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Feeding and Growth Clinic

The Feeding and Growth Disorders Program at Children's is one of a few of its kind in the Midwest. It is designed specifically for infants, toddlers and adolescents who have a variety of feeding and swallowing difficulties as well as failure to gain weight appropriately.

Because the needs of children with feeding difficulties can be so complex, we provide a multi-disciplinary approach that includes highly-trained pediatric professionals such as speech language pathologists, a social worker, dietitian, behavioral psychologist, GI registered nurse, GI physician and occupational therapists.

These professionals work together to help your child become medically stable, meet their nutritional needs, maximize their oral feeding potential and enjoy the social and emotional aspects of meal time.

TEAM MEMBERS

Fernando Zapata, M.D., Pediatric Gastroenterologist
Mindy Cooman, MS, RD, LMNT, Pediatric Clinical Dietitian
Amanda Coffey, OTD, OTR/L, Pediatric Occupational Therapist
Amanda Beranek, RN, Pediatric Nurse
Megan Enenbach, APRN, Pediatric Nurse Practitioner
Sarah Wilson, MS, RD, LMNT, Pediatric Clinical Dietitian
Jenna Schaecher, LCSW, Medical Social Worker
Karen DIttmer-McMahon, Ph.D., L.P., Pediatric Psychologist
Kristy Anderson, MS, RD, LMNT, Pediatric Clinical Dietitian
Katie Hansen, MS, CCC-SLP, Pediatric Speech Language Pathologist
Megan Crimmins, PCMSW, PLMHP, Medical Social Worker

CLINIC SUMMARY

The Feeding & Growth Clinic is designed to treat infants, toddlers and adolescents who present with a variety of complex feeding difficulties that impact proper growth and development. This clinic offers a multi-disciplinary approach to the treatment of pediatric feeding disorders through the combined expertise of a pediatric gastroenterologist, a pediatric nurse practitioner, pediatric clinical dietitians, a pediatric speech language pathologist, a pediatric occupational therapist, medical social workers and a pediatric psychologist. Patients are evaluated by each of the clinic specialists and interventions are implemented to meet the individualized needs of each patient. 
 
The Feeding & Growth Clinic also facilitates and coordinates additional follow-up needs in the community and to other departments within Children’s, i.e. referral to Behavioral Health services, referral for additional medical work-up (i.e. Genetics, Endocrine), ordering for a swallow study/deglutition study and determination of ongoing needs for outpatient feeding therapy, assistance in setting up EDN services, assistance with transportation, formula authorization through WIC and other resources as indicated. 


PATIENT INFORMATION

Common Diagnoses, Problem Lists & Medical History:

  • Prematurity
  • Heart Disease
  • Aspiration
  • Dysphagia
  • Food Refusal
  • Oral Aversion
  • Malnutrition
  • Developmental Delay
  • Tube feeding
  • Social Concerns
  • Allergies

EXAMPLE PATIENT SCENARIO

Past Medical History & Problem List:

  • Prematurity (24 weeks completed), oral aversion, atrial septal defect, gastrostomy tube, tantrums related to eating, gagging on food, throwing food

Clinic Visit:

  • Medical Evaluation and Intervention
  • Nutrition Assessment and Intervention
  • Feeding Assessment and Intervention
  • Behavioral Health Assessment and Intervention
  • Developmental Assessment and Intervention
  • Social Work Assessment and Intervention

Feeding Progression & Growth:

  • Outpatient feeding therapy established
  • 90% of nutrition via g-tube to 25% of nutrition via g-tube in 3 years
  • Previously with gagging, pocketing, food refusal, liquid refusal – now all nearly resolved
  • Maintaining age-appropriate BMI with increase transition into oral intake
  • Previous behaviors surrounding eating/drinking nearly resolved


CLINIC OUTCOME GOALS

  • Medical concerns controlled/resolved (i.e. gastroesophageal reflux, constipation, diarrhea, abdominal pain, EoE, eczema, vomiting, H. pylori)
  • Nutrition status optimized (i.e. malnutrition resolved, age-appropriate growth and development achieved, independence from tube feeding, decreased tube feeding support)
  • Feeding strategies and outpatient feeding therapy improved oral intake of nutrition (i.e. oral aversion resolved, resolution of pocketing food, increased acceptance of food textures, aspiration treatment)
  • Behavioral strategies improve negative behavior surrounding eating (i.e. parents equipped with skills to address negative behaviors are able to reduce negative behaviors related to eating)
  • Barriers at home are improved/resolved (i.e. assistance with transportation issues, additional services put in place to support family needs, financial assistance resources)
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