Gastrointestinal Considerations When Thickening Feeds Orally and Enterally

Thickened oral and enteral nutritionOral and enteral feedsnutrition are treatments frequently used for management of both gastroesophageal refluxGastroesophageal reflux and oropharyngeal dysphagiaOropharyngeal dysphagia with aspiration in the pediatric aerodigestive population. There are a variety of thickening options available to patients including use of commercial thickeners, food-based thickeners, or naturally thickened formula such as blenderized tube feeds. Important considerations for thickened oral feeds and enteral feeds include determining a safe and appropriate thickened liquid consistency, method of delivery, type of thickener, changes in stooling, family access to thickeners recommended, exposure to other elements such as heavy metals, and caloric, macro- and micronutrient contributions. If blenderized tube feeding is used as a tool to provide thickened enteral feeds, there are a wide scope of nutrition considerations given these formulas may also make up most, or all, of a patient’s nutritional intake. This chapter will review evidence for efficacy, risks and benefits, and the importance of multidisciplinary collaboration with team members, including pediatric feeding therapists and registered dietitians, when thickening both oral and enteral feeds.