Feeding and Nutrition
Infants exhibiting a suck problem - or a child who is a picky eater and who only eats one or two different foods - can develop a "failure to thrive", meaning they cannot eat enough to grow. The Washington State Community Feeding Teams provide an interdisciplinary approach to address feeding/nutrition concerns for children with special healthcare needs in a comprehensive, cost-effective manner. In concert with this state agency, VMC's Children's Therapy works directly with families to help parents/caregivers resolve important issues related to feeding and nutrition. The team approach can benefit a family by avoiding the duplication of services and allow all issues of food and feeding to be addressed by one team with identification of subsequent services and therapies needed.
PEDIATRIC MODIFIED BARIUM SWALLOW STUDIES
Valley Medical Center's Pediatric Modified Barium Swallow (PMBS) team consists of specially trained speech-language pathologists and radiologists. If the child is not currently seeing a feeding specialist, an outpatient Oral Feeding Evaluation should be performed before the PMBS. This gathers information regarding significant medical history, oral motor skill assessment, and observation of current feeding skills. Results will ensure efficiency of the PMBS in determining problems and appropriate suggestion to make feeding easier and safer.
A physician's referral is needed for a PMBS. If the referring physician also orders an Upper GI, it will typically be scheduled on a day following the PMBS. Swallow studies take place in the VMC Radiology department on the main hospital's second floor.
What you need to know about the study -
- Before the study: Using the history of the child's feeding skills, the caregiver is informed what feeding utensils (e.g. bottle/spoon) and liquids/foods (e.g. formal/baby food) to bring to the study.
- During the study: A seat similar to a car seat is typically used. The caregiver usually feeds the child. Assessment is made using x-rays of the child swallowing and a recorded video. any necessasry feeding modifications are made.
- After the study: Results are reviewed with the caregiver. Any necessary education and referrals, including therapy, are discussed. A PMBS Report and Evaluation Summary are sent to the child's physician and referral agency upon consent.
Cleft Lip and Cleft Palate
Valley Medical Center's Children's Therapy Feeding Team provides services to all babes born in our facility with cleft lip and/or palate. Services initially consist of a complete clinical evaluation of each babe's feeding skills shortly after the babe's delivery. The goal of the evaluation is to gather information regarding the babe's medical status, assess oral/facial structures and oral motor skills, and observe the babe's current feeding skills. After the initial observation, the feeding therapist makes modification to the babe's feeding to maximize feeding success. A feeding plan is created after each evaluation to establish guidelines for feeding each individual babe. Families generally participate in these evaluations and receive training on feeding their child. As warranted, our team provides additional consultative services to address feeding and communication needs or concerns throughout the babe's inpatient stay. Once children go home, if warranted, our team continues to follow these babes' progress with feeding and communication skills, providing therapy services as needed. Families are also typically followed by Seattle Children's Hospital Craniofacial Team or Mary Bridge Children's Hospital Craniofacial clinic.
Families with children who have cleft lip, cleft palate, or other craniofacial abnormalities may also find the following organizations helpful:
Cleft Palate Foundation
Children's Craniofacial Association
Foundation for Faces of Children
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Feeding Matters: Conquering pediatric feeding struggles to nourish healthy futures