Meet the Orlando Health Children's Team
Our team of pediatric experts is united by a shared commitment to helping children thrive. From primary care providers to highly specialized physicians, nurses, and caregivers, we work together to deliver compassionate, coordinated care tailored to every child and family.
Feeding Disorders Frequently Asked Questions (FAQs)
A variety of medical conditions can impact your child's ability to eat, including:
- Attention deficit disorder (ADD)
- Attention deficit hyperactivity disorder (ADHD)
- Autism spectrum disorder
- Brain injury
- Cerebral palsy
- Constipation
- Cystic fibrosis
- Downs syndrome
- Eosinophilic esophagitis (EoE)
- Failure to thrive
- Food allergies
- Gastroesophageal reflux disorder (GERD)
- Mitochondrial disorder
- Noonan syndrome
- Prematurity of birth
- Reflux
- Short bowel syndrome
We believe that parent and family involvement is critical to your child's success in meeting his or her feeding goals. Beyond just the scope of our program, here are some ways that parents can help their child improve their feeding:
- Speak with your child's pediatrician about your feeding concerns.
- Keep a detailed food log of what and how much your child eats.
- Videotape your child during mealtime to share with your child's pediatrician or specialist.
- Set a good example by eating healthy, nutritious foods.
- Do not bribe your child to eat or clean his or her plate.
- Put appropriate portions on your child's plate.
- Establish a routine of snacks and mealtimes to help decrease grazing behaviors throughout the day.
- Provide repeated exposure to new and less preferred foods.
- Share meals together as a family as often as possible.
- Make mealtimes and snacks fun by serving vegetables with dip or sauces, using cookie cutters to make sandwiches or pancakes, or using vegetables and fruits to make simple shapes or characters.
- Give finger foods or cut foods into bite-size pieces, which can assist with improving independence with self-feeding.
- Engage your child by having them help with meal planning, shopping and cooking meals.
- Once a food has been accepted, you can offer it prepared in different ways or offer other foods prepared in a similar way.
Many times, children are referred to the Feeding Difficulties Center for a fairly general problem related to eating, such as failure to thrive or being a picky eater. Once they are seen by our specialists – including our gastrointestinal physician or our neurodevelopmental physician – we sometimes discover an underlying condition that is causing the feeding issue.
Through a thorough history and physical exam, we can oftentimes evaluate for a potential medical condition that is causing the child to have trouble with eating. Depending on the symptoms and issues your child is exhibiting, we may perform specialized diagnostic tests:
- Complete blood panel. All children in our program will undergo a complete blood panel. Blood tests can diagnose certain conditions, including food allergies. If a food allergy is present, our team will know to eliminate that food from your child's diet in hopes of improved feeding.
- Fiberoptic evaluation of swallowing (FEES). In this study, a thin, flexible instrument is inserted into the nose and to the throat. Using this, the speech-language pathologist can observe what happens when your child swallows liquids or foods.
- Oropharyngeal motility (swallowing) study, or OPMS. Also known as a modified barium swallow test, your child will consume small amounts of foods and liquids containing the mineral barium. X-rays will be taken to see what happens to the liquid as it travels through the GI tract.
- Upper gastrointestinal (GI) series. In this test, a technician takes a series of X-rays of your child's upper GI tract to see what happens when he or she drinks liquids.
- Endoscopy. With this test, the doctor passes a thin, flexible tube with a camera through the mouth and into the esophagus, stomach and first part of the small intestine. Several samples are taken and analyzed in the lab. We can assess for gastrointestinal conditions such as Gastroesophageal reflux disease, Eosinophilic esophagitis, exocrine pancreatic insufficiency and other problems
- Blood tests-evaluate for certain medical conditions in addition to nutritional deficiencies
Note that in some cases, children need to receive behavioral intervention services to address an underlying condition – such as ADHD – before we can effectively treat the child specifically for feeding difficulties.
Once we have received the referral from your child’s pediatrician or other primary care provider, we will contact your insurance company and provide you with detailed information on your plan’s coverage. This way, you will know what may or may not be covered prior to your child’s first appointment with us. (Note that we cannot ever guarantee insurance payments, and any balance accrued at the Feeding Difficulties Center is ultimately your responsibility).
Our professional team takes the time to get to know your child so that we can create a customized care plan just for him or her. No two children’s care plans are exactly alike, and we pride ourselves on the expert recommendations and care plans we can provide to families due to our years of success in caring for children with feeding disorders. By entrusting us with your child’s care, we ask that you respect our professional recommendations and follow our care plan that is backed with years of experience in treating children like yours.
You and you child will meet with many different specialists all in one day. You will not need to make multiple trips to the hospital or schedule several different appoints. You should expect the visit to take three to four hours.
What to Expect at the Feeding Difficulties Center
To be seen by our team, your child will first need a referral from their pediatrician or another primary care provider. (Most insurance plans require a referral to be seen by a specialty provider). Once we have the referral, we will contact you to set up your child’s initial appointment with us.
Before the first visit, you will need to provide us with your child’s complete medical history, including past medical testing results, diet log and previous therapy records. If your child is in school, his or her teacher may need to fill out and return a teacher assessment. You will need to fill out our pre-appointment paperwork.
During your first visit at the Feeding Difficulties Center, you and your child will meet with our specialty team.
Once assessed at the initial visit, our team will work together to formulate a customized recommended care plan for your child. Depending on our assessment of your child – and the goals we work with your family to set – he or she will be cared for by a specialized combination of health care professionals and services. We will advise your family – as well as your child’s referring provider – of these recommendations, and we will work with you to move forward with any recommended care.
Before your child starts treatment, your family will meet with one of our social workers to determine your goals. Our team collaborates with your child and family to create meaningful goals based on your child's current developmental status, specific feeding disorder and other personalized factors. For example, some common treatment goals include:
- Increasing the volume of food
- Eating appropriate foods for the child's age and development
- Eating a wider variety of food textures
We then measure your child's success based on progression toward these personalized goals and adjust treatment as needed.
On average, children who undergo treatment in the intensive feeding program at Orlando Health Children's Arnold Palmer Hospital demonstrate two levels of improvement in the types of food textures consumed, as measured using a International Dysphagia Diet Standardization Initiative (IDDSI) model of reporting. This means children who only ate foods like oatmeal now enjoy refried beans, while children who only ate foods like soft fruits now consume french fries or pancakes. More than 30 percent patients in this program exceed these levels. Likewise, 54 percent of patients using a G-tube at the start of the intensive program improved their consumed textures by mouth by two levels. Levels of improvement are based on your child’s developmental age and are assessed based on their individual diagnosis and personalized treatment plan.