When you get most of your nutrition and fluids through a feeding tube, it can be easy to become dehydrated. Even though formula is in a liquid form, not all of that is water. Keeping proper hydration while tube feeding requires care and monitoring.
Getting enough water is crucial to the proper function of kidneys and general health (1). Too little water can lead to constipation and even vomiting. (1)
How do you determine if you’re getting enough hydration?
You should never try to determine your hydration alone. Always consult with your nutritionist and medical professionals. However, according to the Feeding Tube Awareness Foundation (1), a basic guideline for figuring out if you’re getting enough hydration is as follows:
|Up to 10 kg||100ml for every kilo|
|10kg-20kg||1000ml for the first 10kg, 50ml for every additional kg|
|20kg+||1500ml for the first 20kg, 20ml for every additional kg|
Those who eat a blended diet that is not prepared formula will have a slightly more difficult time calculating the water content and should take some things into consideration: (1)
- In formula, more calories (per ounce) means less water. If the calories go up, the water also needs to. It is unclear if it is comparable in blenderized food, but worth consulting a dietician.
- Less water can lead to constipation. When constipation is present, start by adding more water before considering other options.
- Don’t forget the sweat. Hotter weather, greater physical activity or excessive sweating lead to water loss and possible dehydration. Make sure to add water under these conditions.
- Excessive fluid losses, such as through fistula, stoma, diarrhea or vomiting (2), excessive sweating or drooling (3) can also lead to dehydration. Be sure to contact a medical professional in these situations.
Signs of dehydration:
People experiencing dehydration may have a number of different symptoms including: (3)
- Increased thirst
- Dry lips
- Dry warm skin
- Rapid weight loss
- Dark, pungent-smelling urine
In a clinical setting, dehydration can be determined by monitoring urea and electrolytes, in combination with fluid balance, medications and clinical history. (2)
What to do about dehydration?
Be sure to notify your healthcare professional if the cause of your dehydration is vomiting, fever or diarrhea that is present for more than 24 hours. Otherwise, record how much water and formula or blenderized food you are taking in each day, as well as the color and odor of your urine. Be sure to connect with your physician or nutritionist to help you reassess your fluid to nutrition ratio and don’t let dehydration persist. (3)
Fistula: Any abnormal connection between two parts of the body that don’t typically connect. Often caused by injury, surgery or infection. For people with feeding tubes this may occur at or near the insertion site of a feeding tube. (5)
Stoma: The surgically created opening where your feeding tube enters the body.
Urea: A substance found in the body, which contains nitrogen that the kidney normally clears from the body into the urine. (6)
1. Feeding Tube Awareness Foundation. “Calories and Hydration.” https://www.feedingtubeawareness.org/tube-feeding-basics/diet-nutrition/calories-and-hydration/
2. Dunn, Sasha. British Journal of Community Nursing. “Maintaining adequate hydration and nutrition in adult enteral tube feeding.” 18 Jun, 2015
3. Abbot Nutrition. “Guide to Adult Tube Feeding.” 2016. https://static.abbottnutrition.com/cms-prod/abbottnutrition-2016.com/img/Adult-tube-feeding-at-home_tcm1411-57870.pdf
4. Free Dictionary.com. “Medical Dictionary Definition of Electroylytes.” https://medical-dictionary.thefreedictionary.com/Electrolytes
5. US Library of Medicine. MedlinePlus. “Medical Definition of Fistula.” https://medlineplus.gov/ency/article/002365.htm
6. Medicine.Net. “Medical Definition of Urea.” https://www.medicinenet.com/script/main/art.asp?articlekey=5905