Feeding Program Overview

The Pediatric Feeding Program at CHOC takes a multidisciplinary team approach to the evaluation and treatment of children with complex feeding problems. In order to provide the most comprehensive care necessary, this unique program is designed with a team of specialists that work closely with the patient and family to maximize the child’s strengths and improve overall performance.

The Feeding Program was established to evaluate and treat children with significant feeding problems. Children who participate in the program typically have failed outpatient feeding therapy and have either a G-Tube (feeding tube) or are at risk for G-Tube placement.

Children seen in the feeding program have a range of medical/developmental problems including cerebral palsy, developmental disorders, seizure disorders, genetic disorders, oral motor dysfunction, short-bowel syndrome, food allergies, history of prematurity and behavioral disorders. The multidisciplinary program includes specialists from gastroenterology, speech therapy, occupational therapy, psychology, social services, and nutrition.

The feeding program can include one or all of the following components: an initial screening, outpatient feeding evaluation, psychology/behavioral consultation and an intensive inpatient feeding program. After each stage, recommendations are made to best meet the patient/family’s goals for better feeding skills.

Feeding Program Mission

We are dedicated to providing individualized, comprehensive care to children with complex feeding disorders. We strive to:

• Consider all factors affecting the child’s feeding behavior by a comprehensive multidisciplinary evaluation
• Maximize feeding success by identifying strengths of both child and family
• Implement an intensive inpatient program with structured therapeutic, psychosocial, behavioral, nutritional and medical interventions
• Provide a safe, comfortable and fun environment for skill building
• Educate parents and caregivers to apply techniques and strategies to increase independence and generalize increased feeding abilities to the home and community
• Facilitate increased oral intake to meet nutritional needs
• Improve quality of oral feeding including volume, texture and variety
• Encourage positive mealtime experience by effecting the child’s behavior and family interactions

A Comprehensive Approach

Our multidisciplinary team assesses and treats a broad spectrum of complex feeding disorders in children.
Top Five Associated Diagnoses:

• Prematurity
• Cardiorespiratory Disorders
• Severe gastroesophagael reflux
• Structural anomalies (repaired)
• Chromosomal and neurological disorders

Feeding Program Details

A visit with our experts involves the following components:

Initial Screening

• Evaluation of medical/health status
• Comprehensive team review of medical history and records, including any past feeding evaluations or treatments

Outpatient Evaluation

• Two-hour multidisciplinary evaluation
• Assessment of oral motor skills, oral sensory processing
• Observation of parent-child interaction during mealtime
• Interviews iwth individual team members
• Assessment of nutritional status and analysis of three-day food log
• Creation of a comprehensive treatment plan

Psychology/Behavioral Consultation

• Pre-admission appointments to assess for psychosocial barriers to feeding development

Treatment Options

• Outpatient feeding therapy
• Intensive inpatient feeding program
• Dietary monitoring and consultation
• Team reassessment
• Outpatient psychology/behavioral consultations

CHOC Feeding Program Eligibility/Referral Guidelines

Eligibility requirements and referral guidelines for the CHOC Feeding Program are as follows:

• Child is between the ages of 2-6
• Developmental Age of at least 18 months
• Child’s feeding problems have been evaluated by a Gastroenterologist and medical problems related to feeding have been ruled out or treated with medication or surgery
• Child is adequately nourished
• Child’s feeding problems have resulted in significant growth problems and/or G-Tube placement and/or child is currently being considered for G-Tube placement
• Child has received outpatient or in-home feeding therapy for at least six months
• Child continues to have significant feeding problems or requires G-Tube feeding after outpatient therapy
• Family is willing and able to arrange for a parent to stay with the child during the inpatient hospitalization, which may last three weeks