Let's Do Lunch!

A few people have put out for some pics of how tube feeding works - so I've invited you all for lunch at my place today to have a look see.  Come on in...

(pics from my 1MP iPhone camera, sorry, but the upload speeds here would make anything bigger take........for........ever.......)

This is our kitchen table where I do most of my feeds - I call them feeds, but many people prefer to call them meals.  That's OK too.  If my wife is using it, I will often just stand by the kitchen bench.  Let's get set up.

What you see here is my little kit, which comes out a few times a day whenever there's medicines etc involved (otherwise it's just syringe, water, feed, tea towel).  So in the foreground, from left, is a 1/2 cup measuring cup that I use to dissolve crushed meds and liquid meds in, a 200ml glass of water, a pill crusher and some pills, and just under 400mls of yummy blend.  The kit in the middle ground is just where all the medicines, herb tinctures, syringe equipment and so on live together in peaceable harmony between feeding sessions.  What you'll notice in the background is important too.  It's good to make the place you have your food a nice place to be, especially if you're not getting the usual tantalising visuals and textures of having a meal the traditional oral way.  I like to have flowers around if there's some from the garden but today I have Special Birthday Flowers also (thanks Meeta xo) so it's a bonus.

Also, music can be good.  Today for example I have been listening to the indescribable Geoffery Gurrumul Yunupingu.  If you haven't, then I strongly suggest you do yourself a favour.



OK, getting hungry now so let's get it on...

That's herb tincture and medicine soup, that is.  The eagle-eyed amongst you may have detected the water level going down in the glass - as well as making the medicine soup, I added just a teensy dribble (that's the technical term) into my blend container and gave it a shake (remembering to put the lid back on - I haven't done that one, yet :-) to turn it from a 'needs pushing' blend to a 'gravity is my best friend' blend.  The ridiculously eagle-eyed will wonder why the folded paper towel has moved from right to left also.  Well, I don't know either.

Today's lunch comprises:
Leftover vege pasta bake with rice+corn pasta, wholewheat tortillas, and lots and lots of different veges in a tomato-based sauce.  Smelled great.
Walnuts
Avocado
Olive oil
Homemade applesauce (it's just apples, some spices, agave nectar and lemon juice)
Digestive spices and herbs (cardamom, ginger, dill)
Organic oat milk
Pomegranate and cranberry juice.

OK, this next bit is what has proved hard to describe adequately and in part inspired this post - so here's a picture:

This is The Grip. Thumb and forefinger are holding the syringe barrel down into the feed port while the other fingers help by supporting it.  The Very Important Part of The Grip is the part of my palm (yes, that's my hand, I couldn't afford a professional Hand Model for the shoot) , under the first finger knuckle, that's sitting firmly on top of the pesky med port cap.  If you do not hold this cap down, and you are using the syringe plunger to push a thick blend - and this even happens sometimes just with gravity feeding - IT CAN BURST OPEN SUDDENLY AND HAVE YOU AND THE SURROUNDINGS WEARING THE CONTENTS OF THE SYRINGE IN POSSIBLY ALARMING, OFTEN HUMOUROUS, BUT DEFINITELY MESSY FASHION.  Note also I am wearing light-coloured trousers today, which dramatically increases the chances of a spillage event.  This applies to any PEG-end or extension that uses a cath-tip port.

Oh, and the colour of the tube itself?  Over its life to date (about 16 months now) it's gone from a nice clear non-colour to the deep burnished mahogany you see here.  This is just staining and is not a problem in the least.

Finally, the money shot:

It's just as easy as that; I have poured in a syringe-worth of feed, and it is slowly running through the tube, whilst I maintain The Grip, under gravity.  If I were doing a thicker bolus (that just means feed without a pump, for non-tubetalkers) with the plunger, then that little white med-soup cup would be serving also as a rest for when I put the plunger down during the plug in-pour-insert plunger-push-unplug-take out plunger (rest in little cup)-plug in (repeat all) routine.  If it's a rubber-tip like this one then I'd be dipping it in the blend too every second or third syringeful for a bit of lubricatory action.  When all the feed has gone from container into me, I just tip the rest of the water in to flush the tube.  Then....

Do, please do, always just have a little double-check that YOU'VE ACTUALLY CAPPED THE TUBE if you have a PEG and not one of those high-tech one-way valve low-profile button doovers.  Because sometimes, I've not quite closed the cap all the way and, well, let's just say I'd never win a wet t-shirt contest, so I don't want to wear one.

Now, let's go wash up.

Note here the pristine paper towel - it can be saved for next time, as I was dribble-free today.  Yay for no mess!  All this'll just be given a good rinse in very-hot water.  If things are starting to look a bit too grimy I'll break out the dish liquid and get serious, but really, it's a cosmetic and psychological thing, cleanliness, as much as a common-sense thing.  Air-drying means no contamination from dish towels etc too.

