Product exposure to heat and freezing temperatures
Functional Formularies Liquid Hope and Nourish are designed to have a shelf-life of up to 2 years from the date they are cased based upon how the product is stored and handled over the time period. Under guidelines of our research laboratories, if Liquid Hope and Nourish are stored and handled properly at ambient temperatures of 60º to 70º degrees Fahrenheit the maximim shelf-life of 2 years is within the maximum time frame for use.
Is it OK for Liquid Hope/Nourish to sit outside in the heat for short periods of time? YES! Exposure to higher heats (75-100º+) for short periods of time will not negatively affect the nutritional values. The only time the nutritional values will begin to be affected is if the products are stored at high heat for extended periods of time (6-12+ months). If exposed to high heat for an extended period, the nutrient value may be decreased over time.
My Liquid Hope/Nourish was delivered and sat outside in freezing temperatures and is frozen. Is it OK to use? YES! When Robin was making Liquid Hope for her father she would make a weeks worth of food for him in advance and freeze it. Then she would pull out a portion to thaw as needed.
Freezing can be a very good way to preserve the nutritional value, texture and flavor of many foods. As long as the food was grown in a high-quality way (for example, organically grown) the overall nutrient retention in a frozen food will remain high. In other words, the vitamins and minerals will keep well when food is frozen.
If you do find that your Liquid Hope/Nourish has been frozen just store at ambient room temperature and it will thaw naturally. If you need a pouch right away, please thaw unopened pouch gently. If you find that your product has been frozen, the product may separate a bit. The product is still perfectly good to use, just shake thoughly or reblend in a blender to re-emulsify.
What if my shipment/package is damaged?
If you receive ANY units of Liquid Hope or Nourish that appear to be bloated, damaged or leaking to any degree, please contact us immediately at 937-433-4673 / Toll FREE: 1.844.631.8365 and/or send an email to firstname.lastname@example.org. Do not open, consume or wash any product that appears to be damaged. Though rare, damage may happen during shipping; under those circumstances, and with sufficient proof of damage, your product will be replaced by either your Durable Medical Equipment Company or Functional Formularies.
Liquid Hope: LHWS124
Canadian Liquid Hope: LH224CA
How many ounces are in each pouch of Liquid Hope and Nourish? Why are there variables in ML from pouch to pouch?
By law, we are required to list the "ounces" and "grams," which are measures of weight, not measures of volume, on the food label. Because the formula is made from real food, its density can vary and, as such, so can the volume of the formula in each pouch. Rest assured, each pouch of Liquid Hope and Nourish contains 341 grams as measured on a gram scale.
This is a confusing subject for most but first I will tell you that all nutritional as stated on our website and packaging is correct, it is calculated and tested per pouch and the most accurate measure is 341 grams which is what our manufacturers use as gauge of measurement and what their scales are set to. Any below is rejected.
The conversation of weight is complex one due to the fact that our product, per food labeling laws, has to show 12 oz on the label. However, our products are not fluid ounces as most people expect, due to the viscosity. A glass measuring cup or syringe with ounce measurements is designed to only fluid ounces. Our product due to not being "fluid" or thin as water will only show 10 ounces.
We have done our best to offer accurate ML measures as a courtesy knowing that RDs are used to working with this measuring system.
Why are there variables in ML from pouch to pouch?
When it comes to measuring solids and liquids, weight (gram) is generally considered as more accurate than volume (Ml). This is because the weight of a substance on Earth will remain constant even if its surrounding condition changes (e.g. if it gets hotter or colder). On the other hand, the amount of space (volume) occupied by a substance – especially if it is a liquid – can be affected by things like changes in temperature without the substance changing its form (i.e. whilst remaining a liquid still).
Does insurance cover Liquid Hope and Nourish?
YES! Liquid Hope and Nourish is covered by Medicare and Medicaid. We have an insurance specialist on staff, free of charge, to help those using Liquid Hope and Nourish with the insurance and Medicare approval process. We are the first organic enternal formula to be approved by Medicare. The Medicare billing code for Liquid Hope and Nourish is: B4149 — Blenderized Natural Foods with Intact Nutrients.
Liquid Hope: Insurance Data Bank & Billing Code: 57858-0004-11**
Nourish: Insurance Data Bank & Billing Code: 57858-0004-12**
** Medicare, Medicaid and health insurers may ask you to provide a National Drug Code / NDC number for insurance claims, billing or reimbursement purposes. Because our products are whole foods and do not constitute "drugs", we have an Insurance Data Bank and Billing Code that you should use when asked for an NDC number for our products.
Are there any variations in consistency with a real food product?
Liquid Hope and Nourish undergo regular nutritional assessment and lab testing. However, as with all real food products, the nutrient levels may vary a bit due to growing season, soil, and weather conditions. If you have a specific medical condition that requires you to be exact with certain nutrient levels, please discuss the use of this product with your medical team.
Is this safe?
