Administration Guidelines

The formulas that we have developed at Functional Formularies are created out of whole food ingredients. Our formulas do not contain any added chemicals, preservatives or emulsifiers and as a result, the viscosity can vary.

TEMPERATURE: One of the factors that can change the viscosity of the formula is temperature. The temperature of the formula is integral to their successful use as cooler temperatures will thicken the viscosity of the formula.

It is essential that the formula is at room temperature or a bit warmer in order to ensure that the formula is at its ideal viscosity. If  stored in a room that is cool or cold, the formula will thicken making it more difficult to administer. We recommend warming a pouch of formula in a bowl of warm water prior to administration to bring it back to room temperature.

BLENDING: It is best to ensure that the formula is thoroughly shaken or blended prior to use. If mixing the formula with anything, including water, the formula will need to be re-emulsified using a blender or another mechanical method, especially if using a feeding pump. If you choose to add water or other ingredients to the formula, please ensure that the added components are at room temperature or warmer to prevent thickening of the formula.

ADMINISTRATION: All of our formulas were created to be delivered either via a pump, gravity feeding bag or a bolus syringe.  When using the various methods, the following tips should be considered.

Feeding Tube Pump
  • Either an Infinity Pump or a Kangaroo Joey Pump can be used.
  • Follow temperature guidelines by ensuring that the formula is at room temperature or warmer.
  • Priming takes longer with blended whole food formulas than with synthetic formulas. It may be necessary to hold down the manual priming button until droplets appear.
  • Formula will accurately run at the desired rate, but please note that the priming will go slower.
  • The hang time for our formula is 12 hours.

  • When using a gravity bag, a “large bore gravity bag” works best due to the thicker viscosity of whole food formula.
  • Follow temperature guidelines by ensuring that the formula is at room temperature or warmer.
  • Ensure the clamp on the large bore tubing is fully open.
  • To prime the bag, squeeze formula in the bag until droplets appear at the end of the tip. This will allow formula to start dripping down the tubing.

  • For bolus syringe feedings, you may need to use a plunger. Some of our thinner products (such as our peptide options) can successfully be delivered by gravity syringe, other products may need the plunger. Be sure not to plunge the formula down the syringe too quickly.
  • Follow temperature guidelines by ensuring that the formula is at room temperature or warmer.
  • Try to extend formula delivery to mimic the length of an oral meal (20-45 minutes).

  • The reusable tube feeding pouches such as the Bolee® Bag & Bolink® Large Cap system work well with whole food formulas.
  • Follow temperature guidelines by ensuring that the formula is at room temperature or warmer.
  • Ensure the clamp on the Bolink Large Cap is open when feeding.
  • Squeeze the bag to control the delivery rate if warranted.
  • Check out this administration video for a step-by-step guide on how to use Functional Formularies products with the Bolee® Bag & Bolink® Large Cap system.

Our formulas can be used for all tube types including G-tubes, NG tubes, low profile buttons, and J-tubes. Our formulas can be delivered through tubes which are the following tube sizes:

  • Liquid Hope: 8 French Tubes and Larger
  • Nourish: 8 French Tubes and Larger
  • Liquid Hope Peptide: 8 French Tubes and Larger
  • Nourish Peptide: 8 French Tubes and Larger
  • Keto Peptide: 8 French Tubes and larger

  • Shake pouch for 15-30 seconds prior to administering the formula.
  • If adding water, use water that is room temperature or slightly warm. The addition of water and amount of water needed throughout the day must be determined by a patient’s medical provider.
  • Adding water to infuse the formulas is not a necessary requirement, but some providers may make this recommendation. If additional water is needed to infuse our blended formulas, we recommend starting with 30 mL (1 fl. oz) of water per pouch and increasing as needed.
  • Ensure that added water is mixed well with the formula by shaking, stirring, or blending the formula to allow water to emulsify with the formula and to prevent separation during the delivery infusion process. 

SHELF LIFE: Functional Formularies formulas have a shelf-life of up to 2 years,  as long as the product is stored and handled properly at ambient temperatures of 60º to 70º degrees Fahrenheit.

If the product is exposed to higher temperatures (75-100º+) for short periods of time, this will NOT negatively affect the nutritional values. Nutritional values will begin to be affected and have the potential to decrease over time if the products are stored at high heat for extended periods of time (6-12+ months).

If the product is frozen, the nutritional value remains intact. When thawing, the product should be stored at room temperature and allowed to thaw naturally before using. If you need a pouch of formula right away, we recommend that you thaw the unopened pouch by gently placing it in a warm bath of water until the formula is brought up to room temperature.

Weight vs. Volume

  • Although commercial enteral formulas are measured in volume, our blended formulas are liquified foods. Food is best weighed in grams. Each pouch is 341 grams with the exception of Keto Peptide which is 227 grams.
  • The USDA requires that food labels include a volume measurement. Each pouch of our formula is 12 ounces when manufactured, with the exception of Keto which is 8 ounces

Note: Due to temperature changes from manufacturer to use, volume contraction may occur and volume may be slightly less when poured. As long as the entire pouch is utilized, the patient will receive all macro and micronutrients stated on the label.

Transitioning to a whole food, blended formula:

  • To assure tolerance and assist the GI tract in adjusting to any new formula, we feel it is important to transition from a synthetic formula to a whole food blended formula over a period of time.
  • The transition time needed will vary between individuals and be based on previous formula, age and healthcare status.
  • A transition schedule and plan should be determined by a patient’s medical provider.

 

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