Articles and Updates from Phoenix Children's
Feeding disorders have been found to occur in up to 25% of the pediatric population. Those with a pediatric feeding disorder can struggle with feeding difficulties that are sometimes persistent and create considerable difficulties including nutritional deficiencies, poor weight gain, growth and family stress.
The definition of Pediatric Feeding Disorders (PFD) is defined as impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction (Goday, 2019).
February 7-11, 2022 is Feeding Tube Awareness Week and it’s the perfect time to learn about our family-centered interdisciplinary team who offers a variety of feeding programs to address and eliminate feeding difficulties of all levels. In fact. It’s the only medical program in the state of Arizona that provides a comprehensive evaluation and treatment for medically complex children with pediatric feeding disorders. Our highly specialized team with years of experience is committed to research and providing care for feeding disorders including:
- Failure to thrive, poor weight gain, weight loss
- Enteral tube feeding dependence
- Oral motor skills, lengthy mealtimes, difficulty advancing to new foods
- Selective eating and sensory feeding difficulties
- Swallowing difficulties
The Feeding Disorders Program at Phoenix Children's Hospital provides individualized treatment recommendations for each patient and family through a comprehensive approach including a multidisciplinary clinic evaluation by Gastroenterology, Psychology, Registered Dietitian, Speech Pathology, Occupational Therapy, as well as a lead clinical specialist and program coordinator.
Our team is highly skilled with the use of feeding tubes to help provide the nutrition and hydration that a child is not able to sustain orally. This provides a bridge that allows a child to learn the skills needed to eat and drink by mouth while receiving the critical nutrition and hydration provided by the feeding tube.
Types of feeding tubes include:
- NG-tubes: NG-tubes enter the body through the nose and run down the esophagus into the stomach.
- ND- or NJ-tubes: ND-tubes are similar to NG-tubes, but they go through the stomach and end in the first portion of the small intestine (duodenum). NJ-tubes extend even further to the second portion of the small intestine (jejunum). Bypassing the stomach can be beneficial for those whose stomachs do not empty well, who have chronic vomiting, or who inhale or aspirate stomach contents into the lungs.
- Gastrostomy tubes (G-tube): are the most common type of feeding tubes. G-tubes are placed through the abdominal wall into the stomach.
- PEG and Long Tubes: These are one-piece tubes held in place either by a retention balloon or by a bumper.
- Gastrojejunal Tubes (GJ-Tubes) GJ-tubes are placed in the stomach just like G-tubes, but a thin, long tube is threaded into the jejunal (J) portion of the small intestine. The vast majority of children who get GJ feeding tubes begin with G-tubes; it is rare for a GJ-tube to be placed initially. Most often, the J-port is used for feeding and the G-port is used for venting and sometimes for medications.
- Gastric Tube Considerations: G-tubes can be more comfortable than nasal tubes and are a safer option for longer-term tube feeding. There are low profile, button-style G-tubes that are not as noticeable under clothing. A trained parent or caregiver can replace the balloon button G-tubes at home.
Approximately 70% of patients seen in clinic are referred to our outpatient intensive feeding therapy (IFT) program, regarded as the place of choice for treatment of severe feeding disorders. The primary goals include reducing or eliminating the need for liquid or enteral tube feeding, successful oral feeding while minimizing the risk of pulmonary complications and maximizing the quality of life.
IFT includes three phases of outpatient treatment:
- Intensive Phase (5-6 weeks) 30 visits including daily therapies and three to five GI and RD appointments.
- Transition Phase (4-6 weeks) with reduced weekly therapies and a 2-month follow-up with GI and RD appointment.
- Maintenance phase (6months) reduced monthly therapies and six-month follow-up with GI and RD appointment.
Post program follow-up every 6 months up to 3 years.
We have two locations to help your kids with all their needs: our Main Campus team is led by Dana I. Williams, MD, Medical Director, Aerodigestive and Feeding and Swallowing Program, Department of Pediatric Gastroenterology and Nutrition. Our Mercy Gilbert Team is led by Soofia Khan, MD, Aerodigestive and Feeding and Swallowing Program, Department of Pediatric Gastroenterology and Nutrition.
For more information about the Phoenix Children’s Feeding Disorders Program, contact us:
Jennifer Urich, M.S., OTR/L Occupational Therapist, Team Lead (firstname.lastname@example.org / 602-933-1166) or Cali Crever, M.A., Program Care Coordinator (email@example.com / 602-933-3664).