Enteral Feeding Formula:
The provision of enteral nutrition support requires the proper assessment of the nutritional status. Assessments for biochemistry, diet history, anthropometry, and clinical need to be performed by a dietitian. The primary aim of nutritional assessments is for the determination of the nutritional requirements of the patient and for the provision of a basic measure for observing the effectiveness of the intervention on the patient.
The following details provide you with information about the above-required criteria,
While choosing a tube feed formula, an osmolality value of about 300 to 500 Osm/kg is considered to be iso-osmolar. This means that the concentration of blood solutes is approximately equal to that of the formula. As the theory goes, this optimizes the formula absorption as higher osmolality can stop the emptying of the stomach. A formula which is hyperosmolar when delivered to the stomach leads to the triggering of the gut to secrete additional fluids to dilute the formula to a comfortable osmolality which causes diarrhea. However, in practice, such results are not experienced by patients, and also concern about foods and medications having higher osmolality is rarely raised even though they have much higher osmolality than tube foods. Further, feed osmolality becomes quite relevant if it is to be fed directly into the small intestine or if the intestinal absorptive capacity of the patient is very limited as in the cases of intestinal failure. It is mandated to avoid hyperosmolar fluids, foods, medications and enteral formulae in such cases.
Nutritionally complete formulations
A nutritionally complete formula is described as one which can be used as the sole source of nutrition for an individual. This implies that it must essentially have all the necessary nutrients in a defined volume. However, it is to be noted that some products having complete nutrition have a high RDI volume. Further, for an average patient, the necessary amount of formula can be very high which exceeds the energy requirements of the patient.
The Enteral Feeding Formula adequately providing the required and necessary amounts of all the essential micronutrients is known as the RDI volume. The micronutrients include vitamins, minerals, and trace elements.
About 20% of the volume of the enteral feeding formulae consist of solids, and the remaining 70-80% is water. The solids are mostly not used by the body. It is necessary that the actual water content of the formula is used for the accurate calculation of the fluid being fed and not the total volume of the formula being given. The above is to be considered when noting the fluid restrictions or the fluid requirements of the patient.
There are a variety of specialty formulations available with qualities apart from the above. These include the formulae specifically designed for people suffering from diabetes or respiratory disorders and wound healing formulae, branch chained supplements containing amino acids, low energy formulae, and low sodium formulae are among many others. It is to be noted that in many cases, their benefit is quite limited and it is to be reviewed critically for the assessment of the feasibility of the formula on an individual patient.
Enteral Feeding Formula is non-recommended that home-made tube feeding formulae are used because of the fact they are very time to consume to prepare, and it is also hard to determine whether such formulae have adequateness of nutrition. Further, formulae made with a blender from whole foods are likely to cause the deterioration of the tube and the blockage of the tube, and also they are not nutritionally complete posing a very high risk of contamination due to bacteria. Therefore, vigilant attention is required on food safety and the risks and disadvantages need to be noted meticulously. It is to be noted that infant formula is a very reasonable substitute when enteral formulas are not available, and also carries very less risk.