Outpatient Services for Children with Feeding Difficulties
Comprehensive services for children with varying degrees of feeding difficulties are provided through a network of clinics at The Children's Hospital at Westmead; The Dysphagia and Nutrition Clinic, The Multidisciplinary Clinic and the Speech Pathology Department.
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Dysphagia Management Clinic
The clinic provides a service to children with feeding difficulties as a result of chronic and complex medical conditions including cerebral palsy and other physical and intellectual disabilities. Many patients present with supplemental feeding.
The clinic offers:
- Consultation and feeding assessment as necessary
- Modified barium swallow investigations
- Advice on enteral feeding and stoma therapy support
- Endoscopy through the Gastroenterology Department
- Bone mineral density/body composition studies
- Referral for other medical investigations, as necessary
- Multidisciplinary reviews, including dietetics, speech pathology and physiotherapy
- Ongoing management, with referral back to local services as necessary
Indications for referral include:
- Nutritional concerns
- Failure to thrive
- Gastro-oesophageal reflux/vomiting
- Naso-gastric or gastrostomy problems
- Swallowing incoordination
- Chronic lung disease, recurrent aspiration and chest infections
- Associated osteoporosis
Feeding outcomes
Restoration of healthy nutritional status and healthy bones, and safe oral feeding, if possible.
Referral process:
Written referral from attending medical officer.
Contact: Clinical Nurse Specialist, telephone 9845 3971.
Clinic Frequency: Every Monday morning
Multidisciplinary Feeding Service
The Multidisciplinary Feeding Service provides a service to children with feeding difficulties that result from, or are a part of, medical conditions, eg., cardiac, renal, and mild to moderate disability, but excluding cerebral palsy. It provides continuum of care for discharged inpatients. The majority of patients are infants whose prognosis for oral feeding is yet to be determined.
The clinic offers:
- Consultation and in-clinic assessment of feeding and nutrition
- Breast feeding assessment with a Child and Family Health CNC
- Enteral feeding support
- Stoma therapy
- Community and nursing liaison
- Occupational therapy on call
- Psychological medicine involvement for families
- Modified barium swallow investigations
- Specialist medical investigations
- Review, including dietetics and speech pathology
- Ongoing management, with referral back to local services as necessary
Indications for referral include:
- Enteral nutrition
- Failure to thrive
- Oral motor and sensory problems
- Swallowing incoordination
- Behavioural or interaction issues surrounding eating/food refusal including autism
- Specific stoma problems combined with feeding difficulties
- Breast feeding difficulties
Feeding outcomes
Eventual transition from non-oral to normal oral feeding patterns, whilst supporting a healthy nutritional status.
Referral process:
Written referral from attending medical officer.
Contact: Clinic Coordinator, telephone 9845 2076.
Clinic Frequency: Every Monday.
Speech Pathology Department
The Speech Pathology department provides a service to children whose feeding difficulties arise mainly from oral motor and sensory difficulties and other mealtime management issues.
The clinic offers:
- Consultation
- Ongoing management, with referral back to local services as necessary
- Review
- Modified barium swallow investigations
- Therapy
Indications for referral include:
- Oral motor and sensory problems
- Swallowing incoordination
- Behavioural or interaction issues surrounding eating/food refusal including autism
Feeding outcomes
Safe feeding practices, normalisation of mealtime patterns and oral feeding in the long term for non-oral patients.
Referral process:
Written referral from paediatrician and specialists associated with The Children's Hospital at Westmead.
Contact: Speech Pathology Secretary, telephone 9845 2076
Clinic frequency: Every Tuesday.
Click here  for the clinic referral form and email to Outpatients@chw.edu.au
This document was updated on Thursday, 17 July 2008.
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