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08-11-2014, 02:39 PM   #1
dodie74
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Flavoured shakes

Appointment went ok today, everything looks ok. He has grown up the way but no weight on so we have been given paediasure shakes and enshake powders to try. Just made up the choc enshake and it's awfully thick, is it ok to add more milk than it says to make it go down easier? Do the shakes make a big difference in their weight? Just hoping he does gain now. Xx
08-11-2014, 03:12 PM   #2
Momtotwo
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Some parents have had great success with the shakes. I cannot get my child to drink them. I don't know the answer to your question about diluting, but I agree they are very think. We tried Orgain brand and they were not nearly as thick. My son still didn't drink them, but it is something to consider if thickness is an issue.
08-11-2014, 04:07 PM   #3
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Glad the appt went okay. I'm sure it would be okay to add more liquid to the shakes. It might be worth making it up and putting it in the fridge for a while or adding ice cubes. I remember reading they taste a bit better if really cold
08-11-2014, 09:41 PM   #4
my little penguin
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DS did well with peptamen jr - still drinks 2-3 a day .
Pre mixed
Are you using a gram scale or the plastic scoop it came with .
Kitchen gram scale is better - also his many cal /oz some are 1.0 cal and some 1.5 cal
The 1.5 is much thicker and harder on the stomach .
Shakes can't be frozen but you can make them the night before and kept in the fridge .
Pediasure here is also premixed .

Good luck
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08-11-2014, 10:04 PM   #5
SmellyMelly
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Just made up the choc enshake and it's awfully thick, is it ok to add more milk than it says to make it go down easier?
Do you mean cows milk?

From my understanding and experiences, cows milk is normally not recommended for IBD sufferers, as can make the condition worse.

Can you make it / thin it with water instead?
08-11-2014, 10:43 PM   #6
Catherine
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I have mixed Ensure powder and we only ever add water. It does require a lot of mixing. Have you tried blending?
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08-12-2014, 04:49 AM   #7
dodie74
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The pediasure is already mixed but the ensure comes in sachets and we add to 250ml of milk, I used the hand blender last night to mix it too. Kian is fine with cows milk, no problems at all and we have been advised by his team to use full fat like butter, full milk etc. will try another tonight and see how he goes, at least it is only one a night he has to take. Xx
08-12-2014, 05:30 AM   #8
DanceMom
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FWIW, we were advised to give A cow's milk and butter to help with weight gain. Even with a Crohn's diagnosis. It did not seem to bother her gut either.
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08-12-2014, 07:50 AM   #9
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I hope it's ok for me to post here, as I'm not a parent, I'm sick myself, but I've a lot of experience with the various liquid supplements and shakes, including some of the paediatric ones.

With all the ones I've tried (Scandishakes, various forms of Ensure and Fortisips/Fortijuices, various forms of Calogen), it's been fine to mix them with all sorts of things. Ice cream is a good one to mix them with in order to improve taste and gets them to go down easily.

A lot of the websites for these shakes have sections on recipes - you can make them into smoothies, etc. You can also get build-up supplements in powder form, which are designed to be mixed into food - you can get savoury flavours to mix into soups and sauces.

Do you mean cows milk?

From my understanding and experiences, cows milk is normally not recommended for IBD sufferers, as can make the condition worse.

Can you make it / thin it with water instead?
This is only the case if you have lactose intolerance, or if you have found dairy to cause an increase in symptoms. Many IBD sufferers can tolerate dairy. If you suspect dairy is a problem, you can ask your doctor for a lactose intolerance test. The only way to determine other forms of sensitivity to dairy would be to eliminate it from the diet for a couple of weeks and look for improvement, but I would not recommend this to a child needing shakes, as if a child (or adult for that matter) is having trouble gaining weight or getting adequate nutrition, it's not the time to start restricting foods, especially dairy, which can be an important source of nutrients, especially for children. So only consider eliminating dairy if there's a very good reason to suspect it's causing a problem.

The other problem with diluting it with water is that water adds no calories. One of the main point of these drinks is that they provide a lot of calories with a relatively low volume (which is why they can be quite thick). If you start adding water, you start filling the stomach up without adding calories.

