Feeding Clinic provides multidisciplinary assessment for children (birth to age 18) with feeding concerns related to oral motor/ pharyngeal dysfunction due to an underlying physical or neurological condition. The focus is on swallowing safety, development of feeding skill, progression through textures, and optimizing nutrition. The team consists of a Registered Dietitian (RD), an Occupational Therapist (OT) and a Speech – Language Pathologist (SLP). Some and/or all team members may be part of the initial assessment.
This clinic may conduct Video Fluoroscopic Swallowing Studies (VFSS) for clients actively followed by the KidsInclusive Feeding Clinic. VFSS are best used to determine risks of aspiration and characterize an individual’s ability to meet nutritional needs orally. Alternative, less invasive investigations are more appropriate for evaluating the presence or cause of peripheral concerns (e.g., persistent gagging, laryngeal cleft, oral motor delays).
Service delivery is provided using a consultative model, where suggestions, strategies and education are provided to families/ caregivers.
Feeding Clinic referrals are only accepted from a pediatrician. Medical issues as they relate to feeding (medications, reflux, gastric delays/ constipation, oral structural anomalies, allergies, congenital anomalies and/or other medical issues associated with feeding difficulties) are first assessed by the pediatrician prior to making a referral to Feeding Clinic.
Some ‘red flags’ that may signify feeding difficulties or swallowing risk with paediatric clients are:
Unable to meet nutritional needs/ low weight for length (fall off in percentiles) due to oral motor dysfunction
Child unable to move on to textured foods
Child having difficulty managing liquids
Query / Increased risk of aspiration (history of eating and breathing coordination problems, with ongoing respiratory issues).
Unable to progress child from enteral tube feeding to oral feeding
Food refusal if it is related to a significant event in the client’s medical history (e.g., refusal after being extubated or concurrent with GERD).
REFERRALS FOR THE FOLLOWING MAY BE REDIRECTED BACK TO THE REFERRING PHYSICIAN:
Video Fluoroscopic Swallow Studies (VFSS)
Requests for VFSS for children who are not active clients of the KidsInclusive Feeding Clinic will be redirected to the Department of Audiology/Speech Language Pathology at KHSC – Hotel Dieu Hospital Site.
Feeding Concerns Related to Behaviour
KidsInclusive Feeding Clinic does not have the clinical expertise to see children whose feeding difficulties relate primarily to an underlying behavioural issue, mental health issue, Autism Spectrum Disorder or parent-child interaction difficulties.
Children with long term enteral needs or children fed exclusively with enteral nutrition should be referred to Nutrition Support Clinic at the KHSC by their pediatrician. Feeding Clinic will provide consultation to clients with enteral tubes (G-tubes, NG-tubes, etc.) where oral motor intake contributes to their daily nutrition and advice/ support is required to progress the client off enteral feeds to oral feeding.
Referrals for the sole purpose of pediatric nutrition/ dietitian consultation should be directed to a community dietitian or to the child’s Family Health Team.
Note that KidsInclusive does offer a Picky Eater Parent Workshop at various times throughout the year.
For any inquiries related to feeding referrals, please call the System Navigator at ext. 2074 or 3455.