So, thanks for dropping bye!  I hope this was of some use to some of you.  As you may know, I have an on-again-off-again issue with motility and reflux so for the next hour after feeding time I need to stay pretty upright, but just like all us creatures after a lovely feed sometimes....well....it's a good time for a little siesta:

Tell me Cisco here doesn't have it all worked out.

.

Let's Do Lunch!

Joleanna's simple breakfast for Demetri

This is a simple, basic, standard-ratio breakfast blend:

1/3 cup dry Quinoa flakes cooked for 90 sec. in 1/2 cup water
1 tsp oil
1 tsp honey
1 kiwi
3 ounces whole non-homogenized milk

makes 8 ounces
approximately 320 calories, 9 grams of protein and fat. (pediasure 8 oz: 237
cal, 7.1 g protein, 9.4 g fat)
I compare my blends to pedisure only to appease physicians and honestly it does
give me a good cal/protein/fat ratio b/c he is sensitive to fat overload
so about 40 cal/ounce if my figures are correct. it was very thin so may go
through continuous feeds, not sure though b/c i gave it via syringes.
lol, and yes i'm the one who pre-fills or draws up all the syringes ahead of
time. it seems to make it easier for the grandmum's when they watch him.

Joleanna's simple breakfast for Demetri

The Results: and I Would Like Your Ideas Please

The results of the Inaugural Giraffe and Coconut Survey are in, and I am most pleased with how it all went.


On the serious side for a moment, I learned many important things in preparation for the next Big Project; a quantitative survey of the experience of doing BD versus commercial formula.  Read on down for what YOU can do with 2 minutes of your time to help make this a total and awesome success.


But first, the news:


In a disturbing development, it seems that 16% of respondents are not sure whether they in fact have a giraffe.  I mean, you'd notice, surely, wouldn't you?  But it also seems that 11.1% of respondents do in fact report having a giraffe.  This remains true if we filter for country of origin and look only at the USA.  Logically then we can extrapolate that there are approximately 34 million giraffes resident in the United States.

See how careful you have to be with looking at stats?  Obviously there are more giraffes than that. :-)


One thing I should have included was a free-text comment box for the question "Do you possess the answer to globalisation-induced poverty?" because 19% said Yes, and now we'll never know........


Of all the choices, the favourite method for preventing giraffes from eating the unripe coconuts was to "Tie a bell around the giraffes' necks so the coconuts can hear them coming and hide"  Closely followed by "Don't be stupid. Everyone knows giraffes don't eat unripe coconuts. They always wait until they're ripe."


There were many very practical and imaginative solutions to this problem offered, one of my favourites being to first teach the giraffes to read, have them read the Bible and the Ten Commandments and place reminder notices up in the coconut palms saying stuff like "God is watching".  Although I'm not sure if this is more or less humane than the electric fence option.

Unsurprisingly, stepping in giraffe poo in your bare feet while being distracted by the pretty ribbons the giraffes tie around the coconuts rates VERY HIGHLY on the annoyingness scale.

Useful stuff.  Who knew?

The favourite colour option for repainting the Capitol Building is in 'all the colours of the rainbow' but in the free comments section beige made a very strong showing as did green. "Sage green to attract sages, not fools", "Green, the color of money, because that is all that any of the politicians working there care about."  "Green, with little pictures of famous men for accent, just like all the $$$ they foolishly spend in that place.", "Green: because i'm hopeful about the eco thing sticking, but realize it's the allmighty dollar that sets the rules.", "neon green" and my favourite "Lime Green with purple trim - looks great in my daughters bedroom and cheers everyone up when they walk into her room."  Who'd have thought there would be so much politics in colour???  Pretty much every colour combo was mentioned, including the creative purple, being a blend of red and blue.  Nice.


75.9% of people do not know what a delicious Mangel-Wurzel is.  And pretty much everyone loves potatoes.

There was a great response to the "Which vegetable would the Capitol building be and why?"  question, but again...so much hilarious politicking!  Gas-producing and otherwise stinky vegetables featured strongly, as did the Mangel-Wurzel because, in the words of a few "I don't know what it's for or what it does".  Too much creativity to boil down here.  






I used the free version of SurveyMonkey, and it's quite limited in terms of pulling reports and sharing data with y'all.  But I shall be ponying up for the proper version and then can make all the coconutty and giraffey goodness available in a better form for you to examine fully (minus names etc, sorry, but they must stay confidential and then be destroyed once the data's all pulled).  Then I can also find out the really nitty-gritty stuff like "of those who responded 'yes' to owning both giraffes and coconut plantations, how many thought the Capitol Building would be a vegetable from the brassica family?"  

Because you can see how useful that will be to know.


OK, maybe not, but I will want to know answers to cross-referenced enquiries like "what percentage of those people who switched from formula to BD and had a decrease in reflux also reported greater volume tolerance?"  This sort of thing may prove to be very interesting.