What the medical profession has forgotten for the most part is that feeding tube formulas used to be prepared from real food and used to be the standard of care in hospitals and long term care facilities. It was only after having conversations with various medical professionals who remembered and understood this did I feel safe in setting out to make my formula and bring it to market. Liquid Hope and Nourish meet all food safety requirements and meet all GRAS, HACCP, and CGMP standards. Liquid Hope and Nourish are produced in an FDA/USDA registered facility with a USDA inspector on site. They undergo thorough testing before they are released from the manufacturer. They are both shelf-stable, require no refrigeration, and have a two year shelf life. After eight years of extensive research and development, we believe we finally have the perfect real foods formulas that are a true meal replacement and can be someone's sole source of nutrition.
What is the hang time?
Both Liquid Hope and Nourish are approved for 12 hour hang time!
Functional Formularies recently tested both the adult and pediatric enteral formulas for microbial activity and there was zero microbial activity after a 12 hour hang time test (conducted at room temperature). This is a 3-fold increase in the hang time that was last tested (4 hrs). The increase is simply a function of the company carrying out an extended duration microbial test and is not the result of any changes to either formula.
Has this been tested?
Yes, Liquid Hope and Nourish have been tested extensively in the lab, as well as with many customers over the course of its development. We launched our shelf-stable Liquid Hope formula in January 2013. Since the launch of Liquid Hope, the market has changed considerably. There are now thousands of people using Liquid Hope and hundreds of health care practitioners recommending it.
Both Liquid Hope and Nourish should work with any pump although if possible, we feel that a bolus feed using a syringe at regular meal times works best for everyone. With the syringe, you will always need to use the plunger by gently applying pressure to push the food in to the feeding tube.
If mixing the products with anything, including water, you will need to use a blender to make sure the product is emulsified, especially with using a pump.
If the products are cool at all, even by keeping in an air conditioned room, the product will thicken. You may run the unopened pouch under hot water for a minute or two to thin the products down if needed.
95% of our customers have no issue with our real foods formula especially when using a 60 cc no-ring syringe bolus (syringe) feed or a large bore gravity bag. Also, you might be interested in the Jofas Clamp. The Jofas is a 24" flexible arm that holds a 60cc syringe tube for nasal gastric (NG) and gastric (G) gravity feeding systems. One end of the flexible arm has a clip that holds the syringe up to 24" high. The opposite end has a C-Clamp that attaches to any flat surface up to 2" thick.
So why organic?
I remember many years ago, when I first started in the food business, it seemed pesticides were the only thing I had to be worried about. For that reason alone, I made the decision to use only organics, both personally and for my customers. Fast-forward years later, with many more things to be concerned about most all of GMOs, I still would never sacrifice quality for cost. I feel that my customers understand how deep and serious the issues are with our food supply, and they are willing to spend a little more to get quality ingredients.
Are there other products like this on the market?
There are a lot of products out there, some labeling themselves as real food and/or organic. These companies are using either a lot of sugars, oils, or a very limited ingredient profile that creates more of a supplement than a true meal replacement. Even though I have whole-foods nutrition in my background as well as being a chef, it still took eight years of research and development to get this formula to the point where I felt comfortable we had a product that would actually help people — one that could be used as a sole source of nutrition. With 16 different whole-food ingredients put together in a way to keep high nutritionals, yet be thin enough to flow through a feeding tube, it was no small feat. But we did it!
Can I afford an organic whole foods enteral formula?
At just $7.99 per serving, we have decided to put our customers before our bottom-line and have purposefully priced Liquid Hope and Nourish to be available to people of all means. Also, consider this: How much would you be spending per meal if you or your loved one were still able to eat by mouth? What would the quality be? If you were making it yourself, how much time and money would you be spending on getting the ingredients and putting together the meals?
Why don't you use fruit or free sugar of any kind in your blends?
In our experience and vast amount of research, we believe sugar contributes to many of the disease processes. Because we work with a large number of folks who have compromised immune systems, are at risk for infections, have cancers, etc., we have made a very strong effort to provide the best nutritional support humanly possible. To this end, we consciously avoided the use of sugar in Liquid Hope and Nourish. If we would have chosen to use the sugar from fruits — as well as other ingredients many suppliers are using to get their seemingly adequate nutritional profile — it would have made us just like everybody else … and in our opinion, less healthy. Sometimes you have to look beyond the numbers on the label to understand whether you're getting the best possible combination of ingredients for your real, whole food tube feedings.
So what did I do?
I set out to create better meals for my father, and make them in a way he could have them. I wanted him to have real, whole food tube feedings — not chemicals and sugar. First, I had to run this idea by many people, including a doctor who I had enlisted to oversee the process of creating a better liquid diet for my dad. Then, I began to look at all of the issues my dad had begun to experience as a result from the brain injury. This led me to research the concept of "food as medicine" and "functional foods." I found an amazing book, "Healing with Whole Foods," by the brilliant Paul Pitchford. With the help of Paul and some other inspiring minds, Liquid Hope was created!
