Dwellness • Enteral Recipe Components

Enteral Recipe Components

Dwellness customization for:

Your Patient

[NOTE: All routines and schedules are flexible. Carefully observe your patient’s condition before and during feeding.]
[NOTE: Many aspects of your patient’s care may be flexible, but this depends on your powers of observation. When you are with your patient, keep your senses focused on any signal your patient gives that might indicate how your patient feels and how your patient's internal systems are functioning. Over time, you will learn how to respond with different approaches to your patient's care that maximize your patient's comfort, safety, and health.]


General ideas for enteral diet
  • All organic, non-GMO, and lactose-free
  • Emphasize deep-colored fruits and vegetables for antioxidant properties
  • Always consider the cells’ micro-environment
  • Give at least one type of probiotic food every day
    • Best results
      • Give three different types of probiotic foods each day
      • Give one probiotic food with each meal (not snacks)

→ CAUTION: Never give warm or hot water from the tap. If you are using warm or hot water — like for tea — heat the filtered water in the microwave. ←



Grains, seeds, and nuts
  • Rice

    Cooking the rice

    1. Measure 2 cups rice into a sieve
    2. Rinse the rice thoroughly under cold water
    3. Put the rice into the cooker
      • Add 4 cups water
      • Add 2-3 Tbsp organic, extra-virgin olive oil
      • Add a dash of salt
    4. Set the cooker and press Start
      • Brown rice
      • White rice
    5. Do not open the lid while it's cooking
    6. Watch for when the bubbles are just above the surface of the rice
      • The rice is done approximately 4-5 minutes after this
    7. Turn off the cooker and remove the pan
    8. Immediately stir the rice and place in a sealed storage container
  • Heritage Flakes cereal (http://us.naturespath.com/product/heritager-flakes)
Fruits
  • Apple, pear, plums, other woody fruits
  • Banana
  • Cherries, strawberries, blueberries
  • Oranges, other citrus
  • Kiwi, papaya, mango, other tropical fruits
Greens

[NOTE: Use baby greens, which will blend to a consistency that prevents clogging of the tube. Mature greens are too fibrous.]

  • Lacinato (Dinosaur) kale, red kale, kale, etc.
  • Red chard, rainbow chard, etc.
  • Spinach
  • Other deep colored greens
Protein
  • Yogurt (lactose-free)
  • Kefir (lactose-free)
  • Protein powder
    • Be sure to find one you trust
      • Check accuracy of the actual amino acids content
      • Whey protein powder repairs damaged muscles
  • Animal protein
    • Chicken
    • Pork
    • Fish
    • Sometimes beef
Fats

It's crucial to get adequate fats, which must be high-quality and mostly unsaturated. Use approx. 3 Tbsp of organic, extra virgin olive oil in cooking the rice. Separately, I recommend two Tbsp of organic walnut oil.

Probiotics

[NOTE: See yogurt and kefir, above. Cultured cheeses, especially blue, Gorgonzola, etc. are also good probiotics. Cultured vegetables such as slaws are an excellent probiotic boost. Kombucha is a helpful culture also. Use Miso when possible.]
[NOTE: Give at least one type of probiotic food every day. Much better to give at least three portions of the total, across the day’s schedule.]

  • With breakfast, lunch, or dinner each day give one of these choices
    • 60mL of Kefir
    • 60mL of Yogurt
    • 1 Tbsp of Miso dissolved in warm, filtered water (warm in the microwave)
    • ½ cup of Kombucha
    • 2 Tbsp crumbled Blue cheese or Gorgonzola
    • ¼ cup cultured slaw
  • An optional way of giving probiotics, especially Blue cheese and Slaw
    1. Using the normal blend of food, measure out what’s needed for the meal in a cup
    2. Put the food mixture and one portion of probiotics in the "Goodful" single-serve blender cup
    3. Process until the mixture is smooth enough for the G-tube

[NOTE: Be sure that there are no excess air bubbles in the syringes before you give the meal.]

Liquid base
  • Nestlé Nutren 2.0 (very concentrated caloric intake — by prescription)
  • Liquid Hope
  • Cow milk (lactose-free), oat milk, or other milk substitute

[NOTE: Do not use soy milk. It causes gas for your patient.]

Intake
  • Fluid/beverage intake
    • 1400mL total free water daily, including with meals and snacks
  • Enteral nutrition intake (See also: Enteral Schedule and Method)
    • 3 meals/day
      • Each meal is 300-360 ml/meal
      • Plus one portion of a probiotic food
    • 2 snacks/day
      • 120−180 ml/snack
Enteral recipe template

→ CAUTION: Do not use dairy products that have lactose. Use only lactose-free dairy products. ←


[NOTE: Provides nutrition for one typical day.]

Add to blender in this order:

  • Vitamin B complex, one capsule
  • 1½ cup organic, lactose-free milk or oat milk
  • 375ml (1½ carton) Nestlé Nutren 2.0
  • 341g (1 pouch) Functional Formularies Liquid Hope
  • 1 large, organic banana
  • 1½ cups organic, cooked rice
    • Cook with 3-4 Tbsp organic, extra virgin olive oil
    • Always include rice, but options are…
      • Brown rice under normal circumstances
      • White rice when there is diarrhea or very loose stool
        • For loose stool or diarrhea, add 1 cup organic applesauce
  • 60-80g organic baby spinach, baby kale, or other deep-green vegetable
  • 2 scoops whey protein powder
    • ...or one scoop powder + 60-100g cooked meat of your choice
    • See list of meats above
  • 1½ cup whole Heritage Flakes (pulverize separately in spice blender after measuring)
  • 1 medium organic orange, or 6-10 organic strawberries for vitamin C (optional)
  • 1 organic apple, pear, mango, or papaya (optional)
Blender

[NOTE: Best results are with a Vitamix Ascent Series (model A3500 or newer), programmed to actually liquify almost anything, including a raw, whole carrot so it moves through the g-tube.]
[NOTE: The air that is worked into the mixture by the blender needs to be removed before feeding. Excess air can cause stomach pain and discomfort. After the smoothie cycle finishes, remove the air bubbles by taking the container off the blender body and using a whisk to stir the mixture. Keep the whisk under the surface and move it gently so it disturbs the air and forms bubbles, which then rise to the surface. You can release the bubbles on the surface by holding the container with two hands and tapping it on the counter.]


HPCA Input

Dwellness input from HPCA and family caregivers can serve to improve the ongoing support system. Feel free to speak up!