AND THIS IS WHERE YOU COME IN


I and my few motivated cohorts in the spearhead are already working away on your behalf on the survey construction and design.  As per your responses just now it will be short enough to be completed in well under 20 minutes, yet long enough to catch a lot of really meaningful data.  But the outcomes to be aimed at are the main thing.


I am appealing to you to give me your feedback on the following issues, to supplement the things we here in the vanguard have already compiled.

• What are the main objections you have been presented with by members of the medical profession, family, and others when considering BD?

• In simple or single words (eg reflux, vomiting) what are the greatest symptom improvements you experienced when making a change from commercial formula to BD?

• What were the main problems or worsening symptoms when changing?

Either pop a comment in below or email me with your thoughts, please.  Comments might be better, because then others can see what you've written and it may inspire them to think of something too.


Thank you all, very much.  The response was larger, faster, more creative and certainly a lot funnier than I had dared hope for.  I look forward to the next step feeling well-supported and like we're about to do a very good thing.  A first step to something which might change a lot in how we understand the BD experience across a wide range of people's experiences, and a powerful tool to help educate the medical community a little better, in a way they can only respect.

The Results: and I Would Like Your Ideas Please

I'm excited: New Survey Trial

I'm excited.  I'm hooking up with some other equally motivated folks to use the awesome power of internet data collection to do something that's missing from the whole Blenderized Diet oeuvre.  A proper, wide-ranging study of people's experiences and evidence about the differences between feeding with canned formula and feeding with actual food.

To that end, I'm testing some online survey software - the cheap-ass free version, sure, but a useful start - and I want you to take the survey please.  It'll take 5 minutes.  You'll like it, I promise.

Hopefully, this link will work.  thanks!

Click here to take survey

I'm excited: New Survey Trial

A Weighty Issue

One thing that so often crops up for people switching from canned formula to a food diet is the conundrum of weight loss/weight gain.  There is always some fear in change, and so many of us are conditioned to trust medical professionals' knowledge in all areas they choose to speak on; and to trust 'scientifically' determined ratios and amounts of calories, nutrients and so on that it can be hard to leap out of that way of thinking.  The need we so often have to be as in control of an out-of-control situation as we can (like a loved one's health) can cause us to lock us into a search for absolutes, for rules, for prognosis: "If I do X, will Y happen, and when?"

But of course nature, of which we are all a part (and we forget this sometimes too, that we are animals in an environment) does just not work this way.  Furthermore, we are all so very different.  We each respond to various formulae, and foods, differently too.  This is why prediction, prescription, growth and weight charts, calorie plans and the like are guidelines to start with at best; frightening, irrelevant and wrong for us at worst.  The best way forward always ends up being from our direct experience.

All that being said, there are some recurring themes that seem to crop up with a switch from formula to BD when it comes to the issue of weight.

Something that really gets my goat* is the habit of modern medicine to create bogus 'diagnostic' terms that really just medicalise something simple and obvious, as if by giving it a fancy, formal-sounding acronymic name some power can be achieved over it.  One such term that gives me the screaming willies** is Failure To Thrive (FTT).  It is NOT a diagnosis, any more than GERD is. It is a shorthand pointer to a description of some of a set of symptoms, that is all.  In FTT's case, it means 'not growing so well'.  So many parents whose child is 'diagnosed' with FTT have all sorts of fear put into them about caloric values and density and have a hard time even considering a way out of the formula can as a result.  Partly perhaps because one of the 'scare stories' is true some of the time at least:

Kids and adults alike can often lose weight initially when switching from canned formula to food.

So why might that be?

The most commonly presented answer points at the 'empty calorie' syndrome.  This is where despite being perhaps 'underweight' by standard measures, someone is carrying excess unhealthy fatty tissues just pumped up by the very high relative percentage of refined carbohydrates (sugars) present in canned formulae.  The body can only use or process and excrete so much of the caloric value put in because there's just too much of the one kind of caloric substance so it stores it.  As soon as the topping-up is stopped (no more formula going in) the body starts to rid itself of its toxic and unhealthy burden and switch into a different mode of assimilating nutrients.  The same thing is seen with really high-fat diets.  Our modern obesity epidemic really has two main causes - simple overeating and the composition of what we kid ourselves is food.  Many would be surprised just how much fat and sugar there is in the most innocent-seeming processed foods.

Lots of parents experiencing this will say that the child in question is technically losing weight, but is visibly less 'puffy', and developing a healthier colour.  And the thing is, it rarely seems to last very long - a couple of weeks generally before the turnaround begins.

Another possible answer is that it's just a change thing.  If you've been on formula for a while then your body gets used to it - even if there's all sorts of intolerance, vomiting, diarrhea and the whole catastrophe going on.  We are amazingly adaptable survivors and can extract sustenance when we really have to, even when it's mixed in with something that is poison to us.  So it can take a while for the body to adapt (or re-adapt) to digesting new things.  During this time some weight may be shed.

