Blenderized diets consist of a wide range of table foods such as fruits, vegetables, meat and legumes, pureed in a blender and administered via gastrostomy tube. In a recent study, the investigators reported that children receiving blenderized feeds via gastrostomy had fewer total admissions and respiratory admissions, total emergency room visits, and improved gastrointestinal symptom scores compared to those fed formula. The goal of this project is to understand how these diets affect gastroesophageal reflux burden.

The investigators hypothesize that rates of gastroesophageal reflux will be lower in blenderized diets compared to formula. The investigators will determine if reflux burden as measured by multichannel intraluminal impedance/esophageal pH monitoring performed for clinical purposes differs between low viscosity conventional formula, medium viscosity commercial blenderized diet, and high viscosity commercial blenderized diet in 45 children receiving conventional formula via gastrostomy. All participants will receive each of the three test diets in random order in a 3-way crossover design. Results of gastric emptying scans will be recorded if done for clinical purposes.

Inclusion Criteria:

• Age 1-21 years
• G-tube
• Able to tolerate bolus gastric feeds over 30 minutes
• Use of conventional enteral formula
• Undergoing impedance study for clinical purposes

Exclusion Criteria:

• History of allergy or intolerance to any component of the test diets
• History of Nissen fundoplication (participants with suspected or documented unwrapped fundoplication will be eligible for participation)
• Current use of non-invasive pressure support (continuous or bi-level positive airway pressure)