Thursday, August 13, 2009

How to get Nutrition With A Broken Jaw?

My husband was in a car accident recently and broke his jaw. He can eat very soft foods, but it is so uncomfortable for him to try chewing anything he gets frustrated and avoids almost all his meals now. He has lost about 11 pounds already and doesn't have much to spare, so I am worried. He does drink a can of Ensure every day, but I don't think he's taking in more than 1000 calories and I don't think this is enough. What can I give him to get him to try eating more? Mary E.

Dear Mary,

It's great that your husband is not on a total liquid diet and can still enjoy some texture, like puddings, yogurt, and ice cream. If chewing is frustrating, avoid giving him any foods with bits in them (like fruit pulp or skin, bits of mushroom in soup, or even chunks of a soft food like 'homestyle' mashed potatoes). These can get stuck in between teeth and be very difficult to clear if he doesn't have full use of his jaw. We so take for granted how much we use our jaw, for both up-and-down, as well as sideways motion to chew, and how much our tongue assists in moving the food around to be chewed and swallowed. If this is difficult or painful for him now, it's easy to understand why he's avoiding it.

There are several liquid beverage supplements available that can get him the nutrition he needs: not just calories, but also protein, vitamin, minerals, and enough fluids for hydration. One can of Ensure provides only 250 calories (as do other brands such as Boost and Walmart's own Equate brand) and many people don't realize you can use several cans a day. People who can't eat at all require up to 8 cans or more. Depending on your husband's size, activity level, and condition (he needs more calories if he is healing broken bones from the accident, for instance) he may need close to 3000 calories a day, especially if he would benefit from gaining back the weight he lost.

You can find many delicious recipes in which you can use these supplement drinks, like making puddings and shakes that have different flavors and textures. Choose the softest ones from here: and of course, find out what is appealing to him to increase the chances he'll eat what you prepare.

You can also ask your local store to purchase higher calorie beverages like Ensure Plus (350 calories per can) or TwoCal HN which has almost double the calories if your husband feels like eating or drinking very little.

Do encourage him to take in several glasses of water or other fluids each day, in addition to the supplement drinks, or he can easily become dehydrated. Use the food guide pyramid to aim for a balanced diet and find liquid or soft options in each food group (strained hot cereal or mashed potatoes for starches; applesauce or juices--including vegetable juice--for fruits and vegetables, etc). Consider mixing baby food meats into soups to thicken the texture and add more protein. The hospital where he was treated should have a dietetics department and they should also have information to provide you regarding a balanced blenderized diet, geared specifically to your husband's case (they will have access to his medical records with your approval).

Hopefully all will be back to normal in just a few more weeks. In the meantime encourage him to take all the nutrition he needs now so he doesn't have to play "catch-up" when he's back to normal.

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