A third good reason I've heard posited is that there's a whole new lease on life going on and since feeling suddenly so much better, increased activity is just burning up all the excess calories!  I know this was part of what happened for me.  I went from gaining a little weight to a plateau and then a loss as I upped the BD but then I thought back and realised I was actually doing things I previously had not had the energy to do.

There must be other theories (please share!) but what it comes down to is that that there's a pretty common observable scenario where people making the switch lose, then gain.

So what I'm saying is, DON'T PANIC!  Of course, you must be sensible.  But a little weight loss in and of itself is not a major cause for concern.  You may feel stuck in a cleft stick - the docs say "OK, try BD, but if there's no weight gain in a month it's back to Evilvomitformula 1.5***" or your child may be at a very low baseline already and you're scared to let it go too far.  It could be of some reassurance to know that in almost every case, the turnaround to a nice steadyish weight gain happens quite quickly.

But weight, there's more! (haha)

Sometimes quite the opposite happens and this can be a bit off-putting too.  Occasionally there's a rapid weight gain, one not also associated with a length or skeletal growth.  This is not entirely desirable, but it's generally an easy fix - less food or less calorie-dense food.  Quite often in these cases it seems that the formula simply didn't absorb well, but natural food does.  And the body is hungry for nutrition and just goes mad for it.

I'll round this out by briefly returning to the subjects of FTT and weight charts.  Too often now I've heard of children who may have been preemies (we call them premmies here in Oz btw, just a pronunciation thing) or are otherwise 'small' for their age - 'adjusted' or otherwise - being measured and judged according to some standard weight/age chart, being pumped up on synthetic empty calories, and then discovering they're carrying too much weight for their bones and organs to handle.  Please remember, height and weight charts are just things made up from measurements of regular, non-special-needs folks, to find some average, and then they have a standard statistical spread applied.  Everyone's different.  Of course, if you or your loved one is an outlier on the charts then it's worth having a closer look - but it's not necessarily a problem at all.

Our human instincts are king here.  Look, feel, all the rest.  You know what's a good weight and what's not.  You have your own special chart and that of your loved ones in your head the whole time.  Trust them, and be sensible.  That is all.

*Not literally, of course.  I don't have a goat.  But I love goats and if I had one I wouldn't let anything 'get' it.
**Again, mostly not literally.  I prefer my willies a lot calmer and composed.
***Evilvomitformula1.5 may not actually exist.  Or it may.

A Weighty Issue

To Nissen Or Not To Nissen

Just yesterday I started writing on the subject of Nissen Fundoplications and the prevalence in many communities of surgical options being pushed on kids with different gastric difficulties.  Then, in response to the topic coming up on the BD forum, the typically excellent and educative Kristina Blizzard had this to say - well put and coming from  experience.  Food for thought indeed.  


Here's Kristina............


"For what it is worth, here is my two cents worth on Fundoplication (Nissen)
surgery in general:

Before starting the blended diet, and eliminating formula, we were told many times my daughter needed a G tube. One of the reasons I was so against the idea was because I was told that most doctors would want to do a Nissen (Fundoplication) as well, due to her projectile vomiting, which she did 3 - 6 times every day. I was told doctors in my area were routinely doing a Nissen when placing a G tube. I believe the complication rate was high enough that they no longer do them routinely.

I asked the nurse at the Cincinnati Aerodigestive Feeding Clinic, what the complication rate was for a Nissen. She said it is about 30%, which seems really high to me. Part of the problem with that surgery is that it is subjective. What I mean by that is the doctor has to decided how tight to make the Nissen. If it
is made too tight, solid food will not be able to enter the stomach easily, and you get gagging, wretching, etc. If it is made too loose, the patient will continue to reflux/vomit/possibly aspirate. There is also the possibility of causing nerve damage that can contribute to the wretching issue.

For those of you who don't know, when they do a Nissen, they basically pull the top part of the stomach up around the bottom of the esophagus, and sew it in place, with the intent of creating a one way valve. Hopefully food can go in, but not back up in the form of reflux or vomiting. This surgery does reduce the
volume capacity of the stomach, which can become an issue, especially for those who already had low volume tolerance to begin with.

In a person with aspiration issues, doing a Nissen can be life saving. There are people who have had the surgery, and have done very well afterwards. Those people are very happy they did it, but don't tend to be nearly as vocal about the surgery as the people who have complications from it.

Sadly, for some people, the Nissen causes more trouble than it solves. Those who are sorry they did it, feel (perhaps quite rightly) compelled to warn everyone of the negative possibilities. I think that is why most of what I hear about Nissen surgery is negative, and often pretty scary.

I think used very judiciously, Nissen surgery can be a good thing, like I said before, life saving in some people. Where I get concerned though, is that often there is not enough investigation of the cause of the reflux/vomiting/oral aversion prior to surgery. I am afraid surgery is sometimes being used to treat
symptoms, instead of identifying the cause of the symptoms. Vomiting/reflux/oral aversion can have many causes, but just be very sure to eliminate food allergy/intolerance as the cause BEFORE you have surgery.

