A comprehensive new practice toolkit has been launched to support health, education and care professionals working with tube-fed children, young people and adults who are considering or using blended diet.
Developed collaboratively by the British Dietetic Association (BDA) and BAPEN, the toolkit is designed for dietitians, nurses, carers, education staff, respite providers and the wider multidisciplinary team, providing practical, evidence-based guidance to support informed choice and person-centred care.
Blended diet uses ordinary food and drink, blended to a suitable consistency, through an enteral feeding tube. It can provide all or part of a person's nutrition and can also be used alongside commercial formula.
A key message from the new guidance is that blended diet should be offered as a feeding option as part of shared decision-making, rather than professionals waiting for tube-fed people or families to raise it themselves. In the patient and public engagement survey informing the guidance, only 18% of families 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.
Evidence has also developed since the previous toolkit. Larger studies published since 2021 have found no increase in infection, tube blockage or hospital visits compared with commercial formula. Tube-fed people and families have reported benefits including fewer gastrointestinal symptoms and improvements to everyday and family life, although the guidance recognises that experiences and outcomes vary.
For the first time, the toolkit explicitly discusses blended diet in adult services as well as paediatric practice. This reflects both children using blended diet transitioning into adult services and adults themselves increasingly initiating conversations about blended diet as a tube-feeding option.
The guidance also aims to address gaps in access to professional support. More than three quarters (76%) of surveyed families reported being self-taught in giving blends through a feeding tube, while only 48% of surveyed professionals felt confident supporting blended diet.
The updated toolkit provides guidance for professionals across health, education and care settings, covering shared decision-making, nutrition and hydration, food safety, equipment, administration and monitoring. It also outlines how blended diet can be supported beyond the home, including in schools, respite care and hospitals.
The toolkit includes resources to support implementation and is accompanied by a position statement setting out the evidence and actions for commissioners, employers and care providers.
The guidance recognises that blended diet will not be the right choice for everyone. Commercial formula remains a wholly legitimate option and some people may choose a combination of blended diet and commercial formula, changing the balance as their needs and circumstances change.
Explore the new blended diet Practice Toolkit and supporting resources.
