Skip to content

Understanding Complex Nutritional Needs

“Food is love, and for children with medical complexities, food and nutrition comes in many forms.” says Pediatric Home Service Clinical Nutrition Manager, Maria Mahady. 

There are roughly 400,000 children with medical complexities in the United States. Tube feeding is a very common method of delivering nutrition in this population.  There are hundreds of medical conditions that lead to a dependence on feeding tubes. Many of those conditions are not always visually apparent and as a result can create or add to social stigmas and feelings of isolation.  

Feeding tubes can be a lifesaving mechanism to provide children that are unable to meet their needs by mouth the required nutrition for growth and development. In order to provide these children a sense of normalcy and support, it’s important for everyone to be aware of this alternate method of receiving nutrition. The message for all should be that feeding tubes are simply another way to eat. They are not weird. They are remarkable. 

What’s on the menu? 

There are over 100 commercially prepared formulas that are commonly used as part of nutrition plans or as sole sources of nutrition. Health care providers and dietitians work closely with their patients to determine which type of formula will meet each individual’s specific nutrition needs.  

One of the primary ways to define the different types of formula is by the structure of the protein. Using this method, there are three different categories of formulas: standard, semi-elemental, and elemental. 

Standard formulas are primarily intended for children who can absorb and digest completely intact proteins, as you would find in the average diet, without difficulty.  

Semi-elemental formulas contain partially broken-down protein which provides the digestive system aid and may enhance tolerance and therefore absorption. 

Elemental formulas contain completely broken-down protein (called amino acids) for those children who have difficulty with digestion, absorption, or have allergies. 

What about whole foods? 

There is a place for everything and there are children who are successfully able to receive whole food formula blends. There are some who use a combination of whole food blends and another formula product because it better meets their specific nutrient needs or they tolerate it better than using all whole food formula blends. 

Whole food formula blends can be very beneficial for some children but it is important to note that some cannot tolerate whole foods even when they are blended. No matter what type of formula is being received, children on tube feedings are still able to be a part of and enjoy mealtime with their families. 

For tips on how best to serve whole food formulas visit PHS at  

Where to begin? 

Start with the experts. Dietitians are adept at looking at the big picture to help find the solutions to not only meet nutrition goals but also find best practices to fit these goals into individual lifestyles and schedules. At PHS, dietitians are an integral part of the care team. They work with healthcare providers, home care nurses and families to tailor a plan for each patient’s unique nutritional needs. 



Originally published: March 9, 2020

Leave a Comment