Blenderized diets consist of a wide range of table foods such as fruits, vegetables, meat and legumes, pureed in a blender and administered via gastrostomy tube. In a recent study, the investigators reported that children receiving blenderized feeds via gastrostomy had fewer total admissions and respiratory admissions, total emergency room visits, and improved gastrointestinal symptom scores compared to those fed formula. The goal of this project is to understand how these diets affect gastroesophageal reflux burden.
The investigators hypothesize that rates of gastroesophageal reflux will be lower in blenderized diets compared to formula. The investigators will determine if reflux burden as measured by multichannel intraluminal impedance/esophageal pH monitoring performed for clinical purposes differs between low viscosity conventional formula, medium viscosity commercial blenderized diet, and high viscosity commercial blenderized diet in 45 children receiving conventional formula via gastrostomy. All participants will receive each of the three test diets in random order in a 3-way crossover design. Results of gastric emptying scans will be recorded if done for clinical purposes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
SINGLE
Enrollment
45
Elecare Jr is a standard pediatric elemental formula
Nourish is a commercially prepared blenderized tube feed that is formulated for pediatric use
Real Foods Blends is a commercially prepared blenderized tube feed that is formulated for pediatric use
Boston Children's Hospital
Boston, Massachusetts, United States
RECRUITINGReflux episodes
Number of total reflux episodes (acid and non-acid) by impedance
Time frame: 4 hours (following feed)
Full column reflux episodes
Total number of full-column reflux episodes by impedance
Time frame: 4 hours (following feed)
Percent of time esophageal pH < 4
Percent of time esophageal pH \< 4 by impedance
Time frame: 4 hours after feed
Average height of refluxate
Average height of refluxate by impedance
Time frame: 4 hours after feed
Number of symptoms
Frequency of pulmonary and gastrointestinal symptoms from questionnaires during impedance
Time frame: 4 hours after feed
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