FORMULA:  ORDERING FOR INFANT AND/OR  
                      
                                                                                                                                                                  ENTERAL FEEDS 
                      
                      
                      
                      
                        PURPOSE                                                                                                                                                                                                                                                           
                      
                        The purpose of this policy is to provide a tool for wards to assist in-patient areas in accessing infant 
                        and enteral formulas. 
                                                                                                                                                                                                                                                                                          
                        Food Services and the Formula Room each provide a different set of infant and enteral formulas. 
                        The guide below will direct in-patient staff to contact the appropriate area to obtain the needed 
                        formula. 
                        SITE APPLICABILITY                                                                                                                                                                                                                                                
                      
                        BC Children’s Hospital 
                        BC Women’s Hospital 
                        Sunny Hill Hospital and Health Centre 
                        BC Mental Health & Substance Use Services 
                      
                        PROCEDURES                                                                                                                                                                                                                                                        
                      
                                                                                                                                                                                                                                           
                        Use the guide below to determine where to call for needed formula and or enteral feeds.
                      
                     Policy # 4-100                                                                                                       Nutrition Services                                                                   Effective Date: Dec-12-2013 
                                                                                                                                                                                                                               Revised Date:  Dec-21-2016                                      
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                                                                                                                                                                                                                                                                                                                                                        FORMULA:  ORDERING FOR INFANT AND/OR  
                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                            ENTERAL FEEDS 
                                       
                                       
                                                                                                                                                                                                                               Infant and Enteral Formula Ordering Information Sheet 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           FORMULA ROOM 
                                                                                                                                     WARD STOCK                                                                                                                                                                                                                               DIET OFFICE                                                                                                                                                                                                                               Local 7608 
                                                                                                                                                                                                                                                                                                                                                                                  Local 3461                                                                                                                                                                            ALL formula room orders need to be 
                                                                                              Enfamil 20 kcal/oz                                                                                                                                                                                                                                                                                                                                                                                                                                                       scanned to: FormulaRoom@cw.bc.ca 
                                                                                              Enfamil Hypercaloric 24 kcal/oz                                                                                                                                                                                                                                                                                                                                                                                                                                    
                                                                                              Pedialyte (unflavoured)                                                                                                                                                                                                           All ‘food’ requests 
                                                                                                                                                                                                                                                                                                                                Orders for oral supplements and                                                                                                                                                                                                  
                                                                                                                                                                                                                                                                                                                                enteral feeds, including:                                                                                                                                                                                                        All Metabolic formulas 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 All infant formula powder for 
                                                                                                                                                                                                                                                                                                                                Carnation Instant Breakfast                                                                                                                                                                                                      addition to EBM (ie. Enfamil 
                                                                                            Need formula after 1730h?                                                                                                                                                                                                           Compleat                                                                                                                                                                                                                          powder) 
                                                                                                                                                                                                                                                                                                                                Compleat Pediatric                                                                                                                                                                                                                 Some specialty pediatric formulas: 
                                                                        Supplies of ready-to-serve and premade                                                                                                                                                                                                                  Ensure Plus Calories                                                                                                                                                                                                               Beneprotein Powder 
                                                                        formula are available to meet urgent needs.                                                                                                                                                                                                             Isosource HN                                                                                                                                                                                                                       Duocal Powder 
                                                                        Ready-to-serve products are located in the                                                                                                                                                                                                              Isosource HN with Fibre                                                                                                                                                                                                            Enfacare 
                                                                        cupboard in the 3F hallway (near the water                                                                                                                                                                                                              Isosource VHN                                                                                                                                                                                                                      Enfamil 27, 30 kcal/oz 
                                                                        cooler) and can be accessed by porter                                                                                                                                                                                                                   Isosource 1.5                                                                                                                                                                                                                      Enfamil Lactose Free 
                                                                        services:                                                                                                                                                                                                                                               Jevity 1.2                                                                                                                                                                                                                         Enfamil Premature High Protein 
                                                                                           •                  Goodstart, Nutramigen, Enfamil                                                                                                                                                                                    Jevity 1.5                                                                                                                                                                                                                         Enfamil Soy 
                                                                                                              Lactose Free, Polycal, Pregestimil,                                                                                                                                                                               Ketocal Liquid 4:1 – Ready to Serve                                                                                                                                                                                                Goodstart 
                                                                                                              Tolerex, Vivonex Pediatric                                                                                                                                                                                        Nepro Carb Steady 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Ketocal 
                                                                        Frozen specialty formulas are located in the                                                                                                                                                                                                            Nutren Junior with Fibre                                                                                                                                                                                                           Lipistart 
                                                                        freezer in room 3F49 (renal supply room) :                                                                                                                                                                                                              Pediasure                                                                                                                                                                                                                          Liquid Human Milk Fortifier  
                                                                                           •                  Lipistart, Monogen, Neocate Infant,                                                                                                                                                                               Pediasure Complete                                                                                                                                                                                                                 Liquid Protein Fortifier 
                                                                                                              Neocate Junior, Polycal Solution,                                                                                                                                                                                 Pediasure with Fibre                                                                                                                                                                                                               MCT oil 
                                                                                                              Pro-Phree                                                                                                                                                                                                         Pediasure Plus with Fibre                                                                                                                                                                                                          Microlipid 
                                                                                                                                                                                                                                                                                                                                Peptamen 1                                                                                                                                                                                                                         Monogen 
                                                                        Please record the product removed on the                                                                                                                                                                                                                Peptamen 1.5                                                                                                                                                                                                                       Neocate Infant 
                                                                        sign-out sheet and leave a message at 7608                                                                                                                                                                                                              Peptamen Junior                                                                                                                                                                                                                    Neocate Junior 
                                                                        so supply can be replenished.  If a patient                                                                                                                                                                                                             Peptamen Junior 1.5                                                                                                                                                                                                                Nephea Kid 
                                                                        requires a specialized formula after 1730h,                                                                                                                                                                                                             Peptamen PreBio 1                                                                                                                                                                                                                  Nutramigen  
                                                                        please contact the Nutrition Services Clinical                                                                                                                                                                                                          Resource 2.0                                                                                                                                                                                                                       Polycal Powder 
                                                                        Coordinator on call (pager 604-871-5004).                                                                                                                                                                                                               Suplena Carb Steady                                                                                                                                                                                                                PurAmino 
                                                                        They can help you identify a suitable                                                                                                                                                                                                                                                                                                                                                                                                                                                      Pregestimil 
                                                                        alternative, or come into hospital to                                                                                                                                                                                                                   *changes to enteral feeds need to                                                                                                                                                                                                  Tolerex 
                                                                        prepare the formula if necessary.                                                                                                                                                                                                                       be written on Diet Order Change                                                                                                                                                                                                    Vivonex Pediatric 
                                                                                                                                                                                                                                                                                                                                sheet                                                                                                                                                                                                                              Vivonex Plus 
                                      Policy # 4-100                                                                                                                                                                                                                                              Nutrition Services                                                                                                                                                                                                                                                                                                                                                       Effective Date: Dec-12-2013 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           Revised Date:  Dec-21-2016 
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