http://functionalformularies.com/ 
1. What is Liquid Hope?
Liquid Hope is the worlds’ first and only organic, whole food, and plant-based feeding tube formula and oral meal replacement. Unlike other enteral formulas on the market, Liquid Hope is made with no added sugars and no artificial ingredients – just the wholesomeness of 16 whole food ingredients like garbanzo beans, quinoa, kale, and broccoli and a vitamin blend to make it nutritionally complete. It is gluten-free, soy-free, corn-free, and dairy-free.
2. What led to the development of Liquid Hope?
Robin Gentry McGee, the founder and CEO of Functional Formularies, created Liquid Hope shortly after her father suffered a traumatic brain injury, could no longer eat by mouth, and was being fed formula through a feeding tube. After turning around the can of the formula that was being poured down his tube, Robin realized that the ingredients (like corn syrup solids, soy protein isolate, and sodium caseinate) were far from what he would be eating if she were preparing foods for him in her home. Robin took to the Internet to find a healthier alternative, but after her search fell short she enlisted the help of several integrative practitioners across the country to develop what is now known as Liquid Hope.
3. This is an organic GMO free formula- why is this important?
Liquid Hope is the only certified organic, no added sugar, and GMO-free enteral formula on the market. Organic foods are beneficial for a variety of reasons including a decreased exposure to pesticides in the diet, soil biodiversity, and water conservation. At the same time, there are no long-term third-party human safety studies on the use of genetically modified organisms (GMOs), and since all organic foods are non-GMO it’s important to look for the certified organic label. Also, contrary to popular belief, you cannot cook the pesticides or GMOs out of foods. Choosing organic and GMO-free foods is important for everybody, and we feel especially for those who may already have compromised health lending to the placement of a feeding tube.
4. Is the pediatric version of Liquid Hope available? What ages do you recommend the pediatric version for?
Nourish, the newest formula from Functional Formularies, is slated to launch within the next 90 days. Nourish will feature whole food, organic ingredients similar to Liquid Hope but will be free of almond butter (so its ingredients will be void of the top 8 food allergens) and free of rosemary and garlic (so it will have a sweeter taste). In terms of nutrition content, there will be 400 calories, 17 g fat, 47 g carbohydrate, 7 g fiber, and 14 g protein per 12-ounce pouch (355 mL). Nourish was designed with the nutritional needs for children in mind. It is up to each individual’s medical team to determine the recommendations for Nourish.
5. So many of our patients with feeding tubes have underlying GI issues such as gastroesophageal reflux, constipation, slow motility, and food intolerance. Do you feel Liquid Hope is tolerated well for children with these issues?
Anecdotally, yes. We receive calls and posts to our Facebook page everyday of individuals who have seen changes to their health when using the formula. This is supported by the well-known clinical efficacy of the ingredients and nutritional properties in the formula, like the impact of fermentable fibers in supporting a healthy gut microbiome versus the implications of fructose and polyunsaturated fatty acids (found widely in other formulas) in endotoxemia promotion. Additionally, there is research (out of Cincinnati Children’s Hospital) that demonstrates that the administration of blenderized feeds via gastrostomy tube decreases gagging and retching in children. We feature all research related to Liquid Hope on our website at http://functionalformularies.com/medical/research .
In our first clinical trial in a burn unit at Baton Rouge General Medical Center, researchers found in a case study that the patient’s stool was “more formed when on organic whole foods enteral feed compared to the conventional enteral feed.” As more research is released about Liquid Hope, we will be sure to post it on our website.
6. Can Liquid Hope be taken orally? If not, do you have plans for an oral supplement?
Yes, Liquid Hope can be eaten orally. What a lot of our customers (and office staff) like to do is heat it on the stove and enjoy it as a soup. The liquid can also be mixed with mango, pineapple, and coconut water to create a smoothie. The flavor of Liquid Hope is savory, yet sweet, so it can be used as a very versatile ingredient in the kitchen as the base of a soup or as the liquid to cook grains like quinoa or rice.
7. Can you use Liquid Hope for continuous feeds? Or through a J tube?
Liquid Hope has been used by many customers who are on continuous feeds. Please note that the hang time for Liquid Hope is 4 hours. Liquid Hope has also been used through J-tubes. Please check with your medical team before beginning the use of any new nutrition product.
8. Does insurance or US Medicaid typically cover Liquid Hope?
Yes, with billing code B4149, Liquid Hope is covered by many insurances including Medicare and Medicaid. The company offers free insurance advocacy for customers to help them with obtaining coverage for the formula, and they have about a 95% success rate.
