The Bombacinos and their son, AJ, have learned a lot the past eight years.
"We were thrown into this world of special needs feeding that we never really expected," mother Julie Bombacino says.
When AJ was only 6 months old, he had a 45-minute seizure. It was then that doctors placed a feeding tube in his stomach and prescribed him formula.
But his reaction to the formula created a new kind of problem.
"Those first five, six months of him being on a feeding tube, it was constant nausea and vomiting and constipation for him, and he was just miserable," Julie says. "He also wasn't growing like he was supposed to be, and we were miserable, and we were scared."
So the Bombacinos started researching and found a community that was blending whole food instead of formula.
Brian Liebenow is one of those people using whole food.
"Probably 2012 up [until] now, I've been blending my food," he says.
Liebenow is an Air Force veteran, who travels the world. But back in 2003, doctors found lymphoma in his tonsils, leading to rounds of chemotherapy and radiation. Now, he's cancer-free, but the radiation severely damaged his jawbone.
"The last jaw surgery I had in 2009 cut a nerve, and I wasn't able to swallow again after that," Liebenow says.
As someone who had been able to eat whatever he wanted for a majority of his life, he wasn't ready to trade in steak and vegetables for formula. So, he started taking a blender to restaurants and feeding himself pureed food through his tube. He became an advocate for what's known as a "blenderized" diet, and another inspiration for the Bombacinos to make a difference in the feeding-tube world.
"We're both from big Italian families; we love to eat," Tony Bombacino says. "Why can't our son eat the same way that everybody else does, just through his tube?"
Within two years, the Bombacinos created Real Food Blends . Each package contains a balanced meal with five to seven whole food ingredients like salmon, oats and squash. The food is pre-packed, shelf-stable, and covered by most insurance.
The family-run business started in their kitchen, but with such a need across the country, Real Food Blends has taken off in only five years.
"All day every day, there's trucks going across the United States, delivering real food blends to people from California to Florida and everywhere in between," Tony Bombacino says.
Using blenderized food in feeding tubes is a fairly new concept. Hospitals have been prescribing formula for decades. However, new research from the Journal of Pediatrics is starting to push the idea forward.
"The most recent study that came out of Boston showed that children who were tube fed tended to do better if they were tube fed a whole food diet. Go figure," Julie Bombacino explains. "So, they went into the hospital less. They had less respiratory-related illnesses and less emergency room visits, which is a big deal in the special needs community."
Dr. Russell Cameron, a pediatric gastroenterologist, says many hospitals are still only offering formula, but they're having big conversations about blenderized food. In fact, he's been able to educate his patients about the option.
"We get our complete nutrition over time, and we get it through variation," Dr. Cameron says.
According to Dr. Cameron, blenderized food is proving to be beneficial for many people with feeding tubes. The only potential for harm comes if the food isn't completely blended, or sometimes, if a person has a complex digestive system, formula would be the safest option.
"In some patients that have severe food allergy, we do need to use proteins that are broken down into much smaller less recognizable components."
But for people like AJ, whose digestive system works fine, blended food is leading to a happier lifestyle.
"People are living with feeding tubes, living in all capitals. They're not sitting in the corner," Tony Bombacino says. "Some people are very sick that have a feeding tube, 100 percent. Many of our customers are very sick. But that doesn't mean they're not human, that doesn't mean they shouldn't have the right to have food and nutritional variety."
As for Liebenow, he's still traveling and keeping up his blog "The Blog of the Traveling Tubie."