And no, just trying someone on Elecare or a similar formula is not considered a sufficient investigation in my book. Not everyone tolerates Elecare despite what the doctors say, it CAN cause issues. I know several kids who couldn't tolerate it at all. I think it should be a criminal offense to alter someones anatomy
like that without first doing an elimination diet to rule out food allergy/intolerance issues.

If you are thinking, what about allergy testing? It is often not reliable either. (A topic for another post perhaps.) In my opinion, an elimination diet is really the only way to know for sure what someone can tolerate.

The medical community doesn't as yet have a very good understanding of the many interactions between food, and the digestive system. They know even less about the role of the immune system in reactions to food.

If it wasn't for me finding the blended diet, and starting my daughter on a hypoallergenic blend, she would have had surgery. It was scheduled for two days later, but she did so well on the hypoallergenic blend I made her, I was able to cancel the surgery.

I had been told repeatedly, her vomiting was a result of her brain injury, and something we would just have to live with. Once I figured out everything she doesn't tolerate, her vomiting went away. Her oral aversion is gone now, but she still has texture issues, probably because her esophagus doesn't contract well. With blended diet, my daughter, is now able to happily, comfortably and independently meet her calorie & nutritional needs, something I consider miraculous when thinking about where we were back in Sept 2009.

So my word to the wise, unless it is life threatening, don't do surgery for reflux/vomiting/oral aversion without first trying an elimination diet to rule out allergy/intolerance as the cause. Maybe you will get lucky and not need the surgery at all."

Warmly,
Kristina

Retired ICU RN, BSN

Mother to Morgan, 3 years old, former 26 week micro preemie with a bilateral
grade 4 brain bleed, cognitive delay, communication disorder, mild cortical
visual impairment and feeding disorder. She takes her blends orally, in her
bottle.

To Nissen Or Not To Nissen

In small praise of homegrown.

First, let me say thanks to all you readers and lurkers out there.  This blog's pageviews continue to climb steadily and are coming from all around the globe.  This can only mean that it's helping to do some good somehow, and that people are sharing it with others.  That's great, it's what it's all about.  Almost as gratifying, I've been made aware that there's a creeping, growing awareness of this site in medico-land, with a number of dietitians and nutrition program managers and the like telling me that it's one of the main resources they direct new tuberfolk to.  So please folk, keep your input a-comin; people need us, and love what's going on!

That said, here's a picture.

Those of you who read my other blog will know I moved house last year and have faced a number of challenges getting the garden up and running.  It's spring here, and despite the difficulties I've had my first little harvest.  Oh, and that isn't some weird mold on the broad beans, it's frost - I harvested them the day before, blanched and froze them in portion sizes.   Yes, I trimmed and cooked the artichokes (only two of them, my wife had the other and another besides) but the herbs (coriander and mint in this batch) and everything else went in as is.  The blend, if you're interested (usual memory disclaimer and apologies for my non-measuring system as always), was:

Walnuts, a large handful
Quinoa, uncooked, maybe a cup
Sesame seeds, a short pouring
Two artichokes
Double handful broadbeans (fava beans, same thing)
Strawberries, just four gorgeous little ones
Coriander (cilantro)
Mint
Sweet potato, two smallish orange ones
Banana, one of
Dark agave syrup, a few tablespoons probably
local EV olive oil, lots more than you'd normally think was good for you
garlic-infused olive oil (really STRONG too, yum) just a bit
cardamom, ginger, turmeric, all dried and ground, about a teaspoon each
organic oat and honey milk, 1 litre
carrot and orange juice, to top up and thin just enough.

This all made just under 3 litres, so I split in into 7 feeds of roughly 400mls.  And I have to say, it smells just divine.  Juuuust thin enough to gravity-feed via syringe body.

So the real question is, what's with the strawberries?

Yes, there were only four little ones.  They were the vanguard of our strawberry pots production and all that was available on the day - so why bother at all?  Because it's about the connection.  The link between the (organic) way we grow food, the soil and air and water and sunshine we help along with our designs and efforts to make food, and with my inner self - in all senses of that term.

In gross terms, four strawberries isn't going to amount to much in 3 litres of tubefood, but the energy (for want of a less New Age term) is really important.  The blend above is a celebration of the season, and how it is at my home.  This sort of stuff I believe is every bit as important to our whole-person health than just a calorie and mineral count.  You'll know by now I'm not a rampaging ideologue on the 'anything less than permacultured organic local produce is contributing to the death of the planet and will probably give you cancer' bandwagon, but there's no doubt in my mind that food made as close to us as possible, by our own efforts if possible, in as much of a naturalistic way as possible, will trump every other conceivable form of fuel intake available to us - in the way it supports us individually, and as a collective of people on a fragile world.

