Our Guide on Enteral Feeding Supplies
Home enteral feeding doesn’t have to be daunting. With the help of specialist dietitians, we’ve collated a list of all the important and useful equipment you might need to support your tube feeding journey.
How you tube feed and your nutritional approach – whether that’s formula, blended, or a combination of the two – requires different types of equipment. But this list has you covered. If you’re unsure of any terminology, we have a tube feeding glossary for you to have a look at.
Something missing? Please contact us via talkingtubefeeding@uk.nestle.com.
Contributing experts: Annina Whipp, Specialist Paediatric Dietitian, & Clare Thornton-Wood, Specialist Paediatric Dietitian
Formula Feeding
Formula is a type of liquid nutrition, which contains all the nutrients a child needs for growth and maintenance. The key pieces of enteral feeding supplies for formula feeding are typically prescribed and provided by your GP, community nurse or feeding company.
Ready-to-hang formula
Feed container
Giving set
Syringes
Extension set
Sterile water
pH paper
Feeding pump
Feeding pump stand
Feeding pump backpack
Blended Diets
Blends are created from whole foods, which are blended to a smooth consistency so they can pass easily down a tube. Unlike formula, where most of the equipment is prescribed and provided by a hospital, blends are created yourself at home. This means you need to source several pieces of home enteral feeding equipment to get started.
Sourcing home enteral feeding equipment for blended diets can be an investment, you don’t have to use the most expensive ingredients. In fact, many of the blends can be made from food eaten by the rest of the family and supplemented with other foods to increase nutrients as required by the tube-fed child.
Consider asking your healthcare team if you need financial support, as they may be able to direct you to funding provided by local charities.
Syringes (60ml)
Extension set
Sterile water
Blender
Sieve
Kitchen scales
Airtight food containers
Cool bag with ice blocks
Freezer
(Prescribed by your GP)
Ready-to-hang feed is stored in bottles that can be attached to a pump, while powdered formula must be prepared as per the manufacturer’s instructions.
Your dietitian will recommend the best formula based on the child’s needs, and then advise your GP who will organise the prescription. This prescription is free of charge to you and will be ready to collect from your local pharmacy. Some feeding companies may also deliver the formula directly to your home, after your GP has arranged the prescription. This delivery option needs to be set up by your dietitian or community nurse.
(Prescribed by your community nurse)
If you’re making up powdered formula, your community nurse will provide you with a single use plastic container that allows for easy decanting of feeds and water. They come in either 500ml or 1,000ml sizes. Formula feed should only be kept at room temperature for 4 hours and any remaining feed should be discarded.
(Prescribed by your community nurse)
A giving set is a flexible tube that helps deliver feed. It is attached to the ready-to-hang feed or flexitainer containing the feed at one end and the feeding tube at the other end. A giving set should be changed every 24 hours or if you have had to change the bottle of feed.
(Prescribed by your community nurse)
Syringes can be used to administer feed, medication and water through the tube. While there are some single-use syringes, most are typically reusable and need to be washed in warm, soapy water after every use. Syringes should be replaced after seven days or thirty washes, although the frequency of replacement is down to local policy. To check what your local policy advises, speak to your community nurse.
(Prescribed by your community nurse)
An extension set is used if a child has a low-profile gastronomy device. Extension sets are plastic tubing that attach the low-profile button device to the feeding set. Extension sets are reusable and must be washed in warm, soapy water after every use. Typically, extension sets should be replaced every ten days, although the frequency of replacement is down to local policy. To check what your local policy advises, speak to your community nurse.
(Prescribed by your community nurse)
Water can be given through the tube using a syringe. It is essential for water to be flushed down the tube before and after feeds to reduce the risk of blockages. While some community nursing departments prescribe sterile water, most nurses advise using cool boiled water from home.
(Prescribed by your community nurse)
pH paper is used to test a child’s pH level before feeding via a nasal gastric tube (NGT). As an NGT carries food and medicine to the stomach through the nose, it’s important to check that the tube is in the correct position – and testing the pH confirms this. Check you always have an adequate level of pH paper available so you don’t run out, as you shouldn’t feed through an NGT without first testing the pH level.
(Provided by the feeding manufacturer)
Feeding pumps allow you to set the distribution rate and are used for bolus feeding or continuous feeding. Feeding pumps are loaned by the feeding company and usually returned after usage. Training on how to use a feeding pump is provided at home by nutrition nurses, who should be contacted if ever you need a replacement.