Do the shakes make a big difference in their weight? Just hoping he does gain now.
They can do. If your child can have them on top of his normal diet, he'll be getting a lot more calories. If he doesn't have the appetite to have them on top of what he's already eating, but if you can use them to replace other drinks - water, juice, etc. - he will still be getting more calories than he has been. The other benefit of these supplements is that most of them contain all the vitamins and minerals he needs, so there is less need to make sure he consumes lots of fruits and vegetables, so he won't be filling up on low-calorie foods. I don't know if there's anything magic about the drinks - I think calories are calories whatever form they come in, but I have heard some people say that liquids are easier to digest than solids. Either way, they should help!
08-12-2014, 02:51 PM   #10
kiny
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Issue with milk is that besides lactose intolerance, it is also not very bioavailable. The casein in milk is not and the fat in milk is not. On the EN it often says MCT, that's the medium chain fatty acids they use since they are bioavailable, the higher the amount of MCT, the better you're going to digest the fat, and instead of casein some EN use hydrolised whey (not all, modulen uses casein, but their argument is that they want the TGF from casein). The reason EN is so expensive is because it's not like milk, they isolate the fats into MCT and they break down the protein from the whey by hydrolysing it, milk doesn't digest easily. All of the drinks that are cheaper and aren't really EN, have casein and milk fat, it's easy to make and cheap, hydrolised whey and MCT are much cleaner and better protein and fat sources, but it costs money to make, so that's why real EN costs money.

The only good thing about milk is that it's rich in TGF-beta, but then you can get this from modulen too, which is richer in MCT, and is much easier to digest, but too much TGF is not good either, because it can support fibrosis, you need a balance, enough TGF will help healing, too much can lead to fibrosis. There's a lot of money spent to convince people cow milk is good for them, the reality is different I think, most of the world is lactose intolerant, and milk just isn't very easy to digest.

Last edited by kiny; 08-12-2014 at 03:11 PM.
08-13-2014, 12:24 AM   #11
SmellyMelly
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This is only the case if you have lactose intolerance, or if you have found dairy to cause an increase in symptoms
Hello.

I understand about lactose intolerance and I understand that a lot of people with IBD are also lactose intolerance, and I also understand a lot of people are not.

But that is not what I was referring to when I mentioned about the milk.

The casein in dairy can act like a glue or mucous in your body and can add to and worsen internal inflammation.

This is the naturopathic approach to management of IBD (i.e.) avoiding dairy whether officially lactose intolerant to it or not. Just avoid it if you have IBD. Full stop.

Of course a doctor and gastro would tell you something different, but I was only mentioning the point from my own understanding and experiences.


I took one of these flavored shakes years. It made me worse and then I found out later that it had milk powder, soy and gluten in it - this triggered a UC flare.
08-13-2014, 12:29 AM   #12
SmellyMelly
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The other problem with diluting it with water is that water adds no calories. One of the main point of these drinks is that they provide a lot of calories with a relatively low volume (which is why they can be quite thick). If you start adding water, you start filling the stomach up without adding calories

Could you use something like oat milk, rice milk, seed milk, hemp milk or almond milk instead?

Almond milk has calories; but without the irritating inflammation of casein.

I suppose best to make it into a "thick shake" instead of a normal drink then. Or even a pudding style thick blancmange.
08-13-2014, 04:29 AM   #13
UnXmas
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Could you use something like oat milk, rice milk, seed milk, hemp milk or almond milk instead?

Almond milk has calories; but without the irritating inflammation of casein.

I suppose best to make it into a "thick shake" instead of a normal drink then. Or even a pudding style thick blancmange.
I guess you could, but why would you if dairy's not a problem? It's probably much cheaper to use normal milk too.
08-13-2014, 04:40 PM   #14
Cross-stitch gal
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Before work I usually make a shake consisting of: Ice cream, 1 scoop of protein powder and enough lactaid milk in order to make it easy to drink with a straw. Sometimes it's still thick enough to eat mostly with a spoon. But, once it melts a bit I'll need the straw. Only problem is the protein powder I use doesn't help with gaining weight. But, otherwise I have no problems.
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