G-tubes, PediaSure®, and Pureed Whole Foods

By July 8, 2014 Nutrition

Please be sure you have already read my post Is there a natural alternative to PediaSure®?

G-tubes have saved hundreds of thousands of lives, my niece Keara included.

Heres 13-year-old Keara

Here’s healthy Keara!

Keara is now 13 years old and was born with Down Syndrome. Several months after she was born, she had to have emergency surgery for duodenal atresia.

This is a GI issue that is not uncommon for babies with Down Syndrome. After surgery she needed a G-tube for many months. She could not take in enough calories by mouth to allow her to grow and thrive.

I was in medical school at the time and while I didn’t yet have the medical background to understand the complexity of her medical case, my sisterly antennae resonated with the anxiety and stress that her mother, Karen, experienced. 

Feeding Keara through a G-tube was probably the most traumatic thing I have ever done because it was so foreign at first. But once I got used to it – ’twas not so scary. ~My sister, Karen

Breastfeeding when kids have a G-tube

Karen was committed to breastfeeding her precious baby, but her milk supply was low, which meant she had to give Keara formula through her tube. For a mother who successfully breastfed three older children, this was difficult to say the least. 

Karen also did not want a formula based on cow’s milk, but Keara vomited the soy formula she tried, so cow’s milk base it was. At that time, my sister did not know there were any other alternatives.

Always follow your intuition when it comes to your child’s health

The good news is, once Keara was stronger, she was able to take formula or breast milk from a bottle. However, my sister wanted to breastfeed. And despite every doctor and nurse telling her that Keara could not breastfeed due to her low muscle tone, my sister knew in her heart of hearts that she in fact could.

And of course Keara ended up breastfeeding like a champ. To this day she is one of the healthiest little kiddos I know. I do think this is in part due to my sister’s tenacity in giving Keara the benefits of breast milk and the oral/motor muscular benefits of breastfeeding (not to mention the emotional bonding!) 

G-tubes are not always permanent

Eventually Keara’s tube was removed, but it was a long road and not without many bumps. Some people only need G-tubes for several months, like Keara, while others require them for a lifetime. 

I thank God regularly (as does the rest of my family) for modern medicine that saved her life. And although this blog is on whole food nutrition through G-tubes, I would like to acknowledge that standard formulas have been a part of saving hundreds of thousands of lives. I am glad I live in this modern age where my niece is still alive thanks to these formulations. 

The complexity of G-tube nourishment

Doctor with stethoscopeSo now that I’m an integrative pediatrician and have looked at G-tube feeds through three different lenses at three different points in my life (as an aunt, then as a traditionally-trained doctor, an now as an integrative doctor trained in nutrition); I have an entirely different approach to these kids than I did when Keara was born. 

There are many variables to take into consideration when formulating diets for babies and children: 

  • Providing adequate nutrients and calories for proper growth 
  • Packing this nutrient dense liquid into a relatively small volume so the child does not vomit when receiving it as an infusion or bolus
  • Maintaining the integrity of the lining of the gastrointestinal system  
  • Keeping the formula of a consistency that will not clog the tube
  • Making sure the child is getting the correct nutrient and calorie balance for brain growth, body growth, and development
  • Kids with certain conditions have higher caloric needs and may need more or less of certain nutrients (i.e. kids with kidney disease often have to be very careful about their sodium and potassium intake). 

I recently tried creating a whole food pureed recipe that could act as a natural replacement for one of the specially designed commercial formulas and now I have to chuckle at my ambition. There are so many variables to take into consideration, it makes your head spin. 

Blenderizing

Preparing smoothies with fruit and yogurtWhile I was doing my research, I came across a new movement called blenderizing (yes, this is a word; it is the present participle of blenderize). 

Moms of kids with G-tubes have begun making their own formulas. I love that they are being proactive, educating themselves to know that a “real food” diet is far better for the body than synthetic substitutes and doing what they feel is best for their kids. 

Here is a brief excerpt from a mother’s post about blenderizing.

Once she was on the full homemade purees she stopped vomiting almost entirely within the week…Her digestion was regular and she seemed to have an immediate boost in energy. We were hooked and have never gone back. It is a little more work and we are busy people so there are days that we still use canned formula. It’s important to do what is right for you.

A little further on down the post she also states. “Being a bit of an idealist the way I see it is that I would never feed my other children “PediaSure®” just because it’s easier to pop a can so why would I do that for my child who needs good nutrition the most?”

And I couldn’t agree more. 

Natural foods are always better for healing than processed foods

So I am here to be the mouthpiece of the medical community to say there is another way to nourish children with G-tubes besides synthetic formulas!

In addition to homemade blenderizing, there is also a new whole-food based, organic formula on the market called Liquid Hope. This company was in R & D for eight years. Over the past 16 months, Robin tells me, they just continuously have to increase production to keep up with  demand.People have realized the health benefits of whole food plant based nutrition for individuals with G-tubes and they are gobbling it up. 

