The Age of the Tubie
‘Rate = Volume ÷ Time’, linocut print on paper by Kathryn Lean
Think you’re in a niche? News flash: You’re not. The global tube-feeding community is growing, getting attention and giving the medical sector a much-needed shake-up.
There’s never been a better time to be tube-fed. Not only because, a century ago, tube-feeders received nutrition through a decidedly unappetising orifice*. But also due to the fact that we, the tube-feeding community of today, are a booming market. We have a rising voice and we’re demanding better.
Not long ago, the first issue of this magazine was described as ‘radical’ by a professional in the paediatric feeding space. That professional is pro-choice when it comes to what their patients put down their tubes, but all the same, they were extremely careful to detach from the major hospital they worked for while discussing blended feeds.
Up until very recently, this diet was controversial.
For decades, the vast majority of the medical sector has prescribed a limited range of commercial formulas for tube-feeders. But in the privacy of home kitchens, people were blitzing forbidden fruit, vegetables, meats, grains and dairy - even the occasional slice of cake - on the sly.
Oh how things started to change when, in July 2021, the Australasian Society of Parenteral and Enteral Nutrition (AuSPEN) released its blended tube-feeding consensus statement - a seven-page document neatly summarising the current research and expert clinical opinions around enteral blended tube feeds.
No longer was this diet shrouded in doubt and questions like, should we be doing it? Is it safe? Does it block tubes?
“That’s all changed to, ‘what should we recommend?’, which is really brilliant,” says Lina Breik, a senior dietitian with a particular passion for helping people tube-feed, known professionally as the Tube Dietitian. Marvelling over this refreshing reference for medical professionals, she describes the general vibe of the AuSPEN statement as ‘extremely positive’.
Advanced accredited practising dietitian, Lina Breik
“It's very much about autonomy, independence and people’s choice and I think that’s where the shift is happening,” says Lina. “Tube-fed nutrition - especially in the home - is no longer a medical thing. And it shouldn’t be. Nutrition in the home is about love, connection and culture.”
Baffled by the lack of existing data around Australians who tube-feed, Lina has decided to spend three years gathering stories from this community as part of her PhD.
“I want to hear about people’s experiences,” Lina explains. “Say you’re a 40-year-old person who’s had a stroke and now needs a feeding tube. You’re at a cafe with your friends, everyone’s tucking into their meal and you’re there with your tube. Do you feel welcome? Do you feel comfortable whipping out your bolus syringe? Do we need to have tubie-friendly stickers in cafes so people with tubes can feel comfortable feeding in public?”
Lina dreams of a day when every Australian city has its own tube-feeding hub, where people can come together and access experienced specialists.
“Imagine not having to go to hospital and instead going to a beautiful centre where everybody's got what you’ve got - a tube - and it’s OK,” she says. “We need to convince the government to fund this sort of thing and for that, we need data. I’m hoping to start the process of collecting information on who’s in this community and how they’re feeling.”
A decade ago, Brett Matthews was feeling desperate.
His teenage son, Skyler, was getting progressively sicker and his doctors couldn’t figure out why. “They were going to put him on chemotherapy - nuke his system - and that just didn’t feel right,” Brett recalls. “We were searching for solutions and met some amazing naturopaths who, through nutrition alone, got Skyler on a path of healing.”
Kate Farms CEO, Brett Matthews
Brett is now the chairman and chief executive of Kate Farms, a US company producing organic, plant-based formulas that started because an unwell girl had parents who, like Brett, weren’t willing to accept the status quo.
“I met Richard and Michelle Laver and their daughter, Kate, who was born with cerebral palsy,” he says. “At five years old Kate was severely underweight. She got a feeding tube, but her body couldn’t process the synthetic formulas available to her.”
As the Kate Farms origin story goes, Richard and Michelle were frustrated that while they got to eat fresh, healthy food, Kate was forced to make do with formulas made of sugar, corn syrup and emulsifiers. So they raided their local organic grocery store, revved up their blender and, after trialling 70 different recipes, number 71 saw Kate’s health dramatically improve.
“She just turned 16 and she’s thriving,” says Brett. And so is the business that she inspired.
Last September, Kate Farms raised $US75m in its Series C round of funding. Seven years ago, Brett himself was an early investor and believer in Richard and Michelle’s vision. “I’m passionate about innovating in this space making sure good nutrition is accessible to families in the US and, hopefully, worldwide,” he says.
Kate Farms’ products, which will soon expand to a range of shelf-stable blended meals, are now available in 95 percent of US hospitals. But as Brett points out, this didn’t happen without a fight.
“Honestly, we were kind of locked out,” says Brett. “Hospitals could only buy synthetic formulas. Through a lot of research and hard work with doctors and consumers, we broke up that monopoly and created two categories in the healthcare system. One is the synthetic formula category and one is a plant-based organic category - both are now covered by insurance.”
Kate Farms can be hard to come by south of the equator - something Brett promises will change - but with the global enteral formula market set to reach $US8.2 billion by 2027, we can all expect a broader range of better nutrition options.
Consumers started this movement and, mercifully, the medical sector is finally catching up. We will not tolerate a sub-standard life for ourselves, our children and our families. Be it by way of commercial formula, blended food or a winning mix of both, tube-feeders are taking their health and happiness into their own hands.
Here’s to a brighter future of fresh perspectives and exciting innovations in our burgeoning sector.