Inside Pediatrics Winter 2017

Unique program offers support for parents, picky eaters

By Marti Webb Slay Photos by Denise McGill

M any parents struggle with a child who is a picky eater or exhibits concerning eating and drinking habits. Once the issue is brought to a pediatrician’s attention, subsequent evaluation and treatment by medical subspecialists and outpatient feeding therapy help many families. But when the eating challenge is not transient and persists despite intervention, a more targeted and intensive approach may be needed. Children’s of Alabama offers such an approach. One of a handful of programs of its kind in the U.S., the Intensive Feeding Program at Children’s offers a transdisciplinary approach to treating children with intractable feeding challenges that often impact their growth, nutrition and development.

The program treats children with oral aversion, total food refusal, feeding tube dependence and challenges transitioning to appropriate liquids and food textures. Children in the program often have histories of complex medical problems, developmental delays, sensory issues, oral motor deficits and/or behavioral challenges. The initial evaluation seeks to identify medical, nutritional, oral- motor and behavioral feeding problems, and provides recommendations for further evaluation and treatment. Recommendations may include participation in a day treatment program. Participation in the program is a big commitment for the patient’s family as well as the care team that specializes in children with feeding challenges. The day treatment program currently involves

four feedings a day, five days a week, for six to eight weeks. Caregivers can expect to participate in the meals during the first day of treatment and then observe each meal from an observation room for the next several weeks. As children approach their eating and drinking goals, caregivers are reintegrated into feeding sessions in order to learn and implement the same strategies used with therapists throughout treatment. The program uses a bug-in-the-ear technology so coaching can be offered to caregivers without the treatment staff physically in the feeding room. This offers an opportunity to begin the practice of mealtime at home without the day-to- day support of the program. “Incorporating the family is a key component to our treatment program”

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