Monday, August 25, 2014

Blended Diet recipes

This is just a little update on the types of things we feed Elsie through her gtube. I feel like I've settled into the BD groove since starting out in February, and feel pretty comfortable and confident with the foods she gets. I've definitely learned a lot, through trial and error, and things have been going really well lately.

Since we discontinued her night time feeds, Elsie is able to tolerate a much higher volume of food than she used to. We also learned that if we give her breaks between ounces, then this also helps her tolerate more food. For example, at each meal, we feed her four ounces, give her a ten minute break, feed two more ounces, give another ten minute break, and then feed the last two ounces. She currently gets a total of eight ounces for each meal, which is huge compared to the five ounces that she used to get a few months ago. We have very little unexplained vomit now, which we used to have lots of problems with. Now, Elsie throws up for very specific reasons: she has gagged/choked on something, or she is crying too hard, or even sometimes when she laughs too hard. That's about it. It's really nice to know the reasons for her vomiting, instead of the "I have no idea why she puked", which used to happen so often and was so frustrating.

Anyway, I wanted to post some of the recipes that I use to feed Elsie. I try to go off of the guidelines on the "Choose my Plate" website as far as keeping her diet balanced. Of course, nobody's diet is perfect everyday, whether you are orally fed or tube fed, but we all try our best.

For Elsie's breakfasts, I made a "porridge" in my crock pot. I put in 1/2 cup ten grain cereal mix, 1/2 cup quinoa, 4 cups water, and 1 cup canned coconut milk. It cooks on low for 5-6 hours or until everything is soft and mushy and well-cooked. The coconut milk adds lots of great calories. I usually add some cinnamon, nutmeg, ginger, and ground cloves, just to make it smell nice, and because I can. Once it is cooked and cooled down, I blend the porridge in my Blendtec until it is smooth, and then freeze it in individual portions. Each morning, I mix together 4 oz of breakfast porridge with 2 oz mixed blended fruit, 2 oz milk, a liquid multi-vitamin, and a tablespoon of olive oil for essential fat and extra calories. Sometimes I'll add some yogurt. Some of the fruits I have used in her mixed fruits include but are not limited to: apricots, peaches, pears, apples, pineapple, kiwi, avocado, blueberries, strawberries, blackberries, raspberries, watermelon, cantaloupe, and mango. Pretty typical breakfast of cereal, fruit, and milk, huh?

For lunches and dinners, I make a "whole blend", which to me, means that it's a mixture of many foods which, when blended together make a nutritionally complete diet. It's kind of gross to some people when they see the things we have blended together, and I wouldn't recommend eating her food orally because they are unlikely food combinations, but it works for tubefeeding. For example, this is the "whole blend" that I made today:

1 cup milk
1 cup whole fat Greek yogurt
1/2 cup rolled oats
1 cup Honey Bunches of Oats with Almonds cereal
1 cup peaches canned in heavy syrup
1 cup spinach
1/2 cup frozen peas
1/2 cup summer squash, sauteed in butter, salt, and herbs
2.5 oz cooked ground beef
1 oz walnuts

So yeah, it smells kinda funky and looks ... unappetizing, but like I said, it works for tubefeeding. And it includes all of the recommended amounts on the government's website.

I generally use the same basic recipe for Elsie's whole blends, but rotate the foods that I use so that she gets a variety of foods in her diet. So a whole blend that I made a few days ago contains the same amount of milk and yogurt, but chicken instead of beef, and brown rice and multigrain bread instead of oats and cereal. The fruits and vegetables are also rotated. We've been using lots of squash and zucchini and apricots lately, as that is what has been bountiful in our family's gardens this summer, but also enjoy using sweet potatoes, carrots, green beans, swiss chard, bell peppers, collard greens (stinky but very nutritious), and frozen vegetable mixes, just to name a few. I add a few ounces of seeds or nuts to each blend to add nutritious fats and calories, such as sunflower seeds, pumpkin seeds, almonds, walnuts, cashews, and peanuts.

When we have a surplus of veggies or fruits that somebody has so kindly given to us, I freeze or preserve it to save for later. I have cooked and mashed up extra veggies, and then I freeze it in ice cube trays or in small size plastic containers. I froze apricot halves as well as pureed apricots in ice cube trays, and also preserved apricot puree in bottles. I'm definitely loving this summer's harvests and looking forward to more harvesting throughout the fall; I can't wait to get my hands on some fresh peaches and pears to freeze and preserve, as well as the apples growing on my trees outside. If anyone has an abundance of produce that they are wanting to share, we'd love to have some!

Before I go to bed each night, I give Elsie 4 ounces of fortified breast milk. I stopped pumping breast milk about a month ago, but have enough saved in my deep freeze to be able to feed it to her for several more months. We have also found that, while Elsie is not lactose intolerant, she does a lot better with goat milk than cow milk. Cow's milk made her constipated and seemed to aggravate her eczema. Goat milk is the closest in composition  to human breast milk, and is so much easier for little tummies to digest. It's also the most comparable to whole cow's milk in terms of fat and calories; cow milk alternatives like almond milk or soy milk generally have very low calories and are low-fat. I'm not anti-cow milk by any means, but Elsie has been doing great on goat's milk, so we will continue to use it as the base liquid for her blends.

Anyway, thanks for listening to my food rambles. I so enjoy making wholesome food to feed Elsie and thinking of new ingredients to add to her blends. It helps me to feel more like a typical mom who cooks for her family, which might seem kinda silly to you, but as the mother of a tube-fed child, anything that makes us feel more "normal" is a good thing.

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