FAQ Category: General

Any additions to Functional Formularies formulas should be cleared by your medical team.

It is our general approach to nutrition that foods should be nutrient dense in order to support health. Therefore, we highly recommend that foods added to our products be both nutrient dense and compatible with a patient’s physiology or ability to metabolize them.

We never recommend adding fruit juice or any refined sugars or sweeteners.  Many patients needing more fat or calories have had success using foods such as avocadoes or almond butter to increase the energy content as well as the percentage of calories from healthy fats.

Coconut butter and/or extra virgin coconut oil may also be excellent choices, but we suggest going slowly with their addition as they can rapidly change the viscosity of the formula and may also cause diarrhea if the amount added challenges the patient’s digestive capacity.

Most vegetables can work well as long as they are blended very thoroughly. Meats and/or poultry have been blended with Liquid Hope, but again, the extent to which they are liquified is critical.

One of the easiest additions to increase a patient’s protein levels, as well as adding beneficial flora, is to mix with a high-quality yogurt.  The yogurt, or kefir, should preferably be from goats, sheep, or grass-fed Guernsey or Jersey cows and should contain live cultures.  For those who tolerate dairy products, this may be both one of the easiest and most nutritionally rewarding additions. Redwood Hill Goat yogurt is a good example and is nationally distributed.

Functional Formularies products can be used with most pumps. We recommend using the formula at room temperature. If the products are cool at all, even by keeping them in an air-conditioned room, the product will thicken. You may consider running the unopened pouch under hot water for a minute or two to thin the products down if needed.

The pump takes longer to prime than with commercial formulas, and it needs to be primed until it begins flowing.

If you are mixing formula with added water, you will need to re-blend it in a blender to make sure that the product is emulsified and does not separate. Some caregivers that we have talked with have noticed that if more than one pouch is prepared and administered at a time, even with adding water and blending it, there may be some settling depending on the length of feeding time. We recommend only one pouch being prepared at a time.

Infinity pumps tend to work better with blenderized formulas compared to Joey pumps.

95% of our customers have no issue with our real foods formula especially when using a 60 cc no-ring syringe bolus (syringe) feed. If using a bolus, it may be necessary to use the syringe plunger. If your plunger has a rubber O-ring, these are nearly impossible to push down without a lot of force, a scenario some people mistake for our product not going through.

For further information, read our Administration Guidelines

Switch over slowly to allow the body time to adjust to real food (ie; fiber) again. Most patients start by replacing ½ to one serving of their current formula with Functional Formualries products, as tolerated, until a complete switch over is achieved. Most caregivers report transitioning over the course of 7-10 days. That is just a general guideline. Everyone is different, so the patient will need to be monitored.

Use clinical judgement to titrate. For recommendations, please check with your medical team.

The transition to Functional Formularies formulas typically produces favorable changes in an individual’s stool consistency, often referred to by clinicians as a Bristol Stool Score, from soft and diarrhea-like to more solid and/or normal. This was confirmed by a study at Baton Rouge General Hospital.  The primary investigator, Dr Tracee Short, observed that burn patients using Liquid Hope had better and more normal stool scores than those using commercial formulas.  This is largely a function of our products not having any added sugar and having greater compatibility with the patient’s microbiota.

On rare occasions, some patients transitioning to Functional Formularies temporarily experience mild bloating.  This is also a function of the individual’s microbiota receiving fermentable fiber for the first time since receiving enteral support. It is almost always only a temporary symptom, with bloating dissipating after 1-3 days.

For patients with a history of loose, watery stools and the associated issues such as malabsorption, there is usually an increase in those biomarkers associated with iron status.  Improved absorption of micronutrients is a common change in those switching to Functional Formularies.  Improved absorption combined with more effective protein digestion and metabolism is one reason why children with failure to thrive respond favorably to Nourish.