Why the name?
Six weeks after starting my father on this formula, his health was definitely improving, whether it was by way of modern medicine, the grace of God, or anything in between — so much so that his doctor phoned to tell me it was "a miracle." My reply? "No, not a miracle. Simply nutrition." This was the first real glimmer of hope we'd had in a very long time, so my family began to refer to this real, organic whole food feeding tube formula as Liquid Hope.
Has the medical community responded to your efforts?
Yes, and the response has been resoundingly positive. Some examples: LIQUID HOPE:
"Functional Formularies product is exactly the sort of formula that I have long looked, and hoped for. It offers the kind of positive experience - of both good nutrition and active participation in promoting one's own health - that all of us need, particularly when we're at our most vulnerable." ~ James S. Gordon, M.D. Founder and Director of The Center for Mind-Body Medicine and Food as Medicine conference.
"Wow this product is AWESOME!!! As an exercise specialist with over 20 years of professional experience I have never encountered a nutritional product quite like Liquid Hope. Simply put - it's perfect and I can not wait to introduce Liquid Hope to all my clients." Brad Thorpe RTSm, MATCS Creator of the Isometric Training System
"Finally, a formula that delivers the healing power of nutrition from organic, whole foods. This is the "food as medicine" nutrition support product that patients have been hungry for!" ~ Kathie Madonna Swift, MS, RDN, LDN, FAND Swift Nutrition Recently named by Today's Dietitian as one of the top Registered Dietitians in the country who are "making a difference".
"As consumers become more savvy about true, whole foods nutrition, they balk upon reading the ingredient list of common hospital-based meal replacement formulas. Yours fills the void nicely!" ~ Jeanne M. Wallace, PhD, CNC Nutritional Solutions Widely regarded as one of the nation's most prominent experts in nutritional oncology.
"I cannot overstate what I feel to be the need for such a whole foods based product and I predict that once it is available, many, many physicians and other healthcare providers will jump for joy at the prospect of being able to offer their patients HOPE and a truly healthy option." ~ Kristine Noonan RN CHHC Board Certified Health Counselor Honor & Hope Wellness Center
"I have been working with people who have cancer for the last 13 years and been a nurse for over 30 years. I have been searching for a "whole food" based, nutrient dense formula to recommend to my patients my entire career! Liquid Hope is truly an answer to this prayer. There is NOTHING out there that is suitable for human consumption. Those products are filled with chemicals and sugar, which PROMOTE disease. People need "food" to assist the body's innate quest to heal, strengthen the immune system, and support that process. It truly does give HOPE!" ~ Laurie McCracken, RN, OCN, HHC
"Thank you for thinking outside the box and developing products to help folks who are ill." ~ Jean Schmidt United States Congress
"We are very excited that Nourish is finally on the market. Blenderized foods are a benefit for patients who have intolerances or are allergic to certain ingredients in standard enteral formulas. It is also a quality-of-life issue as some of the patients prefer natural, organic, and real foods. In addition, in our experience, tube-fed children especially experienced better GI tolerance, health, and well-being when using blenderized foods. Nourish, Functional Formularies' new commercially available blenderized tube feeding formula, will alleviate a risk of inadequate or unbalanced nutritional intake, microbial contamination, and tube clogging when compared to blends made at home." ~ Yuliya Rekhtman, MD Associate Professor Chief Pediatric Gastroenterology and Nutrition Georgetown University Hospital
"Whole, nutritious, real foods should be a part of everyone’s diet, including and especially for children with feeding tubes. Just because someone has a feeding tube does not mean they need to be succumbed to solely eating formula with added sugar and other unwanted additives day in and day out. You try drinking those conventional formulas for the rest of your life! I am elated that there is finally a ready-to-feed formula out there for children, made from all real foods, is nutritionally complete, and with no added sugar, juice, or unwanted additives. As a dietitian providing blenderized formulas for children, I have seen the benefits of real food in a child’s growth, bowel function, skin and hair health, and overall nutrition status. I cannot wait to recommend Nourish to my patients!" ~ Robyn Felten MS, RD, LDN, CNSC Medical Advisory Board - Functional Formularies
What's been some of the response you've gotten from consumers who've used Liquid Hope and Nourish?
Someone will be available to take your calls Monday - Friday 9-5pm, EST (excluding major U.S. holidays). Your call is very important to us, so if you receive a recording please leave us a message with your name and number and we will return your call within 24 hours. We can also be reached by email.
Due to the nature of our product we cannot return the item to stock. After Liquid Hope leaves our facility we can not control how it is stored or cared for. We would never ship previously sold formulas to customers and we feel that you would not want us to. We would recommend donating your unopened Liquid Hope to someone else who could benefit from it or using it to make a great protein shake for yourself. Replacement of damaged goods on a per case basis.