9.4 Oral Nutrition

See guidance on oral nutritional supplements (ONS):

Powdered ONS – Cost Effective Choice for Primary Care

These are approximately 50% cheaper than ready-made ONS and are a cost effective option in primary care. However they are not suitable for all patients, therefore the following should be considered for each individual patient prior to prescribing:

  • Ability to (or someone to assist to) make up shakes?
  • Access to fridge and fresh milk and adequate storage for both milk and prepared product?
  • Ability to adhere to the requirements for safe handling of a fresh milk product?

Powdered ONS  >1.5 kcal/ml to make up with milk

Formulary ChoiceProduct namePresentation Nutritional content#Flavours
First choice

Aymes® Shake

57g sachet
Available as 1 box of 7 x 57g sachets of one flavour
388 kcal
16g protein
Banana, Chicken, Chocolate, Neutral, Strawberry, Vanilla

Ensure® Shake

57g sachet
Available as 1 box of 7 x 57g sachets of one flavour
389 kcal
17g protein
Banana, chocolate, strawberry, vanilla

Foodlink® Complete

57g sachet
Available as 1 box of 7x57g sachets of one flavour
385 kcal
19g protein

Banana, Chocolate, Strawberry,
Natural

Prescribing Notes

  • Reconstituted with 200ml FULL CREAM MILK (NOT WATER).
  • Unsuitable for those requiring ONS as sole source of nutrition.
  • Use with caution in CKD Stage 3 patients with hyperkalaemia – use under guidance of dietitian in CKD stage 4 & 5.
  • Can be used in reduced volume as per manufacturer’s instructions.
  • Do not reconstitute with fortified milk unless directed by a dietitian.

Powdered ONS 2.4kcal/ml Compact Milkshake style

Formulary ChoiceProduct namePresentation Nutritional content#Flavours
First ChoiceAymes® Shake Compact57g sachet
Available as 1 box of 7 x 57g sachets of one flavour
320 kcal 12.2g proteinBanana, chocolate, Strawberry, Vanilla, Neutral

Prescribing notes

  • Reconstituted with 100ml FULL CREAM MILK (NOT WATER).
  • Suitable for those requiring low volume.
  • Suitable for those with early satiety.
  • Unsuitable for those requiring ONS as sole source of nutrition.
  • Use with caution in CKD Stage 3 patients with hyperkalaemia – use under guidance of Dietitian in CKD stage 4 & 5.
  • Do not reconstitute with fortified milk unless directed by a dietitian.

Ready Made ONS

Ready Made ONS  2.4kcal/ml Compact Milkshake style

Product namePresentation Nutritional content#Flavours
First choice

Altraplen®Compact

125ml bottle
Available as pack of 4x125ml in one flavour
300 kcal
12g protein
Vanilla, Strawberry, Banana, Hazel Chocolate

Ensure® Compact

125ml bottle300 kcal
13g protein
Banana, Strawberry, Vanilla

Fortisip® Compact

125ml bottle300 kcal 12g protein Apricot, Banana, Chocolate, Forest Fruit, Mocha, Neutral, Strawberry, Vanilla.

 Prescribing Notes

  • Suitable for those requiring low volume.
  • Suitable for those with early satiety.

Ready Made ONS 1.5kcal/ml Milkshake style

Formulary choiceProduct namePresentation Nutritional content#Flavours
First choiceAymes® Complete200ml bottle
Available as pack of 4x200ml in one flavour
300 kcal
12g protein
Banana, Chocolate, Strawberry, Vanilla
Ensure® Plus milkshake style220ml bottle 330 kcal
14g protein
Banana, Chocolate, Coffee, Fruits of the Forest, Neutral, Orange, Peach, Raspberry, Strawberry, Vanilla
Fortisip® Bottle200ml300kcal 12g proteinBanana, Chocolate, Neutral, Orange, Strawberry, Caramel, Tropical, Vanilla
Fresubin® Energy200ml300kcal
11g protein
Banana, Blackcurrant, Cappuccino, Chocolate, Lemon, Strawberry, Tropical Fruits, Unflavoured

Ready Made ONS 1.5kcal/ml yoghurt style

Formulary choiceProduct namePresentation Nutritional content#Flavours
First choiceEnsure®plus yoghurt style220ml bottle330 kcal
14g protein
Orchard Peach, Strawberry Swirl

Ready Made ONS 2.4kcal/ml  compact Milkshake style with fibre

Formulary choiceProduct namePresentation Nutritional content#Flavours
First choice Fortisip® compact fibre125ml bottle300 kcal
12g protein
5g fibre
Mocha, Strawberry, Vanilla

Prescribing Notes

  • Use of fibre-containing ONS should be part of a constipation management plan, including assessment of dietary fibre and fluid intake.
  • Suitable for those requiring low volume.
  • Suitable for those with early satiety.

Ready Made ONS 1.5kcal/ml Milkshake style with fibre

Formulary ChoiceProduct namePresentation Nutritional content#Flavours
First choice Ensure® Plus Fibre200ml bottle310 kcal
13g protein
5g fibre
Banana, Chocolate, Raspberry, Strawberry, Vanilla

Prescribing Notes

  • Use of fibre-containing ONS should be part of a constipation management plan, including assessment of dietary fibre and fluid intake.

Ready Made ONS 1.5kcal/ml Juice style

Formulary choiceProduct namePresentation Nutritional content#Flavours
First choiceEnsure® plus juce220ml bottle 330 kcal
11g protein
Apple, Fruit Punch, Lemon-Lime, Orange, Peach, Strawberry
Fortijuce®200ml bottle300kcal
8g protein
Apple, Black currant, Forest Fruits, Lemon, Orange, Strawberry, Tropical
Fresubin® Jucy200ml bottle300kcal
8g protein
Apple, Blackcurrant, Cherry, Orange, Pineapple

 Prescribing Notes

  • Suitable for those who do not like milky products but these are NOT MILK FREE.
  • Not recommended as first line product for those with diabetes.
  • Note protein content lower than milkshake style products.
  • Unsuitable for those requiring ONS as sole source of nutrition.

Ready Made ONS Dessert style (>200kcal and >10g protein per portion)

Formulary choiceProduct namePresentation Nutritional content#Flavours
First choiceNutricrem®125g pot
Available as pack of 4x125g in one flavour
225 kcal
13g protein
Strawberry, Vanilla, Chocolate orange
Second choiceFresubin® 2kcal creme125g pot
Available as pack of 4x125g in one flavour
250kcal
13g protein
Vanilla, Chocolate, Praline, Wild strawberry, Cappuccino

Prescribing Notes

  • Suitable for those requiring low volume.

 

*Refer to individual product data sheets for full information

#Protein content rounded to the nearest whole number