Dr. Stillman's tube-feeding formula

I just had to make this up for a patient

Two people asked me about tube feeding formulas in the last week. What are the odds? Not a single person has asked me about tube feeds since I left the hospital.

I recommend this product. I have no affiliation with them, haven't tested it personally, and haven't used it clinically, but it is what I would buy if it were myself or a family member who needed it.

However, a patient couldn't get this product in-hand for a whole week. Rather than leave them in limbo, I decided to create a quick and simple tube feeding replacement.

Here it is. This isn't medical advice, this may not be right for you, and you should discuss any and all tube feedings with your doctor or healthcare provider, because you likely have unique nutritional needs that I can't possibly imagine as I write this post. I am also no expert in tube feeding - I am just a general internist.

Combine the following:

1. Blackstrap molasses, 1 tsp

2. Essential amino acids, 10-12 grams of protein total (this varies by product)

3. MCT oil, 1 tsp

4. Coconut water, unsweetened and unfortified, 1 cup

5. One dash of salt (0.4 grams)

This should make a little over 8 fluid ounces. It should be free of any debris or particulate. If it isn't, you can always rig a tube feeding system with a filter.

This yields:

• 135 calories

• 10-12 grams protein

• 10 grams carbohydrates

• 5 grams fat

• Approximately one third of calories from protein, fat, and carbohydrates each

• Plenty of minerals and vitamins

To reach the nutritional requirements of an inactive adult, you might need ten or more servings of this in a single day.

Here are a few important caveats about nutritional restrictions:

• To reach the nutritional requirements of an active adult, you might need fifteen or more servings of this per day

• You’ll get plenty of water with this and therefore may not need any additional free water, but you need to check with your doctor or dietician about this

• If you are on a 2 liter fluid restriction, this would be 8 servings

• If you're on a 2 gram or less sodium restriction, this would be less than 10 servings (you could omit or reduce the salt in that case)

• If you're on a potassium restricted diet (less than 3 grams per day), this would be 5 servings or so

I would make this fresh daily and refrigerate between administrations. I am not sure about hang-time. I would give as a bolus, I would warm it to body temperature, and I would flush the tube with warm water afterward to make sure everything has cleared the tube.

Let me know if this is helpful in the comments. This is probably more of a niche problem, but you never know when you're going to need something like this in your back pocket.

Until next time, be well,

Dr. Stillman