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 in any way, the formula will thicken thus making it more difficult to administer. If this is the case, 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 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 conventional formulas. Be sure to prime the pump until droplets appear.
  • The hang time for our formula is 12 hours.
  • Formula will accurately run at the desired rate. (Note: expect priming rate to be slower)

  • When using a gravity bag, a “large bore gravity bag” works best due to the thicker viscosity of whole food formula.
  • Follow temperature guidelines.
  • Ensure the clamp on the large bore tubing is fully open.
  • Squeeze the formula in the gravity bag to allow formula to start dripping down the tubing.

  • If a Syringe is used for bolus feeding, the plunger for the syringe must be used. The formula will not move through the syringe by gravity. Be careful not to plunge the formula down the syringe too quickly.
  • Follow temperature guidelines.
  • Use a plunger and slowly push the formula down the syringe. 
  • Consider delivering the formula slowly and if possible, deliver to mimic the length of an oral meal, ~20-45 minutes.

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 from there.
  • 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 iis 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 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

  • It is important to transition from a commercial formula to blended formulas over a period of time, typically, 5-10 days. Please use clinical judgement, but titration typically starts with ½ to a full pouch over the first 1-3 days. Increase by a half to full pouch thereafter.

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