Henry's Homemade Formula

Our journey towards adding "real" foods into Henry's Homemade Blended G-Tube Formula

Unclogging an Entralite Infinity feeding bag… a required skill for using homemade foods!

When using homemade food with a feeding pump, clogs and “error” messages are a fact of life.  There isn’t a week gone by that we haven’t been plagued by them.  Some days are better than others, and we’ll have a clog-free streak sometimes, but they always return.  When we first started getting repeated error messages, I thought I was doing something wrong either blending the food or using the pump.  I’ve come to realize that error messages are just a fact of life when using homemade formulas, and while they can be minimized, they can never be banished forever.

As this post contains lots of information, here’s an outline of what’s to come:

  • What is an error message?
  • A (very) short course on how the pump works
  • Some locations & causes of clogs
  • Hints & tips on the location of clogs and how to avoid them…
  • Hints & tips on the causes of clogs & how to resolve them…
  • Final thoughts

What is an error message…?

An error message occurs when the pump believes food is either not flowing into the pump (from the food bag) or out of the pump (to Henry).  There are two sensors that monitor the flow of the food.  They are there for some very good reasons, such as to stop the pump if there is no food – without this function the pump would continue pumping air into a person’s stomach after the food is gone. 

(Note to users: in our experience, the “no food” function does not always work when using homemade formulas.  Because the food is so thick, the tubing gets coated and the sensors don’t always realize there is no food left and only air is being pumped.  Careful monitoring is a must!)

Error messages can occur for some very valid reasons (like the food not flowing due to a clog in the tubing), but they can also occur when there is no apparent problem.  The Infinity pump is calibrated for use with commercial formulas (as most are).  Homemade food (or expressed breastmilk, like we used to use) is a very different consistency and the pump doesn’t know how to monitor this. Thus, we will sometimes get errors when there is no problem.

A (very) short course on how the pump works…

Before we go any farther, it’s important to know a bit about how a feeding pump works, in order to understand how clogs occur.  Here is a photo of the inner mechanism of the pump:

The tubing wraps tightly around the black roller on the left, and it is this roller that moves the food through the tube.  It turns at a pre-programmed rate, depending how fast we have set the pump.

Here is a photo of the tubing inserted into the pump.  It’s hard to notice, but you can see the clear tubing coming down from the bag (hanging above), turning a teal colour as it enters into the pump, wrapping around the black roller and exiting just below where it entered.

Some locations & causes of clogs…

So… with these basics of how a feeding pump works in mind, clogs ca occur at different places along the route the food travels from the food bag to Henry’s tummy:

  • at the bottom of the food bag, where the food enters the tubing (although this is rare);
  • where the tubing wraps around the roller;
  • at the “flow out” sensor, located just after the black roller (very common!)
  • in Henry’s button (not very common, but can be very hard to unclog)

Clogs can also be caused by many factors, some more controllable than others:

  • lumps or grit in the food;
  • poorly blended food that is not smooth enough;
  • food that is well blended, but too thick;
  • air bubbles in the food;
  • food, hair or other particles on the pump’s sensors.

Hints & tips on the location of clogs and how to avoid them… (aka my hubby the engineer…!)

One day when we were having error message after error message and Shawn & I were at the end of our wits – Shawn decided to cut apart the tubing of the food bag so he could try to figure out what was going wrong.  We’d tried everything else we could think of!  Here are some photos of what the tubing looks like – the section that is inserted into the feeding pump.

You can see on the”lower” side of the photos, how the tubing is sticking out, so to speak.  This tubing would normally overlap the clear plastic part beside it.  Shawn pulled it off to look inside.

If you look closely, in this last photo (below) you can see a blue toothpick sticking out the side of the clean plastic section on the bottom side.  Ah ha… this was the culprit!  Not the toothpick, but the teeny weeny hole the toothpick is stuck in!

We had always thought the entire length of the tubing was a consistent diameter – not so.  Where the teal rubber section attaches to the clear plastic section, the two sections of tube do not attach one “on top of” the other.  Instead,  there is a small horizontal hole the food must pass through.  Picture two sections of garden hose being screwed together – instead of the water flowing freely from one hose to the other, instead there is a cross section blocking the way and the water must flow through a small opening to get through.

So… if there is any amount of grit, food particles or other fibrous bits that have management to get this far along the tube, they will be stuck here and eventually block the flow of food enough to cause an error message.  The problem is… even very, very, very tiny pieces get stuck – so food that could pass through Henry’s button just fine, clogs the tubing.

From what I know the pump manufactures designed it this way so that thin liquids won’t flow freely through the tubing.  By having this sideways opening, the tubing rests tight against the wholes preventing liquid from flowing past unless it is either (1) under pressure from the pump or (2) the tubing is manually “clamped” using your fingers or a clip.  By manually squeezing the tubing this released the tubing and allows liquid to flow freely past.   But for us… what a horrible design!  This is the root of most of our troubles!

Other areas that clogs can occur are…

  • in the teal tubing as it stretches about the black roller.  This is usually pretty easy to clear by taking the tubing out the pump and massaging the area.
  • at the bottom of the bag, where the food enters the tubing.  This is rare and can be cleared just by massaging the area and/or putting hot water through the bag.  Usually this doesn’t actually get clogs, it’s just hard to clean afterwards.
  • at Henry’s button.  This is also rare, but can also be more difficult to clear.  Using a small syringe (10 or 5 ml) and the extension tube, warm water can be pushed through the button to see if this clears it.  Smaller syringes have more pressure, so work better than larger ones.  If pushing alone doesn’t work, then a combination of pushing and pulling back on the syringe may work.  Usually repeating this several times will clear it.  I’ve been told you can connect a 5 ml syringe directly to the button and pull back on this… I’ve never had to do it yet.  If all else fails, change the button and start fresh!
    • when pushing water through a clogged tube, use caution.  Make sure the extension tube’s other port is tightly closed or it will fly open and you’ll get water everywhere.  Also try using two people and connect a syringe to both ports.  Again, make sure they are inserted well or else you’ll make a mess! (thanks to the nurses in the MDU unit at BC Children’s Hospital for this tip).

