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A baby sitting and waiting to be fed.Program Overview

The Pediatric Feeding Management Program at The HSC Pediatric Center is a collaborative effort between The HSC Pediatric Center and the Children’s National Medical Center. Using the combined resources of both organizations, the program addresses the needs of families who have difficulty feeding their child.

The program addresses alterations in normal feeding patterns or behaviors that compromise nutrition, growth or feeding development and normal family interactions. These may include: difficulty with initiating oral feeding following enteral or parental intervention, total or partial food refusal, oral-motor dysfunction, failure to advance food textures, rumination, dysphagia, and failure to thrive.

Ongoing feeding management services are provided by a transdisiplinary team of selected pediatric professionals including a pediatrician, behavioral psychologist, gastroenterologist, nurses, dietitian, occupational therapist, speech-language pathologist, and rehabilitation technicians trained in specialized feeding techniques and dedicated specifically to the program. Management of a feeding problem involves an initial consultation, a diagnostic evaluation and a personalized treatment program that may take place in a variety of settings.

Intake and Referral

All referrals should be directed to the Feeding Program representatives at (202) 635-6540, 5580 or 6101. The Outpatient Feeding Program representative will gather necessary information, schedule the initial consultation and tour as needed, and will mail a pre-consultation packet.

Initial Consultation and Evaluation

An initial consultation will take place with the Feeding Management Team and is conducted for every child being considered for the program. The Team will review the child’s medical history, evaluations, and information obtained from the family, medical records, primary care pediatricians, GI specialists, and community-based therapists. The evaluation includes an oral-motor/sensory, behavioral, and nutritional assessment. The entire team determines the type of service required, the need for additional diagnostic information or additional evaluations, and program acceptance. Initial Program admission, initial goals for the program and an anticipated duration are made with the team once the evaluation is completed. Once admitted to the Feeding Management Program, Team consultation and parent participation occurs on a weekly basis.

Description of the Program

The Outpatient Feeding Management Program is designed for children who require intensive individualized intervention to accomplish feeding goals, and for children whose clinical conditions and social circumstances support their ability to thrive at home. The Outpatient Feeding Management Program is designed to provide direct therapy services to children who are clinically stable and whose problems can be resolved in the outpatient treatment setting.

Treatments goals are developed that are dependent on the individualized needs of the patient and family. Services include daily monitoring the child’s weight and nutritional status; assessment of the family’s learning progress, and assessment of the child’s adjustment to the treatment plan. Each child is enrolled 5 days per week and will participate each day in 3 structured therapeutic feeding/oral-motor sessions with feeding specialists (Occupational Therapist, Speech-Language pathologist and/or feeding technician). Recreation therapy and educational services are provided between meals to enhance the program goals. The therapists as well as a pediatric physician, behavioral psychologist, nutritionist and a registered nurse will work closely with each child and parent throughout the program. Caregivers will be required to attend weekly clinical meetings with team members as well as individualized training sessions to develop goals, discuss progress and promote carryover of therapeutic techniques at home. The expected length of therapy ranges from 4-8 weeks. Once program goals are accomplished, and as needs change pertaining to level of care, children are then discharged from the Feeding Program and may continue with intermittent services on a per-visit outpatient schedule.

Intermittent Outpatient services may also be provided through the Outpatient Clinic(link) to children whose problems can be resolved in the home setting with periodic advice from team members. Outpatient services include occupational therapy, speech-language pathology, nutrition(link), and psychology(link). Outpatient visits will be used to monitor nutritional status, assess the family’s progress and adjust the child’s treatment plan.

The Inpatient Feeding Management Program is designed for those children who may require more intensive nutritional and/or medical management and monitoring to resolve feeding concerns.



© 2009 The HSC Pediatric Center
1731 Bunker Hill Road, NE • Washington, D.C. 20017 • 202-832-4400 • 1-800-226-4444
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