Look at these fantastic ingredients:

Ingredients of Liquid Hope 

Filtered waterLiquid Hope label

Organic garbanzo beans

Organic green peas

Organic carrots

Organic whole grain brown rice

Organic whole grain brown rice protein

Organic flax and borage oil

Organic sprouted quinoa

Organic sweet potato

Organic broccoli

Organic almond butter

Organic kale

Vitamin blend [Potassium citrate, calcium citrate, acerola (Vitamin C), Vitamin E, niacinamide, cholecalciferol (Vitamin D3), zinc citrate, seleium methionine, pyridoxine hydrochloride (Vitamin B6), thiamine mononitrate (Vitamin B1), riboflavin (Vitamin B2), methylcobalamin (Vitamin B12)]

Organic garlic

Organic turmeric

Organic rosemary

Organic ginger

Organic wakame (seaweed)

Allergens: Contains almonds

NUTRITIONALLY COMPLETE – REAL FOOD

DAIRY FREE

SOY FREE

CORN FREE

GLUTEN FREE

NON GE (GENETICALLY ENGINEERED)

PBA FREE

Liquid Hope does not have a children’s formula yet but it is in the works. And the truth of the matter is, there would be little difference between the adult and children’s formula other than the calorie content per serving and some variation in certain nutrients. 

Robin Gentry McGee, Founder & CEO of Liquid Hope

Melissa giving Liquid Hope thru her husband’s G-Tube

I was able to speak by telephone with the founder and CEO of Liquid Hope, Robin Gentry McGee. She has an amazing story about how dramatically her father’s health improved once she switched off of synthetic based formulas and onto real, blended foods. 

I wish I could write an entire post on Robin (and perhaps I will one day). She has an incredible personal story and has written a book, A Turn for the Worst: Traumatic Brain Injury and a Daughter’s Search for Answers.

Former NFL Player Steve Smith on Liquid Hope

Robin shared with me several other cases including that of former NFL player Steve Smith. He has ALS (usually known as Lou Gehrig’s Disease) and a G-tube. Once he switched from a synthetic formula toLiquid Hope, his blood sugars normalized, his abdominal weight lessened, his skin began to glow with better tone, color, and elasticity, and his eyes now have the “light” back in them.

Look at his skin in this picture! 

Improved vitality on real food nutrition

homemade baby carrot foodSomething similar happened with one of my patients who has a G-tube. She became a brighter more energetic and clear little person when her mother was able to switch her from a commercially based formula to pureed foods. With children however, it is sometimes difficult to maintain their weight so it is critical that they are being followed by a knowledgeable, pediatric trained, Registered Dietician who also has training in whole food nutrition. 

Using Liquid Hope as a base for your child’s G-tube nutrition

Even though Liquid Hope is formulated for adults, many children are using it as a base. The families then work with a Registered Dietician to add things like coconut oil for the individual caloric and nutrient needs of that child. 

So if your child is on a standard formula, I would strongly recommend looking into adding at least some whole pureed foods into their diet by “blenderizing foods at home” or using Liquid Hope. 

How to look for a Registered Dietician with training in whole food nutrition

This combination of training is not easy to find. I am attaching three websites here that educate professionals on whole food nutrition. When looking for a Registered Dietician to help you, be sure to ask them if they are knowledgeable about whole food nutrition.

Physicians Committee for Responsible MedicineLogo for PCRM.org

Institute for Integrative Nutrition

The Center for Mind-Body Medicine

The inflammatory effect of dairy and gluten

Dairy Free Rubber Stamp One the things I like the most about Liquid Hope is that it is dairy- and gluten-free. These two foods are very inflammatory and can contribute to many common issues like: acid reflux, eczema, keratosis pillars (bumps on the back of the arms, cheeks or buttocks), chronic runny nose, recurrent ear infections, stomachaches, constipation or loose stools, allergies, and asthma. 

So if your child with a G-tube suffers from any of these conditions, I highly recommend you consider removing gluten and dairy from their diet.

To read more about the pro-inflammatory effects of dairy read this post.

If your child is on a medication remove pro-inflammatory foods

Gluten Free Rubber StampKids with G-tubes also tend to be on a whole host of medications including: antacids, laxatives, anti-histamines, and breathing treatments. 

The inflammatory effects of dairy and gluten in combination with synthetic nutrients keeps the GI system inflamed and can cause many of the issues I listed above. 

Whole food, plant-based diet is best

Almost without fail in my practice, I recommend a whole food predominantly plant-based diet that is dairy- and gluten-free when kids have the above symptoms, whether they have a G-tube or not.

Keara sticks the landing!

And here, Keara “sticks the landing”

Special thanks to Health Coach Tracey Fox for her input on this post.

Other resources

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Sign up for my online course. My course, “7 Steps to Healthy Kids and Happy Moms” will help you understand which foods and supplements are best for your child, too.  Details here. 

References:

  • The China Study by T Collin Campbell, Thomas M Campbell II, Howard Lyman, John Robbins
  • The Coconut Oil Miracle by Bruce Fife, CN, ND
  • Life Force – Superior Health and Longevity by Brian R Clement, Phd, NMD, LNC
  • Nsouli et al. The Role of Food Allergy in Serous Otitis Media. Annals of Allergy 1994;73(3):215-219.
  • Host A, Halken S. In: Pediatric Allergy: Principles and Practice. Mosby-Year Book, Inc; 2003:488-494.  
  • Australasian Society of Clinical Immunology and Allergy. Adverse reactions to food. Available at:  http://www.allergy.org.au/aer/infobulletins/adverse_reactions.htm.Sicherer SH.
  • Pediatrics. 2003;111:1609-1616.

Join the discussion One Comment

  • Autumn says:

    I just don’t know how to make this all work for my son who is a post g-tube patient. He had his tube removed 2yrs ago and hasn’t grown much since so the GI Dr. just put him back on Pediasure. We took him to a holistic Dr. who said pediasure wasn’t working well with his body. He loves the taste but often gags after drinking it because it’s very thick and milk based. I guess my question is how do I afford to make this change OR what change should be made first? He is already on a GF diet and we try to eat more whole foods and less processed foods.
    Thanks