Efficacy and Tolerance of Blended Diets in Children Receiving Gastrostomy Feeds

BACKGROUND: To determine the prevalence of gastrointestinal (GI) symptoms in children receiving a blended diet via a gastrostomy tube. METHODS: This is a single-center, retrospective study of children ages 1-18 years that received a blended diet. We reviewed demographics, anthropometrics, clinical characteristics, and rationale for switching to blended diet. Fixed-effects logistic regression analysis was used to evaluate the changes in patient symptoms over the 12-month follow-up period, and fixed-effects regression was employed to test for changes in anthropometrics. RESULTS: Twenty-three patients (8 female, 15 male) were identified, and data from 89 outpatient visits were analyzed. The most common underlying diagnosis was neurological disorder. Thirty-five percent of patients received commercial whole cow milk formulas, 30% received hydrolysate formulas, and 35% received amino acid-based formulas. After formula switches were made, 65% received homemade blended diets, 17.5% received commercial blended diets, and 17.5% received a combination of both. Median duration of time on a blended diet was 17 months. Ninety-five percent of patients who were previously experiencing upper GI symptoms improved within the first 3 months after blended diet initiation. Twenty-one percent of patients developed mild constipation on the diet, which was managed with increased water intake and/or polyethylene glycol. Only 2 patients discontinued the blended diet, because of inadequate weight gain and worsening of upper GI symptoms. CONCLUSIONS: In our study population, blended diets were well tolerated in gastrostomy-fed children and were associated with clinical improvement of upper GI symptoms.