Hints & tips on the causes of clogs & how to resolve them…

The consistency of the food is very controllable, but there are times when I’m sure the food is fine and we still get multiple error messages.  With homemade food it is a delicate balancing act – getting the food thin enough to flow successfully through the tubing, but not too thin that it is too diluted. This balance just comes with practice (lots and lots of practice!).

Here’s a breakdown of the various clogs we get, and what we do to clear the tubing:

  • Problems with the food (too thick, gritty, lumpy, etc):
    • the easiest place to start is adding more liquid.  Sometimes thinning the food down slightly is enough to allow it to flow smoothly through the tubing.  Caution is needed though, to ensure the food isn’t thinned so much that the resulting volume can’t be consumed.
    • re-blending.  I’ve had to do this a few times, when there’s just no way it will work.  Usually this happens when I’ve tried a new food, only to find it just won’t blend enough (like large yams, or berries).  I have had some luck with making a 2nd batch and then blending the two batches together – sometimes the additional food will add enough volume that the resulting mixture will work.  Sometimes not :(.
    • when it gets really bad, we stop using the feeding pump and use a 60ml syringe instead.
    • there has been one time I’ve had to throw the food away.  It wouldn’t even go through the 60 ml syringe and the part that I did manage to push through clogged his button.  If I remember correctly, large yams were the culprit and they were just way too fibrous.
  • Air bubbles in the food:
    • air bubbles are an inevitable part of homemade food.  Blenderized foods must be blended so much that air gets trapped in the food.  Once cooled in the fridge much of the trapped air is released (causing difficulties in measuring volume… but that’s another problem!).  But when the food is whisked again after being reheated, more air enters the food.  The feeding pump will sometimes sense the bubbles and believe there is no food left, but often they will go by undetected.  If air bubbles become a problem, adding a small amount of liquid can help, as can massaging the food bag.
  • Food, hair or other particles on the pump’s sensors:
    • if the pump becomes dirty, this can also cause major problems.  I say “if”, but lets face it… we’re feeding a toddler – the pump gets dirty!  The nice thing about the Entralite Infinity pump we currently have is that it can cleaned directly under running water.  We will usually start by washing it in the sink, then cleaning and drying the sensor areas with a Q-tip.  This usually works.
  • Food caught in the tubing, as described in the previous section:
    • Remove the section of tubing shown above (which is located at the “no flow out” error sensor) by carefully pulling it back from the clear plastic tubing so that the offending food can be removed from the small holes.
      • Caution must be taken to remove it gently and, when done, push it back on fully so it seals.  This cannot be done repeatedly as after a few times it will not seal properly and air will get sucked into the tubing at this point.   You can tell if this is what is happening if you start getting large air bubbles in the tubing after the pump, but not in the tubing between the pump and the food bag.

Final Thoughts…

I would love to be able to say that making homemade blended food is as easy as using commercial formula, but clearly it isn’t.  Error messages are just one of the headaches we encounter as we endeavour to provide Henry with nutritious, well-balanced meals of “real” foods.

Is it worth it…

ABSOLUTELY!

Cheers, Shelley

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Louie Schwartzberg: Nature. Beauty. Gratitude. (a TEDx Talk)

I loved this video.

I’ve watched it countless times and it was only just posted online.  Make the time to watch it… all of it… it was worth the effort for me.

The most meaningful moments for me are near the end, at about 6 minutes, when the little girl and the older man speak.  For me it speaks about life… the precious gift of life… and embracing life at every moment.  I watch it when I need a reminder of how fortunate we are.

Louie Schwartzberg films time lapse photography and it is awe inspiring to watch.

 

Here’s the link to the video:

 

Here’s the link to Louie Schwartzberg’s website:

http://www.movingart.tv/wingsoflife/

 

May it speak to you the same as it speaks to me.

Cheers, Shelley

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I’m being published!

“For the Sake of My Son: Communicating in a Medical Crisis”

As many of you know, I have been a member of Toastmasters for many years.  It is my fun; my therapy; and my challenge… and I love it!  Since Henry was born, many of my speeches have been about him and our experiences… both the joy and the heartache.  So last spring when I did a speech focused on what I have learned in advocating for Henry’s care, one of our senior club members encouraged me to “take it on the road”.   He encouraged me to transform the speech into an article and try to get it published.  I wasn’t at a place in my life then to seriously consider his advice, but I also didn’t forget it.

A couple of months later, during one of my many sleepless nights at the time, I pulled out the computer and started writing.  I thought… why not?  It can’t hurt to try. I figured that since the speech was for my Toastmasters group, then I would rework it and submit it to the Toastmasters magazine.  And guess what… they accepted it for publishing!

Toastmasters International publishes a monthly magazine, the Toastmaster, that every Toastmasters member receives – it is a fabulous member benefit.  The organization is in 113 countries worldwide, with over 260,000 members currently – that’s over 260,000 people reading my article!  WOW!

The article is in the current December 2011 issue, right at the beginning on page 5!  It is a full-page article and a… it contains a link to this blog!

This time it’s… yippee for me!

Cheers, Shelley

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