Experience and attitudes toward blended tube feeding in Dutch pediatric healthcare professionals: A cross-sectional survey.
BACKGROUND Blended tube feeding (BTF)-enteral nutrition based on whole foods-is increasingly adopted as an alternative to commercial formulas in children requiring long-term tube feeding. While parents often initiate this practice, healthcare professionals are crucial for its safe and effective implementation. This study explored the perspectives of Dutch pediatric healthcare professionals regarding BTF to identify knowledge gaps and support future clinical guidance. METHODS We performed a cross-sectional survey in 252 participants based in the Netherlands from February to May 2025. The self-developed 30-item questionnaire addressed BTF knowledge, attitudes, and experiences. Responses were analyzed descriptively. RESULTS A total of 252 respondents completed the survey, primarily pediatric dietitians (n = 89) and pediatricians (n = 64). Familiarity with BTF was high (82%), and 56% had cared for children receiving it, most commonly via gastrostomy, although practices varied. Attitudes were generally positive (65%), particularly among dietitians (81%). Reported benefits included improved feeding tolerance (79%), reduced reflux/vomiting (72%), and improved stool patterns (67%); while caregiver burden (61%) and perceived parental insecurity regarding nutrition (28%) were the main challenges. Awareness of the 2022 national BTF position paper was low (54%), especially among physicians (20%), although 77% of healthcare professionals expressed interest in further education. CONCLUSION This nationwide survey reveals high familiarity and positive attitudes toward BTF among pediatric healthcare professionals but considerable variation in practice and limited awareness of existing guidelines. Future interventional studies, evidence-based recommendations and professional training are needed to support consistent, family-centered implementation.