an empty stomach. I have heard the same from many parents, although some children do just fine with prunes simply added to their blended food.

Some people prefer to use prune juice. I personally prefer whole prunes because the fiber of the prunes is retained. But, if you like the prune juice and it is working, go for it! Some have also had success with apricot juice, pear juice, apple juice, and white grape juice.

P Foods

P is for Poo! And it’s also for foods that help kids poo. Pears, pumpkin, peaches, prunes, and papaya added to a blend can help create a softer, easier to move stool. Some children do much better with a blend of these foods for their servings of fruit for the day.

Ground Flax Seed

Flax seed has a high amount of mucilage. This means when soaked in water, it forms a gel-like compound that helps move stool through the bowels. Components of flax seed can also reduce inflammation in the digestive tract, which can greatly improve digestive health overall.

Our bodies are not able to digest whole, unground flax seeds because we cannot break down their outer shell. Therefore, flax seeds need to be ground prior to consumption to experience their full benefits. It is far better to purchase whole flax seeds and grind them just prior to consuming. The healthful oils in flax seeds quickly oxidize and go rancid after grinding, which means many wonderful benefits are lost.

Grinding flax seeds is actually quite easy. Simply place the seeds in a dry blender container or a coffee grinder, and they will quickly grind to a fine powder. I consume ground flax seed in a daily smoothie. I place whole flax seeds in the dry blender first without adding anything else. I turn on the blender to grind the seeds into a powder and then add the remaining ingredients for the smoothie. Try a tablespoon of ground flax seed daily.

Ground flax seed can actually help with diarrhea as well because of the bulk it gives to stool and its anti-inflammation properties.

Blackstrap Molasses

Blackstrap molasses (which is different than the regular molasses we use in baking) contains magnesium and other minerals that help with motility, which in turn helps with constipation. Blackstrap molasses also happens to be a great source of iron. Try giving a tablespoon per day.

Coconut Oil or Avocado Oil

1 tablespoon per day mixed with warm water can keep things moving.

The Poopinator

This is a recipe developed by a fellow tubie mama blogger, and many have had great success with it. Check it out!

Coffee

Obviously, this is a suggestion for teenagers and adults, not children. Caffeine does help get things moving as it stimulates the bowels and can be a great help when used in moderation.

Chia Seeds

Chia seeds form a gel-like compound, much like ground flax seed. They also contain oils that help reduce inflammation, which will help digestive health. Like flax seeds, chia seeds can help with both constipation and diarrhea because of the bulk they give to stool and their anti-inflammatioin properties.

Probiotic Foods

Fermented foods are great for digestive health for most people. You can make your own fermented vegetables or make your own kefir. I plan to do a post on fermented vegetables soon! Because so much gut bacteria can be lost during episodes of diarrhea, probiotic foods are also very important and helpful for most people struggling with diarrhea as well.

Turmeric

Turmeric is an incredible anti-inflammatory food. Keeping inflammation down in the gut will greatly improve digestive health and overall health. It’s good stuff! The anti-inflammation properties of turmeric can also help some people struggling with diarrhea.

Psyllium Husk

Now that Bradley is on a low FODMAPS diet, he basically cannot have a single food listed above. This is because foods that often help with constipation are difficult to break down in the gut, which is why they retain water in the bowel so well. This attribute also means they feed gut bacteria very well. This is wonderful if your child does not have a bacterial overgrowth as feeding the gut flora can vastly improve digestive health. However, it’s horrible if your child does have a bacterial overgrowth since these foods will feed the excess bacteria and allow them to reproduce all the more. Ack!

Fear not. If your child is struggling with a bacterial overgrowth due to slow motility and also struggling with constipation due to the slow motility, there is indeed a solution. Psyllium husk is the outer husk of a seed used to grow an herb (mostly in India). The seed actually isn’t particularly special from a nutrition standpoint. The husk, however, is extremely high in a soluble fiber that does not feed gut bacteria. It forms a gel that is easy to move through the bowel and has worked fabulously at managing Bradley’s constipation issues. I have also read that psyllium husk is a keto-friendly food for those on a keto diet.

I mix 1 tablespoon of psyllium husk whole flakes into 6 ounces of water (no need to blend…simply stir into the water) and then flush with 2 ounces of water. I give the husk and water mixture immediately after mixing simply because it becomes a little more difficult to pull up with a syringe after it has sat for a few minutes (though certainly is still doable).

IMPORTANT NOTE: psyllium husks swell slowly in water. If your child is going to consume psyllium husk orally, use extreme caution as the husks can swell in the throat, causing a choking hazard. Always use plenty of water if using orally and allow it to fully expand prior to oral consumption. Because Bradley is in the early stages of learning to eat, even though he can eat smooth purees, I only give psyllium husks through his feeding tube to avoid this potential danger since swallowing is a skill he is still developing. If your child has any difficulty swallowing, I strongly recommend giving the psyllium husks via the g-tube.

