Choice of Enteral Tube Feed

Enteral feed is a sterile, specifically designed nutritional liquid that is licensed to be administered via an enteral feeding tube. It is often nutritionally complete in specified volumes. There are a wide variety of different ‘feeds’ available from a range of manufacturers to meet patients individual requirements. They also come in different volumes and presentations (e.g. bottle or pack).

In order to determine which enteral feed is best suited to a patient; the dietitian will undertake a rigorous assessment of nutritional status and current clinical condition. The prescription of the feed is tailored to meet individual needs based on a persons’ specific nutritional requirements and the goals of the intervention. See Nutritional Assessment section for further information.

There are a wide variety of feeds available for use at the dietitians’ clinical discretion. Most commercial feeds available provide 1-2 kcal/ml, with or without fibre. Feeds can be broken down broadly into three categories:

  • Polymeric (whole protein): these contain protein in the form in which it is normally within the diet i.e. as whole protein.
  • Pre-digested (peptide/semi-elemental/elemental): these contain protein as smaller molecules i.e. short peptides, or free amino acids. Carbohydrate provides the majority of energy and the remaining proportion will be provided from fat as long or medium chain triglycerides where the ratio is variable based on preparation. The pre-digestion of components aims to improve nutrient absorption in the presence of malabsorption.
  • Disease specific or immune enhancing feeds: these are special formulations for patients with organ failure, which often have nutrients that can modify the immune system.