Understanding the Categories of Enteral Feeding Formulas
There is such a thing as too many choices! I have suffered from decision paralysis on many an occasion. When it comes to enteral feeding there are A LOT of choices. In this article, we are going to group those choices into a few different categories in hopes of aiding your decisions about what formula is best for your situation.
Before we start let's get a quick understanding of enteral feeding. Enteral or Tube feeding is used in a variety of areas. It can be used short term in the case of admittance to the ICU or post surgery; or it can be used as a long term, life saving solution for many people. In short, tube feeding is utilized in situations where a person’s digestive system is working fine but for some reason they are not able to intake nutrients orally (by eating and swallowing).
While different brands of formula vary in ingredients, caloric content (typically between 1.0 and 2.0 kcal/ml), hydration level, etc; it is important to note that they are all composed of carbohydrates, proteins, fats, vitamins, minerals and water to ensure a complete nutritional intake by the person receiving the formula.
But how do we try to make sense of the differences? Here is a simple classification system to help you understand the differences between feeding formulas.
- Standard + Fibre
- (Semi) Elemental
Standard Formulas contain a ‘normal’ mix of carbohydrates, protein, fats and micronutrients. Unless otherwise indicated this is the formula type that most people would choose for their enteral feeding needs as they will provide a balanced healthy nutritional intake.
Standard + Fibre Formulas
As the name suggests, Standard + Fibre Formulas are the same as standard formulas with the addition of fibre. The addition of fibre will help with any diarrhea or bowel irregularities.
An example of a standard formula + fibre is Jevity 1.5 with fibre.
(Semi) Elemental Formulas
Semi-Elemental and Elemental Formulas are also known as peptide formulas, hydrolysed formulas or predigested formulas. These formulas have proteins and fats that are pre-broken down to simple forms in order to make them easier to digest and absorb by one’s gut. These formulas are used for people with mal-absorption concerns.
An example of a (semi) elemental formula is Peptamen® 1.5 Peptide Based Formula.
Blenderized is a growing trend within the tube feeding world. These formulas are most closely related to standard formulas but are all or mostly composed of whole foods. As the name suggests the whole foods are blended into a liquid. Some brands of blenderized formulas state benefits such as less chemicals and/or the use of organics foods.
There are far more formulas designed for specific medical conditions and circumstances. This may include diabetes, renal failure, liver dysfunctions, COPD, injury recovery, low weight and malnutrition. This category can obviously be divided into smaller and smaller categories but to keep this article short and sweet, we will bulk these formulas into one category.
A simple example of one of these formulas is TwoCal HN, which has a higher than normal caloric content.
To wrap things up, choosing an enteral formula will be based on your unique situation and needs. Factors to consider are not only your basic nutrition needs but also your physical requirements, gastrointestinal function, medical history, metabolic abnormalities, overall medical condition, and most importantly your lifestyle and health goals. Before starting or changing your feeding formula be sure to always consult with a qualified member of your healthcare team to help provide an accurate assessment of your unique needs.
- Choosing the Right Enteral Nutrition Formula - Ashley DePriest, MS, RD, LD, CNSC https://youtu.be/d1FwKBq92Hg
- Categories of Adult Enteral Nutrition Formulas https://youtu.be/Wb_3rcMD0V4
- Importance of good nutrition https://www.nestlehealthscience.ca/en/mytubefeedingadult/nutrition-and-formulas
- Enteral Tube Nutrition: https://www.merckmanuals.com/professional/nutritional-disorders/nutritional-support/enteral-tube-nutrition
- Enteral Nutrition Overview and Formula Selection Considerations: https://dietitiansondemand.com/enteral-nutrition-overview-formula-selection-considerations/
- EN Adult Formulas: https://www.nutritioncare.org/Guidelines_and_Clinical_Resources/EN_Formula_Guide/EN_Adult_Formulas/