Non-Food Suggestions

I always recommend starting with food first. If that doesn’t work, it may be time to try non-fresh food solutions. Moms have recommended Fruit-eze, Natural Calm Magnesium, Senna Tea, Oxypowder, Smooth Move Tea, Magnesium, and Natural Calm.

*Always research thoroughly and discuss with your child’s medical provider, especially if your child is on medication. Even natural solutions can be problematic for people living with certain conditions or taking certain medications.

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Not much to write as I feel this video says it all. I hope my son’s amazing story inspires you to see the possibilities even if your situation feels impossible.

It has been a life long dream of mine to write children’s literature. I am extremely excited to announce that dream is becoming a reality. In early 2018, I will be releasing my newest book, “The Adventure of Tom Turnip.”

In this story, filled with beautiful illustrations, Pumpkin, a magical fairy, takes Tom Turnip on an exciting adventure to 3 lands. During his journey, Tom Turnip learns that foods that grow from the ground are the very best foods to be found. He then saves the beloved creatures he met on his journey. At the end of the book are recipes for every food Tom Turnip discovers on his adventure that children can make with their parents. There is also a parent resource section written by an experienced feeding therapist about strategies to increase the variety of foods eaten by young children.

This book is the first in a whole series centered around teaching children to love to eat whole plant foods and is inspired by my son, Bradley, who lives with a feeding disorder. I’m thrilled and can’t wait to share it with you!

Follow my author page on Facebook to watch for updates!

Holy moly, are these lettuce wraps good! Both nutritious and delicious, loaded with plant foods, and bursting with flavor, you can’t go wrong  with these babies. The sauces are just a tad on the spicy side, so you may want to skip them for any tubies with sensitive tummies. However, the meat mixture blended with some romaine lettuce and a bit of brown rice can make for a wonderful blended meal.

This recipe definitely require a food processor or, at an absolute minimum, a chopper. Otherwise, you’re going to have a lot of needed chopping on your hands. With a food processor, you can whip these up pretty quickly.

Ingredients run through a food processor:

• 1 lb bag baby carrots
• 1 8-oz can bamboo shoots
• 1 8-oz package mushrooms
• 7 garlic cloves (run through the processor with the mushrooms)
• 1 large bunch green onions (with only the little “hairy” end cut off before processing)

Other ingredients:

• 2 lbs ground turkey
• 1 8-oz can diced water chestnuts
• 2-inch piece ginger, grated
• 3/4 cup soy sauce
• 1/2 cup orange juice
• 1 Tbsp Thai chili sauce (found in Asian section at the supermarket)
• 4 Tbsp peanut butter
• 1 Tbsp honey or agave nectar
• Romaine Lettuce
• Brown rice
• Spicy Lime Ginger sauce (see recipe below)
• Pineapple chili sauce (see recipe below)

Brown the turkey in a large skillet. When it is thoroughly cooked, drain the grease and add the ingredients that were run through the food processor. Then, add the water chestnuts, ginger, soy sauce, orange juice, chili sauce, peanut butter and honey/agave nectar. Let it simmer uncovered for 5-10 minutes until the veggies are tender. If there is still too much juice, let it cook for a little while longer.

Serve this filling with the lettuce leaves. On the side, serve brown rice to add to the wrap and the spicy lime ginger sauce and pineapple chili sauce to top the filling (inside the wrap) or to be used as a dip for the wrap. I like to top my lettuce wraps with both sauces. You can also serve these with chopped cilantro, chopped peanuts, chili sauce, peanut sauce…or make a concoction of your own!

To make the ginger lime sauce, stir the following ingredients into a bowl:

• 1/2 jalapeno pepper, minced
• 2 inch piece ginger, peeled, grated
• 1/2 cup soy sauce
• Juice squeezed from 3 key limes

Don’t get lazy and use store bought bottled lime juice for this recipe. You will pay for it in taste. Use freshly squeezed lime juice and your taste buds will thank you! Chop some limes in half and give them a good squeeze.

To make the pineapple ginger sauce, put the following ingredients into a blender:

• 3/4 cup rice vinegar
• 1/2 cup water
• 3 Tbsp fish sauce (found in the Asian section of the supermarket)
• 5 garlic cloves
• 1 Tbsp dried crushed chili
• 1 cup fresh, chopped pineapple (substitute with canned, if needed)

Blend all this together for 1-2 minutes, pour into a serving bowl and it is ready to go.

The volume this results in will really depend on how well the veggies are chopped and how long you cook the mixture. So, I can’t give a per cup nutritional analysis of this recipe. However, below, you can find the nutritional information for the full recipe of the meat mixture. Simply measure how much volume it produces and divide the information below by the number of cups to determine the nutritional information per cup. I recommend blending about 1/2 cup of the mixture with 1 romaine lettuce leaf, 1/4 cup brown rice and a liquid of your choice.

• Calories: 2,270
• Carbohydrates: 137
• Fat: 103
• Protein: 210

Enjoy!!!