What Is Nutrition and Feeding?
Feeding is the act of eating and swallowing. Nutrition refers to the quality and quantity of nourishment a child needs for physical growth, thinking and learning development and normal body processes.
Many children who have complex conditions also experience trouble with feeding and nutrition.
Conditions Nutrition and Feeding Treats
Many of the children who have feeding and nutrition issues experience the following:
- A need to follow special diets, such as the ketogenic diet or low glycemic index diet, to treat epilepsy and seizures.
- A need to take medicines that create nutritional challenges.
- A need to use feeding tubes.
- A swallowing disorder (dysphagia).
- Conditions that affect appetite, such as Prader-Willi syndrome.
- Motor conditions that affect their ability feed themselves or nurse successfully.
- Problems with the sensation of eating or swallowing food (oral aversion).
- Weak muscles in the mouth or face.
Several complex conditions can lead to nutrition and feeding problems, including:
- Cerebral palsy.
- Brain injury and related neurotrauma.
- Spina bifida.
- Spinal cord injury.
- Complex movement disorders.
- Neuromuscular conditions.
- Epilepsy and seizures.
- Autism spectrum disorders.
- Being overweight or obese.
- Being underweight.
- Conditions that affect bone health (or a history of taking medicines that affect bone health).
- Conditions that require a feeding tube.
- Developmental delays.
- Swallowing disorder (dysphagia).
- Prader-Willi syndrome.
Nutrition and Feeding Tests and Treatments
Supported by the latest equipment and techniques, your child has many options for getting the nutrition they need through programs at Gillette Children’s Specialty Healthcare.
Feeding Evaluations and Therapy
During feeding evaluations, Gillette specialists test your child to measure their skills related to feeding. For example, some children:
- Can’t tolerate certain food textures (food aversion).
- Experience anxiety at mealtimes.
- Have a hard time chewing or swallowing.
We evaluate many factors during the test, including your child’s:
- Level of independence with feeding.
In some cases, we recommend a swallowing study. This full-motion X-ray shows whether food and liquid can move safely from your child’s mouth to their esophagus.
After a feeding evaluation, we might recommend feeding therapy sessions at Gillette. We often work with families to develop a home feeding program.
Additional Nutrition and Feeding Services
In addition to feeding evaluations and therapy, your child might benefit from the following services:
- Help starting or maintaining the ketogenic diet and low glycemic index diet to manage epilepsy and seizures.
- Neuromuscular electrical stimulation (NMES) to improve swallowing.
- Nutrition management for kids who have feeding tubes.
- Radiology and imaging tests, including upper gastrointestinal X-rays and gastric emptying tests.
Based on your child’s needs, our feeding team might recommend the following treatment approaches:
Beckman Oral-Motor Therapy
In this approach, we gently stretch muscles of the lips, cheeks and nose to increase range of motion and strength for feeding.
Ellyn Satter’s Division of Responsibility in Feeding
With this approach, we teach parents and caregivers about their important role in feeding, focusing on mealtime responsibilities.
This approach concentrates on specific food characteristics, such as texture and taste, to gradually add new foods to a diet.
Get Permission Approach
This approach builds trust in a feeding relationship for kids who can’t tolerate the way eating feels or tastes, or who have trouble chewing or swallowing. The Get Permission approach helps kids learn to enjoy eating and feel more confident at mealtime.
Neuromuscular Electrical Stimulation
This intensive feeding treatment focuses on strengthening the muscles used in swallowing.
This oral aversion therapy uses taste, smell, vision and sound to help kids develop a positive relationship with food and mealtime.
Weaning from Tube Feeding
When it’s medically appropriate, we work closely with other members of your child’s care teams to gradually discontinue the use of tube feedings.
Preparing for a Feeding Evaluation
Before you can schedule a feeding evaluation at Gillette, you must get an order from a physician—either at Gillette or from another facility. The order must show the need for any of the following:
- An interdisciplinary feeding evaluation.
- An evaluation by a speech and language pathologist.
- An occupational therapist and a dietitian.
Once we receive an order, we’ll contact you to schedule a feeding evaluation. Both before and after the test, our team will be in close touch with your referring physician to organize effective care.
To help with the evaluation, we might ask you to bring the following mealtime items to your appointment, so we can better understand what routines your child is accustomed to:
- Food or formula.
- Formulas, rates and quantities for tube feeding (if relevant).
- Plates and cups.
If your child has trouble with eating and nutrition due to a complex condition or injury, you might need extra help making sure they get the nourishment they need. Gillette specialists understand the unique challenges you face as parents and caregivers of children who have disabilities. We also recognize that each child’s nutritional needs and feeding preferences are unique.
Working closely with you, our team of experts will develop a comprehensive nutrition and feeding plan designed for your child and your family. We take an integrated approach to nutrition and mealtime, referring your child to other Gillette specialists as needed.
Your child’s core nutrition and feeding team will include specialists in:
As part of a comprehensive treatment plan, we’ll help you coordinate care from experts in areas such as:
- Ear, nose and throat (ENT or otolaryngology).
- Medical genetics and genetic counseling.
- Pediatrics and general medicine (pediatricians and nurse practitioners who specialize in height and growth concerns).
- Radiology and imaging.