KidsInclusive Feeding Clinic – Physician Section

The focus of the Feeding Clinic is on swallowing safety, development of feeding skill, progression through textures, and optimizing nutrition. This clinic may conduct Video Fluoroscopic Swallowing Studies (VFSS) for clients actively followed by the KidsInclusive Feeding Clinic.

Feeding Clinic referrals are only accepted from a pediatrician. Prior to making a referral, medical issues as they relate to feeding should be previously investigated (e.g. medications, reflux, gastric delays/ constipation, oral structural anomalies, allergies, congenital anomalies and/or other medical issues associated with feeding difficulties).

Signs of Concern

Some concerns that may signify feeding difficulties or swallowing risk with paediatric clients are:

• Child demonstrates oral-motor/ pharyngeal dysfunction (difficulty chewing/swallowing; gagging, coughing, and/or choking during meals).
• 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 may be redirected back to the referring physician for the following reasons:

 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

This clinic does not specialize in servicing children whose feeding difficulties relate primarily to an underlying behavioural issue, mental health issue, Autism Spectrum Disorder or parent-child interaction difficulties.

Enteral Feeds

Children with long term enteral needs or children fed exclusively with enteral nutrition should be referred to Nutrition Support Clinic at 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 caregiver education is required to progress the child’s oral feeding.

Nutrition

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.