Integrated & Community Services - Blended Diet Feed Care Plan

Name:

DOB:

NHS:

Gastrostomy Type:

Diameter: Fr _____ Length (Button): _____ cm

Volume of water in balloon (ml): _____

Problem: Needs nutrition via gastrostomy/button

Goal: To maintain nutrition, comfort and safety

Actions

• Blended foods should be administered with a syringe, using small slow pushes if it does not flow by gravity. PUMP Feeding is NOT recommended
• A 60ml enteral feeding syringe should be used. Remove air bubbles by pushing the plunger just enough for the blend to reach the tip of the syringe, before attaching it to the gastrostomy. If using the push technique, pause every 5-20ml. The blend should be able to be given easily, without having to use force
• The bolus size will vary with age, volume, tolerance, and symptoms
• The duration of the feed might be similar in length to a meal if eaten orally, but this is a guide and depends on individual tolerance
• Follow the enteral feeding regime provided by the Dietitian and refer to “Blended diet via gastrostomy- Shared decision- making document” and “Blended Diet for Enteral Feeds” leaflet

How to feed

1. Collect liquid/blended food, cooled boiled water, or tap water and any other equipment, such as 60ml syringe and extension set
2. Wash your hands. Apply gloves if appropriate (ie. care agency staff policy may call for this)
3. Sit the child/person upright, or their upper body should be at least positioned at a 30 to 45-degree angle, in appropriate seating
4. Dilute blended food to appropriate consistency (IDDSI level between 1-3) if it has thickened up, since originally prepared
5. If the gastrostomy is a button – attach the extension set and prime with cooled freshly boiled water or freshly drawn tap water (depending on what is stated on the feeding regime)
6. Draw up 60mls of feed. Remove air bubbles by pushing the plunger just enough for the blend to reach the tip of the syringe, before attaching it to the gastrostomy tube/ extension set
7. Exert small gentle pressure on syringe plunger, making sure the blend will go through the syringe doing a test first and then give the amount directed on the feeding regime
8. Administer into the gastrostomy at roughly 1ml per second by gentle push on syringe plunger. Tip: Use the ml markers on the syringe barrel – one second per ml. Pause every 5-20ml
9. Repeat until all the blend is finished
10. Depending on the number of boluses a break may be needed with a small water flush to clear tube and reduce risk of blockages. For example, a water flush between each 60-120ml blended food
11. When the blend is finished flush with the amount of water stated on the feeding regime (at least 5-10ml)