Tubefeeding in some ways has given me a keener appreciation of the feel of food than I ever had before.

So I'd just like to take a moment to express my gratitude that I can in a small way help nature make food for me and my wife, and encourage everyone to remember that it isn't an all-or-nothing sort of thing to do.  Just a little pot of herbs on a windowsill, a sprinkling of homegrown, natural parsley on top of your dinner, makes such an immense difference to how the whole meal and mealtime feels.  Connection.  And if you happen to be tubefed, it's really all the easier.

I mean.......seriously, would you EAT all that together?

In small praise of homegrown.

Hi-Cal blend foods

One of the things folk often struggle with at first doing BD is cramming 'enough' calories into a smallish volume of BD.  I think a lot of that comes down to the, er, interesting ways doctors and dietitians have of making statistical analyses of needs and averages, in combination with the incredibly high calorie count per volume of commercial formula.  Which is mostly sugar, in its various guises.

It's very common to find that when you move to BD, a much larger volume is able to be ingested (I really don't like the word 'tolerated') compared with commercial formula, meaning you can make it less calorically dense for the same value.  You will probably find that the body absorbs nutrition far better from food than from formula too, although it can take some time in transition.  There are, of course, lots of variables.

Anyway, I thought I'd do a list of the commonly used calorie fortifiers: please send me your own favourites too and I'll add them to the list.

FATS (mostly)
Olive oil
Coconut oil
MCT oil (generally a blend of coconut and palm oils, these are absorbed in the intestine rather than actually digested)
Various other vegetable oils
Coconut milk/cream
Avocado
Butter
Cream
Half-and-half (an American thing; half milk, half cream)

CARBS/SUGARS (watch the GI of some of these, but they're mostly lower GI than usual sugars)
Molasses
Agave Syrup
Maple Syrup
Dark Chocolate

PROTEINS (mostly)
Quinoa
Chia seed
Hemp seed powders
Tree nuts (too many kinds to list, really)
Sardines
Meats of all kinds
Legumes (again, too many to list)

These are just short lists of things especially high in certain types of calories.  Many of them could easily be in another category too - sardines have great oils, as do most nuts, and avocado and the dairy products have good proteins.  There are tons more you can add, these are just the ones I recall seeing over and over on the forums and lists.  You can help by sending me yours to share too!  Leave a comment or mail me HERE.

Hi-Cal blend foods

Dawn's pre-Vitamix blend

Lots of folks start out without an expensive blender - for many reasons - so prefer to rely for that time on easier-to-blend foods.  Here's a simple one from Dawn that uses regular baby foods and smoother-textured things to make life easier without something like a Vitamix.  I believe Dawn has one now though.

1 jar each - bananas and plums (#2 baby food)
2 jars meat or 1 hardboiled egg and jar of meat
1 jar applesauce, pears, green beans, mixed vegetables or carrots (#2 baby food)
1 jar sweet potatoes, apricots, peaches, or squash (#2 baby food)
Note: I usually use one veggie and 1 fruit from the previous 2 lines
1/2 C yogurt or cottage cheese
2 Tbsp olive oil
1 serving of starch - cream of wheat, oat bran, grits, or oatmeal – grits and
oatmeal need to be ground up in coffee grinder first cooked in 1 c whole milk
1 serving of wheat germ or flax seeds (ground up in coffee grinder) - if you do
decide to use either, start slow
4 tsp cornstarch – don't use with oat bran or oatmeal
½ tsp salt

this is about 1,000 cals and makes about 4- 150ccs of food. 


I only use 2 of them a day and then make a morning puree of:
1/3 c yogurt
1/3 c granola (ground up in coffee grinder)
1/2 c fruit (I liked to use frozen blueberries, mangos, or cherries)
liquid to thin, if necessary

makes about 150cc's

Dawn's pre-Vitamix blend

Beth's "Antonia Soup" blend-fest

Beth does this mammoth cook-and-blend-up once a month or so and freeze it in plastic containers.  Then each day will blend 1200mls of that with a cup of frozen organic fruit or an avocado.  This makes 4 meals for her son who also gets 100ml of organic coconut milk each time too.  I believe the soup is named for her friend, who gave or inspired the recipe.  If I could still eat, I'd eat this.