(Provided by the feeding manufacturer)
A feeding pump stand allows a child to be partially mobile while attached to a feeding pump. It is available to loan from a feeding company.
(Provided by the feeding manufacturer)
A feeding pump backpack allows a child to be mobile, as it has fitted compartments and pockets to easily hold the feeding pump in the bag while a child is at school or out and about. Feeding pump backpacks are provided by a feeding company, although other companies design bags with different designs such as Tubieego.
(Prescribed by your community nurse)
Syringes can be used to administer feed, medication and water through the tube. While there are some single-use syringes, most are typically reusable and need to be washed in warm, soapy water after every use. Syringes should be replaced after seven days or thirty washes, although the frequency of replacement is down to local policy. To check what your local policy advises, speak to your community nurse.
(Prescribed by your community nurse)
An extension set is used if a child has a low-profile gastronomy device. Extension sets are plastic tubing that attach the low-profile button device to the feeding set. Extension sets are reusable and must be washed in warm, soapy water after every use. Typically, extension sets should be replaced every ten days, although the frequency of replacement is down to local policy. To check what your local policy advises, speak to your community nurse.
(Prescribed by your community nurse)
Water can be given through the tube using a syringe. It is essential for water to be flushed down the tube before and after feeds to reduce the risk of blockages. While some community nursing departments prescribe sterile water, most nurses advise using cool boiled water from home.
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A blender is a crucial piece of equipment for a blended diet. A blender will crush the food into a custard-like consistency to pass easily through a tube. In the early stages of trialling a blended diet, consider purchasing a standard blender. Many families will invest in a more expensive commercial blender once a child will be having blended diets on a more long-term basis. However, you can create blends using a standard blender or even a stick blender, so this ‘upgrade’ is optional.
Information taken from BDA (The Association of UK Dietitians) Policy:
There are many different types and brands of blenders available to purchase*. The choice depends on the size and power of the motor and cost.
- This type of blender can blend a greater variety of foods e.g. fruit, vegetables and seeds. They are also a good option for batch blending. However, they are often very expensive to buy.
- These blenders are considered easy to use and clean. They are often smaller than the commercial blenders and therefore are unable to blend such large quantity of food in one go. Therefore, they are ideal for blending each meal separately and for smaller volumes.
- This blender can cope with soft-cooked foods or pre-pureed foods (e.g. yoghurts, baby foods etc.) but not with all fruits, vegetables and seeds. A sieve may be needed to ensure the blend is lump free (if using a sieve, a metal sieve with holes of 1mm or less diameter is ideal as it is easy to clean). These blenders are considered ideal for blending each meal separately and for smaller volumes.
Commercial blenders (e.g. Vitamix®, Omniblend®, BlendTec®)
Mid-Range (e.g. NutriBullet®, Nutri Ninja®)
Basic jug / stick blenders
[*Disclaimer: Annina Whipp, Clare Thornton-Wood and other dietitians remain impartial to branded blenders.]
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When preparing blends, most foods need to be sieved. This is to ensure all small particles are removed and to reduce the risk of tube blockage. It’s particularly important for foods containing seeds and pips.
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When making the blends, you need to ensure the child is receiving all their nutrients in the right volumes. This is where a kitchen scale and measuring jug comes in handy, to help measure the foods.
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Airtight food containers store blends safely and can be used to transport blends in ready-to-feed form, such as for school or travelling out and about. These can be purchased from a local shop or supermarket.
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When transporting blended food, a cool bag with ice blocks is an essential way to keep the blends at a safe temperature. Consider purchasing a thermometer to check the internal temperature of the bag before serving the feed, for extra security.
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It’s important to ensure you have enough kitchen counter space and appliances, such as a fridge, freezer, microwave and oven, to prepare, heat and store blends safely. Freezers (and of course freezer space) and freezer-safe containers are particularly helpful if you plan to prepare and freeze your blends in bulk in advance.
When preparing blended diets, you should keep track of all the ingredients through a food diary. This helps your dietitian analyse the child’s nutritional intake. Remember to also watch out for tube feeding intolerance symptoms, which you can read about with our guide.
You also need recipes to create blends! See our range of tube feeding recipes – they’re designed for blended diets and are highly nutritious.