BAPEN and the British Dietetic Association (BDA) have launched comprehensive new guidance to support professionals working with tube-fed children, young people and adults who are considering or using blended diet.

Presented today at BAPEN Conference in Bournemouth by Dr Sarah Durnan, the 2026 Practice Toolkit marks an important evolution in blended diet guidance, reflecting a growing evidence base and the need for practical, consistent support across the life course.

The new Toolkit has been developed through a programme of work including a review of literature published since 2020, surveys of UK professionals and tube-fed people and their families, four practitioner roundtables and case studies. It replaces the previous 2021 Practice Toolkit and 2019 Position Statement.

A central principle of the new guidance is a move towards more proactive conversations about choice. The Toolkit states that professionals should make tube-fed people aware that blended diet is an available option and support them through shared decision-making to consider whether it is appropriate for their individual needs and circumstances.

Findings informing the guidance underline the importance of this approach. Only 18% of families surveyed first heard about blended diet from a healthcare professional, compared with 45% who heard about it from other families and 41% who found information online. More than three quarters (76%) reported being self-taught in giving blends through a feeding tube, while only 48% of professionals surveyed felt confident supporting blended diet.

“This Toolkit represents an important step forward in how we support choice in enteral nutrition. Blended diet is already part of life for many tube-fed people and their families, and our role as professionals is to make sure both those already using blended diet and those who may be considering it can have informed conversations about the options available to them, with the right support to make choices that work for their individual needs and circumstances,” said Dr Jane Fletcher, President of BAPEN.

“Importantly, this edition reflects how practice is evolving across the life course, supporting children and young people as well as adults, including those moving from paediatric into adult services. By bringing the latest evidence together with practical guidance and real-world experience, we hope the Toolkit will help build confidence across the multidisciplinary team and support more consistent, person-centred care wherever people are receiving their nutrition.”

For the first time, the Toolkit explicitly addresses adult as well as paediatric services, while providing practical guidance across shared decision-making, nutrition and hydration, food safety, equipment, administration and monitoring. It also considers how blended diet can be supported beyond the home, including in schools, respite care and hospitals.

The Practice Toolkit is accompanied by practical resources to support implementation and a Position Statement setting out evidence and actions for commissioners, employers and care providers.

This edition was funded by the British Dietetic Association, through its Paediatric and Parenteral and Enteral Nutrition Specialist Groups, and BAPEN, through its British Enteral Therapy Alliance Special Interest Group and Parenteral and Enteral Nutrition Specialist Group, which is as a core group.