Beth's Antonia Soup
½ cup olive oil
3 large onions
1 head garlic
3 qt. cans organic diced tomatoes-(6- 28oz cans)
2 lb. dried beans (lentils & split peas)
1 pkg carrots
8 organic sweet potatoes
8 crowns broccoli
2 cabbage red
2 large bunch kale
1 bunch asparagus
6 summer (yellow) squash
2 red pepper
6 beets with tops
2 pkg frozen organic peas
2 pkg frozen organic beans
2 pkg frozen or fresh collard greens
2 pkg frozen organic spinach
2 lb. brown rice
½ cup ginger root
1 T. turmeric
1 cup almonds
1 cup walnuts
1 cup macadamia nuts
2 oz. Tahini paste (1/4 c.)
1 bunch fresh dill
1 bunch fresh cilantro
1 T. flax seed
Sea salt to taste

I use all organic veggies, or as best I can.)
To prepare, divide the recipe in thirds and sauté the onions in oil in 3 large
stainless steel or aluminum pots (or one 42 quart pot). Add garlic and tomatoes.
Simmer for a couple of minutes. Cover with 4 quarts of water. Add dried bean and
chopped nuts, seeds, tahini, tumeric. Let cook until rice is semi soft. Add
all fresh items, coarsely chopped. Bring to full boil and turn off heat. Let
fresh items steam (to keep more nutrients). Add remaining ingredients, frozen
etc. Let cool for at least an hour, more if possible. Puree in a Blendtec or
Vita-mix. Pour into containers and store in freezer.

Beth's "Antonia Soup" blend-fest

A sample from Beverly

Young Bonnie gets a really varied diet.  This is just an example of what Beverly made for her one day.

1 cup oatmeal. That is a whopping 180 calories. I do not cook it first. This
helps with her reflux.
1 banana. It was a pretty big one. Sayler scale said it was about 80 calories
1 cup frozen beans. That is about 50 calories
2 pieces tandoori chicken, with skin(gross but caloric!)about 200 calories, give
or take
4 T olive oil, for 480 calories
3 calcium tablets, dash of salt, fluoride

Now this is just under 1000. When she needs more I usually throw in more oats.
For example tonight she might get hungry early. If she does, I'll whip up
another blend. Quite often it would then be our fresh eggs.

A sample from Beverly

Michelle S's vegan blend

This is my three year old son's blend. He is on a vegan, almost raw food diet...

1/2 cup quinoa
3/4 cup lentils
2 slices ezekial 4:9 bread
1/2 cup of three types of veggies (for example...1/2 cup sweet potato, 1/2 cup carrot, 1/2 cup broccoli...all raw)
1/2 cup 2 types fruit (for example...1 apple, 1/2 cup blueberries)
1 handful chard or kale
1 tablespoon almond butter
1 1/2 tablespoon EV Olive Oil
1/2 avocado (unless is it really big, then about 2 tablespoons)
2 cups rice milk

That is pretty much our standard blend and we try to mix it up every day. Substituting veggies and fruits. Sometimes we will do different beans for the lentils. We also do as much organic of these foods as possible. He has thrived on this blend compared to the previous formula he was on.

This one is approx 1200cals and 42-46 oz.

Michelle S's vegan blend

Jenny and Katy's food stuff

This below is pasted from Jenny's comments on another post.  I've included everything she wrote because it can help to know a history when seeing how someone has designed their blends.....

I love your site. Many people just suffer through formula life never knowing how good life can be with real food. My daughter, Katy got her g tube at 10 months old and I fed her human milk exclusively from birth until 2 years old. She still had reflux even on my milk. I later figured out why. Katy does not tolerate milk, soy, corn, eggs and oranges. I had eliminated milk and soy from my diet, but was eating corn, eggs and oranges. When Katy turned 2, I started adding baby foods one at a time to look for sensitivities, that is when I discovered her sensitivities. Once I had a good variety of tolerated foods, I began to cut back on the breastmilk as the base and switch to milk substitutes like Vance's Dari-Free(potato based milk sub) or rice milk. I did not introduce nuts until she was 4, now I use mostly hazelnut or almond milk as the liquid base. I go by the food pyramid at mypyramid.gov to determine how much and what, then tweak it to meet Katy's needs. Katy is 6 years old, but is the size of a 2-3 year old, I use the food pyramid for an active 5 year old to account for her age and size together. Katy is very active and burns a lot of calories, very high metabolism. Her pyramid is 1600 calories and includes:

5oz of grains
2 cups of veggies
1.5 cups of fruits
2 cups of milk
5 oz of meat

I blend foods that taste good together, I always have, but now it is more important because she began eating her food by mouth, thickened with mashed potato flakes or wheat germ about 2 months ago. A days worth of food follows:

Breakfast
1 packet of cream of wheat made with 2/3 cup of milk sub
3/4 cup fruit
2 tblsp of honey
2 tblsp of nut butter
a little margarine(non-hydrogenated, dairy and soy free)
daily vitamin

snack
1/2 cup of veggies cooked with margarine with a little mashed potato flakes and some seasonings

lunch
1 packet of cream of rice made with 2/3 cup of milk
3/4 cup of fruit
2 tblsp of nut butter
a little margarine
2 tblsp of honey
vitmains and wheat germ as needed to thicken

snack
1/2 cup veggies cooked with margarine with mashed potato flakes to thicken with seasonings

dinner
5 oz of meat
1 cup of veggies cooked with margarine
2/3 cup of milk sub
1 tblsp of oil(usually an oil that has omega 3's)
wheat germ or mashed potato flakes

Katy also drinks water, fruit juice and milk subs through out the day, no soda pop for Katy because of her corn sensitvities.

