The Blended Diet Study: the perceived benefits and risk of using a blended diet with children and young people with complex health needs and enteral feeding requirements

Funder

National Institute for Health Research
Department of Health Palliative Care Funding

Total value of project

£266,935

Project team

Professor Jane Coad (PI), Dr Alex Toft, Nicky Thomas (nee Ashley), Dr Joseph Manning

Collaborators

South Warwickshire Foundation Trust (David Widdas, Specialist Consultant Nurse) and Professor Jane Coad and the Children and Families Research Team, CTEHR Coventry University

Duration of project

01/04/2015 - 31/07/2018

Project overview

With the growing number of children and young people with complex care needs or life-limiting conditions, alternative routes for nutrition have been established (such as gastrostomy feeding). The conditions of children and young people who require such feeding are diverse but could relate to problems with swallowing (dysphagia), digestive disorders or neurological/muscular disorders. However, the use of a blended diet as an alternative to prescribed formula feeds for children fed via a gastrostomy is a contentious issue for clinicians and researchers.

From a rapid review of the literature, we identify that current evidence falls into three categories: (1) those who feel that the use of a blended diet is unsafe and substandard; (2) those who see benefits of such a diet as an alternative in particular circumstances (eg, to reduce constipation) and (3) those who see merit in the blended diet but are cautious to proclaim potential benefits due to the lack of clinical research. There may be some benefits to using blended diets, although concerns around safety, nutrition and practical issues remain.

Project objectives

The use of a blended diet as an alternative to prescribed formula feeds is a contentious issue which has provoked strong opinion in research and amongst professionals. The overall aims of the report will be to examine the evidence for best practice with regards to providing a blended diet via gastronomy tube. Providing reliable evidence about blended diets will help to inform practice and policy makers but also demonstrate where knowledge is still lacking in order to guide future research.

• Impact statement

  The anticipated impact from this review are that the experiences and recommendations put forwards by professionals who have examined the use of blended diets and the experiences of families passionate about the advantages of blended diets will be heard and investigated. Findings will help to provide vital guidance for families and professionals in knowing the benefits and risks of using real food blended diets. Findings can also be used to inform policy, practice and further research into safely trialling and evaluating the blended diet with enterally fed children and young people and their families.

  There is also potential for longer term benefits from this review that extend beyond those that are reported, which include empowering families to be together for family mealtimes and improve feeding relationship which parents value so much. Results have found blended diet has been shown to be an effective means of improving short term symptoms and providing nutrition to children with feeding disorders. 

  This work has led to the submission of a large NIHR grant, increased collaboration nationally and we now have a full time PhD student within Children and Families Research whose PhD subject links closely with this work.

• Outputs

  S Durnan, A Toft, H Flaherty. 'It's Just Food, Blended': Exploring Parents' Experiences of Choosing Blended Diet for Their Tube-fed Child. Coventry University funded PhD.

  J Coad, A Toft, S Lapwood, J Manning, M Hunter, H Jenkins, C Sadlier et al., 2017. Blended foods for tube-fed children: a safe and realistic option? A rapid review of the evidence. Archives of disease in childhood 102 (3), 274-278