EnsureTM, FortisipTM and Procal ShotTM are just a few of the many nutrition supplements available for GP’s to prescribe.  Clients who have been hospitalised after a catastrophic injury are often given oral nutrition supplements when their oral food intake is limited — possibly due to a poor appetite, difficulty swallowing (dysphagia) or being weaned off of tube feeding.  Supplements should only be used under the supervision of a dietitian, although GP’s and hospital medics can and do prescribe them at times without any dietetic input.  Occasionally, in the transition from hospital to the community, dietetic follow up can be lost and a client can remain on nutrition supplements much longer than is necessary.

If you have a client on oral nutrition supplements, these are the three questions you should be asking:

1. Is the client, their family and/or the multi-disciplinary team, clear on why this client is on oral nutrition supplements and the intended duration?
2. When was the last time the oral nutrition supplements were reviewed by a dietitian?
3. Is the client actually taking the oral nutrition supplements and enjoying them?

There are numerous oral nutrition supplements available in the UK.  Hospital dietitians are often restricted in the brands they are allowed to recommend, because most hospitals have signed exclusive-rights contracts with one specific supplement company.   Such restrictions do not apply in the community and any brand of nutrition supplement can be used (this applies to thickeners as well).  For that reason, if your clients is not 100% happy with the oral nutrition supplements they are on, it might be time for this to be reviewed.

Many people think that advice on oral nutrition supplements is all that a dietitian is able to offer.  Nothing could be further from the truth.  A dietitian’s role is to ensure the client’s nutritional needs are being met.  Oral nutrition supplements are one way to achieve this, especially if other dietary options have not been successful or if rapid intervention is needed.  It is critical, however, that oral nutrition supplements never replace the necessary investigation needed to figure out why the person is not eating sufficient amounts.  I consider my role to be that of a detective — in this situation, to figure out why someone isn’t eating and to remove whatever barriers are getting in the way of their food intake. Nausea, reflux, oral thrush, constipation, abdominal pain, swallowing problems and depression are just a few of the factors which can reduce someone’s appetite.  If you treat the underlying problem, often the issues with food and weight will take care of themselves which may eliminate the need for oral nutrition supplements altogether!

If you have a client who needs a review of their oral nutrition supplements and/or further investigation into their poor food intake, please contact Sheri Taylor, Freelance Dietitian at 0121 384 7087 or info@specialistnutritionrehab.co.uk.

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