9. Where do you get Liquid Hope?
Liquid Hope can be ordered directly through the company online at www.shop.functionalformularies.com or by calling (937)433-4673. Liquid Hope may also be covered through insurance and available through a local distributor; if interested, please send an email to insurance@functionalformularies.com. In addition, hospital facilities across the country are offering Liquid Hope for inpatient use.
* I want to thank Liquid hope for answering my questions. As a speech pathologist specializing in feeding, I am always interested in the tube feeding formulas used with our patients in terms of tolerance and overall health benefits. We use Liquid Hope with our patients and have found it to be well tolerated. Some of our patients use it in conjunction with a home made blenderized diet. At the moment, our dietitians have been adjusting the adult formula to work for our pediatric patients. We are excited about the Nourish, the new pediatric blend coming out soon. If you are interested, I would encourage you to visit http://functionalformularies.com/. There is an interesting webinar available as well as a blog and other information.
I love the fact that Liquid Hope contains only organic foods. So many of our kids are extremely vulnerable to the pesticides that are abundant on and in non-organic foods. However, I am concerned that Functional Formularies has only 1 formula. When I became involved in guiding parents who wanted to make their own formulas more than 25 years ago it was primarily to be able to support strong dietary diversity for kids. Children on commercial formulas essentially ate the same foods each meal, each day, each month and each year. Many of them who were vulnerable to developing allergies and food sensitivities began to develop problems with these formulas. This was resolved for many kids by rotating formulas so that the primary protein sources were different in each of the formulas introduced. When parents create their own formulas they are encouraged to rotate the protein, grain, fruit and vegetables so that they have 4 or 5 different meals. This dietary diversity offers the child’s body and food exposure a very different experience from eating only a single formula. I wish that Liquid Hope was available in more than one formula and I would encourage Functional Formularies to consider developing more blended formula meal alternatives. Although their formulas are not fully organic, Real Food Blends has addressed this need through having 3 distinct formula food blends. This offers much more dietary diversity for children and adults. One of the concerns that Real Food Blends had in the development of their product was the very high cost of organic foods, especially when much of the superior nutritional profile in an organic blend would be lost in the high heat needed to create a shelf-stable product. They felt that a lower price would better support many parents to seek a food based formula rather than a synthetic commercial formula. Cost is a factor, especially if a family does not have insurance coverage for a food-based formula. Liquid Hope costs almost twice as much per meal as Real Food Blends. There is definitely a place for both formulas and parents and professionals need to know the pros and cons of both Liquid Hope and Real Food Blends.
Suzanne, thank you for your thoughtful comments. I am interested especially in the idea of “dietary diversity” for our clients and the potential health benefits. To me this is one of those “ah ha” moments- of course this would be better and more typical of how we eat. As a feeding therapist I have been more concerned with the additives and sugar in some of the commercially blenderized formulas instead of the obvious fact that we don’t eat the same thing everyday.
I think this brings up several larger issues as well:
1. knowledge of healthy eating and the over abundance of children and families living on a diet of processed foods with very little nutritional value
2. cost and economics of tube feeding
3. tolerance of formulas and the balance of the formula helping with medical needs
4. a families willingness, desire, and ability to make a home made blend
5. Therapists knowledge and understanding to guide a family
I would love to see more children moving to home made blends but many families rely on a commercially made formula for all kinds of reasons and I am so glad we have some real food options. I also like the idea that a family might use one of these formulas as a base and blend foods into them allowing for certain vitamin and nutrients while adding in diversity as well. Perhaps Functional Formularies or Real food Blends would come up with some recipe guides to add nutritional ingredients into their preblends?
