A step-wise approach to calculating modular feedings

Enteral alimentation can be an effective feeding modality for use in the treatment and prevention of nutritional deficiencies. Although specialized commercial products are available for use with various disease states, many institutions are forced to restrict their enteral formularies to more conventional products in order to control costs. Nevertheless, the institutions do occasionally need a more specialized feeding. Although the details of calculating a modular feeding are commonplace for many dietitians, for others the concept is quite foreign. It is possible to individualize a modular feeding using conventional commercial formulas and common enteral modules. A method is presented for calculating such modular feedings using a step-wise approach. The limiting factors for the feeding are considered individually, starting with the most limiting factor. The patient's requirements for energy, protein, and macro- and micronutrients are also taken into consideration. The need for vitamin-mineral supplementation is determined, and the stability and osmolality of the formula are evaluated.