Formulas are made up of protein, carbohydrates, fats and vitamins/minerals. Most are designed to be nutritionally complete, meaning everything a child needs is available in the formula. Medical conditions can dictate the composition of these ingredients and if the proteins are whole, partially broken down (peptide) or are fully broken down to amino acids (elemental).
Many tube feeding formulas are made to also be consumed orally. There are some that have flavor options to encourage oral consumption, where others are usually reserved strictly for tube feeding.
Whole Protein Formulas
Whole protein formulas do not have the proteins broken down. Many children are able to tolerate whole protein formulas. These formulas cover a broad spectrum, from standard infant formulas to formulas that contain real foods. Examples include PediaSure, Nestle Compleat, or Similac. Most are milk- or soy-based, but some are made from real foods.
These formulas have the proteins partially broken down. Peptide formulas make digestion easier, so they move through the stomach more quickly, which can improve tolerance of feeds for some children. These formulas are recommended for any child with a feeding tube placed in the duodenum or jejunum, because they require less breaking down. Examples include Peptamen Jr and PediaSure Peptide. Most are milk- or soy-based.
Elemental/Amino Acid Based Formulas
Elemental proteins in these formulas are broken down to the amino acid level (the building blocks of proteins). These formulas are hypoallergenic. They also are easier for the body to process and absorb. They are commonly used in conditions like small bowel syndrome, eosinophilic disorders, motility issues, and severe food allergies. Elemental formulas are often used in children who are fed into the small intestine. Examples include Elecare, Neocate, or EO28 Splash.
There are also specialized formulas available for children with specific metabolic disorders, kidney diseases, the ketogenic diet and other conditions. These may restrict, eliminate, or add one component of the formula, such as a specific amino acid, carbohydrates, or proteins. In addition, there are modular formulas available, which piece together the building blocks of nutrition to accommodate rare conditions.
A Ketogenic Diet is specifically used in children who have seizures, for seizure control. It is a high-fat, low-carbohydrate diet that puts the body in ketosis, meaning it forces the body to burn fat for energy instead of carbohydrates. The diet can be administered either orally or by tube, or a combination of both.
While the classic Ketogenic Diet is still the most widely used, other versions, including the Modified Ketogenic Diet, Medium-Chain Triglyceride (MCT) Oil Supplement Diet, Modified Atkins Diet, and Low Glycemic Index Treatment (LGIT).