Because Katy doesn't tolerate milk or soy, we use almond, hazelnut or some other milk sub. These milk subs lack the fat and protein of cows milk so that is the reason I use nuts or nut butter in my blend, they add the nutrition that the milk subs don't quite live up to. This is our goal plan and she rarely gets all those veggies in, but we are working on it. She eats much healthier than any other child her age because none of it is processed and sugar laden.

my blog address is
http://busiestmommyinamerica.blogspot.com

Jenny and Katy's food stuff

Darcy's Double blend

We make two blends, and we keep the milk blend separate so that it will settle
faster (milk adds a lot of froth!).

We prefer coconut milk over coconut oil because it doesn't make the blend as
thick. We use prune juice and nutritional yeast because it is extra calories and
iron without much fat.

For an 1800 calorie diet...

BLEND #1

1 1/2 c. prune juice
2 TB Flax meal
2 TB Nutritional Yeast
1/2 avocado
1 fried egg
1/2 c. cooked oatmeal
1 c. whole goat's milk yogurt
1/2 c. veggie
1/2 c. cooked beans
1/2 c. cooked brown rice OR brown rice millet bread
1/2 c. veggie
1 oz. meat
1/2. c. pasta, rice, quinoa, OR hot cereal mix
1/2 c. fruit or veggie
1/4 c. whole coconut milk
1 TB peanut butter or other nut butter
1/2 c. veggie 

BLEND #2

6 oz. of super goat's milk* w/ 1 TB Molasses and 1 TB Nutritional Yeast

*(Super goat's milk is made with 1 cup whole goat's milk and 2 scoops whole
powdered goat's milk)

Darcy's Double blend

Nathan's breakfast

Nathan's about 5 and takes his blends orally so taste is important.  As well as a variety of hearty soups and more 'regular' meals done up in the blender, Michelle S makes this for his fruit/breakfast blend:



16 oz frozen fruit (peaches are one of his favorite)
16 oz frozen fruit (pineapples are one of his favorite)
4-6 oz of another fruit that I'm trying to get him to like (strawberries,
blueberries, plums - thinking about grapefruit, whatever works for you)
1/2 cup of organic, gluten free oatmeal cooked
- cooked in 1 cup of rice milk
- 1 heaping tablespoon of coconut concentrate (for calories)

Blend that up - makes about 8 cups (I think), and I use it for a few days (3?
something like that).

Nathan's breakfast

Anna's recipe

Anna says this one's too thick for bolus gravity or pump feeding; she syringes it in.  Remember you can always thin blends out too.

for 1 litre (approx) of blend which is approx 1400-1500cals:

slightly less than 1/4 cup Organic Brown Rice Cereal (I cook 1/3 cup with 1 cup
of the goat milk add 2 eggs then halve it)
1 egg
2 cups of Goat Milk (cashew nut milk for lots more calories)
1/2 cup of mixed beans (organic pinto/lentil/chickpeas)
1/2 cup peas
1/2 cup mixed root veges (baked in skins then vitamixed)
1/4 cup blue berries
1/2 avocado
1/4 cup of other fruit (oranges/apples/prunes)
2 tsp Molasses
1.5 ounces of sesame and pumpkins seeds
1 tsp spirulina
1 Tbsp Flaxseed Oil
1 Tbsp honey
1 small tin sardines/tuna/salmon ( I alternate the fish and eggs, one or the
other)
2 Tbsp coconut cream
1/4 clove fresh garlic ( would do more but it makes for stinky smooches!!hehe)
slice of fresh ginger


I cook 1/3 cup of the cereal with 1 cup of the goat milk then add 2 eggs then
halve that mix for one day of blend.

Anna's recipe

Tina's basic blend

Tina and her dietitian worked out this basic guideline as a starting point for young June.  Tina no longer measures stuff, and she rotates her ingredients daily.


1and3/4 cup whole grain-cooked oats, rice, quinoa, or I and a half slices
of wheat bread

1 cup veggies- I use some fresh and some frozen to help keep the blend cold

1 cup fruit- fresh or frozen

2 oz. meat, fish, eggs, nuts, beans etc.

2 cups rice or soy milk

then every day I add a pinch of salt (unless one of my ingredients has it)
maple syrup or molasses, olive or grapeseed oil- about two tablespoons, and
sometimes coconut milk

So this is June's basic blend, she is 4 and a half and has fairly low caloric
needs. I use a vitamix to blend and make it fresh each day because I find it
works best for me that way.
One thing I have learned is to be careful to get a good mix of color with the
fruits and veggies. I was really into sweet potatoes and carrots and turned
June a bit orange for a bit. I was just so happy to be giving her food that
wasn't white.

Tina's basic blend