Lastly, I would love to invite Real food Blends to answer questions in a similar post. thank you, Krisi
Suzanne~Thank you for your feedback . There are many reasons that Functional Formularies has only one formula compared to Real Foods Blends three. Liquid Hope is 100% sole source nutrition unlike the five or so ingredients that Real Food Blends offers. And, Liquid Hope also has NO added sugar unlike every other formula on the market including Real Food Blends who use sugar in some form (fruit juice and fruit juice concentrates in this case) to gain their caloric profile. This one little detail alone took 8 year of research and development to achieve. Our company believes and stands behind the integrity and purity of our ingredients including knowing many of the growers and organic farmers personally. You cannot cook GMO’s pesticides and any other toxin out of food it is impossible and the toxic burden that these foods are putting on the body of little ones, aka body burden is astounding so what you are alluding to that the benefits of organics would be “lost in the process” is simply not true because RFB products are processed the same way as ours. In a study spearheaded by the Environmental Working Group (EWG) in collaboration with Commonweal, researchers at two major laboratories found an average of 200 industrial chemicals and pollutants in umbilical cord blood from 10 babies born in August and September of 2004 in U.S. hospitals. Tests revealed a total of 287 chemicals in the group. The umbilical cord blood of these 10 children, collected by Red Cross after the cord was cut, harbored pesticides, consumer product ingredients, and wastes from burning coal, gasoline, and garbage. This study was in 2004 long before GMOs were widely used so I cannot even begin to imagine what this study would show today. These little ones and everyone who is on a feeding tube is already greatly compromised so we believe if your are not consuming the purist diet possible when dealing with any health condition, you are simply contributing to the problem. That said, our product is more expensive and with 17 organic whole food ingredients, of course it would be. We have a vast number of people who receive insurance coverage for Liquid Hope and offer a free insurance advocacy service that will help these folks. But at the end of the day, outcome after outcome from our customers are proving our theory as are first phase clinical studies. We have numerous formulas in the pipeline but with the detail and vast amount of ingredients to source and challenge of sourcing large scale manufacturing supply in the exploding organic market, it adds even more complexity to the process. I have ask one of our RDs to speak to your other points but when I read your post, I felt the need to respond. Also, I see that you co-authored a book with Marsha Dunn who is on the board of Real Food Blends so it is understandable that you have a lot of understanding of that companies products but I would invite you to have a call with Dr John Bagnulo our Nutrition Director who can give you an in-depth download on why we do what we do and the benefits it offers our wonderful customers. Robin Gentry McGee Founder and CEO Functional Formularies.
Dear Robin,
As a Dietetic Intern and soon-to-be RDN, I just wanted to let you know that what you’ve created with Liquid Hope and now Nourish is truly inspirational.
Thanks for setting the record straight and opening a new avenue of whole food-based nutrition support.
My nutritionist has concerns about the protein, and that she maybe getting to much protein with Liquid Hope at this time, and had limit us to 2 packages a day, how will your new product be different for children
Hi Eugena! Thank you for your comment. Liquid Hope was designed to be used for an adult population. That being said, numerous pediatric patients are using the formula under the recommendations of their medical team. In some cases, other Registered Dietitians feel the same way as your nutritionist so they will encourage the patient to dilute the formula, limit the total amount of Liquid Hope, and/or use Liquid Hope in conjunction with other foods or liquids (including home blenderized foods or breast milk) depending on the nutritional needs of the child. Functional Formularies’ new formula, Nourish, will be different for children in many ways – of one which being a lesser amount of protein. If you’d like me to let you know when the formula becomes available – and to see a list of the full nutritional profile for the new formula – please send an email to me at tori@functionalformularies.com. Thank you!!
Hi Eugena, One more thing to note: the protein in Liquid Hope is very different from the proteins present in other formulas. The nutritionist may want to consider this: would he/she be concerned if a child was getting this amount of protein from plant-based foods eaten by mouth?
I have forwarded this to Liquid Hope so they can answer your question, Krisi
Do you ship ‘Liquid Hope’ to Australia?
Hi Narelle,
Yes! Liquid Hope and Nourish (the company’s new pediatric formula) can be shipped directly to Australia. Please contact the company at (937)433-4673 or shop@functionalformularies.com if you have questions or are interested in placing an order.
Thanks!
Tori Holthaus, MS, RDN, LD
Functional Formularies
Hello- I am wondering if the Peadiatric version of Liquid Hope is available in Canada? If so where can it be purchased
Hi Christine,
You can purchase Liquid Hope and Nourish (the company’s new pediatric formula) through our company and we can ship to Canada. Please contact the company at (937)433-4673 or shop@functionalformularies.com if you have questions or are interested in placing an order.
Thanks!
Katherine DiGeronimo, RD, LD
Functional Formularies
Looking for a sugar-free, dairy free alternative tube feeding for my 7yr old to help treat an inoperable brain tumor
Hi Heather,
Here is a little more information on our pediatric product. Nourish is an organic, whole foods feeding tube formula and meal replacement created to meet the nutritional needs for children. It provides complete, balanced, whole food nutrition with no added sugar or chemical preservatives. It is also dairy-free, gluten-free, soy-free, and corn-free. The sugar in Nourish is naturally occurring, meaning that it comes from the whole food ingredients such as peas, carrots, and sweet potatoes.
Thank you!
Katherine DiGeronimo, RD, LD
Functional Formularies