Laura Forwood is Nutrica’s Senior Brand Manager for the Enteral Feeding category at Nutricia. She spoke to us about her role at Nutricia, and some exciting new innovations that have recently been launched for tube feeding. 

I qualified in 2008 as a registered dietitian, and then I worked in the NHS for around six years, primarily in community nutrition support and home enteral feeding, working with a mixture of adults and children. I left the NHS to join a medical nutrition company where I worked for around four years in paediatric medical affairs, and then in 2018 I joined Nutricia.

There was more opportunity at Nutricia from a professional point of view; the medical team here is much bigger and the scope of the role was much broader in terms of responsibility than where I was working previously. But the most significant factor in my choice to move companies was that Nutricia has such a major presence in terms of education and events for HCPs and dietitians - and that really appealed to me.

It differs a lot from the NHS, where the work is highly clinically focused and based on the individual patient, so you’re very much going patient by patient, and you can see the impact you're having on that patient's life - which is super rewarding. But at Nutricia I feel like I get to make a difference for a far greater number of patients, operating on a national level rather than working with individuals. As a dietitian you've got a caseload of 100 patients, for example, and you have a big, direct impact on those specific patients. But at Nutricia, my work on new product innovations, marketing campaigns and the education of HCPs allows me to make a difference to a much larger number of patients.

As the Senior Brand Manager for Enteral Feeding I’m responsible for Nutricia’s tube feed portfolio, and what I love about the role is the pace and variety of new professional challenges I face on a regular basis. There's always a new project to work on, always requiring me to use my clinical skills and knowledge in novel and exciting ways. One day I might be working on our latest innovation that is due to launch, developing campaigns, media and multi-channel engagement to get the latest information and evidence across to HCPs. On another day, I might be working on an innovation further down the pipeline, maybe several years away, developing a business case for a new product and outlining what we would need to do to make it happen, while working closely with our medical team to ensure the innovation is needed and useful. Another significant part of my day-to-day is strategy. We have a huge range of products, and we’re continually looking at which parts of our range we really need to focus on in order to best support HCPs with the information and products that they need. 

There are approximately 40,000 patients¹ that are home enterally fed in the UK, and there is a real need to raise awareness of this because 32% of people have never heard of tube feeding². Yet it is a critical way of receiving nutrition for a wide variety of people. For some, it is a temporary measure while they are in the process of recovery. But for others, there is an underlying condition that means tube feeding will be a long-term measure. The most common would be people with neurological conditions like motor neurone disease or multiple sclerosis. Then there are those who have had head or neck cancer, for example, or post-stroke patients who have lost the ability to swallow. For people like this, tube feeding is how you sustain your life - and as such it is an absolutely enormous part of your day-to-day experience. It would be great if more people had an understanding of tube feeding and it was more widely known about, because when you first start it is such a huge adjustment that it can be incredibly daunting, and you really need a lot of support. There is a social and psychological aspect to it too, and when I was a dietitian a big chunk of my time would be spent ensuring that people were equipped with the knowledge to make an informed decision, and trying to demystify the whole process for them. It can be so scary to have to get to grips with the fact that you’re never going to eat or drink in the same way again, and take on board a new kind of food and new ways of doing things. So raising awareness is super, super important.

We’re always looking for new ways to improve tube-feeding for our patients, and to that end we’ve launched two new innovations recently that will really make a difference in patients’ lives. One innovation is that we have launched our first fully vegan tube feed, by changing the source of vitamin D in our soya feed from lanolin in sheep’s wool to algae. Until now, there has been no tube feeding option for patients who are vegan for religious reasons or by choice. So it has been absolutely brilliant to be able to give that choice back to our patients, and to give HCPs a new tool in their armories. 

The second major innovation has been in bolus feeding, for which we have developed the product Nutrison Bolus Energy HP. A third of home enteral tube fed patients are bolus fed, which means they receive several volumes of feed, normally an oral nutritional supplement (ONS) at a series of specific times over the course of a day, rather than being fed slowly and continuously via a pump attached to their feeding tube. Previously, the most common method of bolus feeding meant drawing up your feed, often an ONS, with a syringe, then pushing it into the tube - and repeating this process five or six times to finish the bottle. Frankly, this can be quite messy, and for patients who are out and about you would have to be really confident to overcome the psychological aspect of getting your bottle of ONS out and going through the process of administering it into the tube. The concept of Nutrison Bolus, by contrast, is that you just bring your feeding pouch of tube feed with you and it connects directly to your feeding tube via a small connector, so you can just squeeze the product to administer it. The patient can apply pressure at a rate that feels comfortable to them, then disconnect and be ready to go. It’s more mobile because there’s less stuff you need to carry about with you, it’s less messy, more hygienic, and our study found that it saved patients time. We extrapolated from the study that if you’re using four pouches a day, you can save six or seven hours over the course of a week. It’s all about putting the patients experience at the centre of our products, making the process quicker, cleaner and more flexible - thereby making life easier for patients who want to bolus feed. 

My favourite part of my job is seeing an innovation come to life and make it to market, and then seeing the difference it makes in people’s lives and hearing their feedback. There’s so much work that goes into an innovation from its beginning to the point of launch, and even though it’s an incredibly busy time with a lot of challenges it always feels super rewarding. I love standing up and training the sales team on our new products, or sharing information at events with HCPs. But the key for me is when we get the feedback - when we hear that a new product is the first feed that a patient has tolerated, and that it has made a real difference to their life. That’s what makes all the work worthwhile. It’s a one-of-a-kind feeling, and what makes it possible is the amazing people who work at Nutricia and the culture they create - which is why I think so many people keep working here for as long as they do.