Pediatric Feeding Program
We assess and treat children who need care for complex feeding concerns. Many of our patients struggle with eating or drinking, or they weigh less or gain weight at a slower rate than is typical for their age. We also support children who are ready to make the transition from tube feeding to eating by mouth.
Our team provides care for children ages 1 through 18.
The Pediatric Feeding Program now includes the services that used to be in our Growth and Feeding Dynamics Clinic and our Intensive Feeding Program. We brought these services together under one name so it’s easier for families to find the care they need.
Why choose Seattle Children’s Pediatric Feeding Program?
Ours is one of the only feeding programs in the Pacific Northwest where experts from many areas of healthcare work as a team to give your child and family complete care.
Comprehensive, team-based care
- Members of our team have special training in their field and in the unique needs of children who struggle with eating or who have growth or feeding concerns.
- Our team includes a gastroenterologist, child psychologists, registered dietitians, speech and language pathologists, occupational therapists, licensed behavior analysts, social workers and nurse practitioners.
- We evaluate your child together — at the same time and in the same room. Each team member brings their special focus to the visit. Then we combine our knowledge and skills to provide care custom-made for your child and family.
- We work as a team to understand:
- Your child’s feeding concerns
- Your child’s skills
- Any sensory or medical challenges your child has that relate to eating
- How your child has learned and felt about eating
- Your child’s response to feeling hungry or full
- How feeding concerns affect your family
- Based on your child’s needs, we will involve healthcare providers from other areas of Seattle Children’s, like Gastroenterology, Neurodevelopmental Medicine and the Aerodigestive Program.
We work with your family
- Our goal is to improve your child’s eating skills and build healthy feeding patterns that your child and family can keep using at home and in the community. We focus on providing targeted treatment that leads to meaningful change.
- Each child with a feeding issue is different. We consider lots of different treatment methods and make a treatment plan and schedule with options that work for your family.
- As a parent or caregiver, you know your child best. You will have an active role in setting treatment goals and figuring out what works.
- We count on you to practice treatment during visits and at home. This leads to the best results for your child.
Focus on success
- During treatment, we may ask you and your child’s team to carefully collect data to learn what is working for your child.
- We may ask your child to answer questions about themselves, if they can. We may also ask you about your child’s behavior and symptoms related to feeding. Based on your child’s needs, we may ask you to complete data sheets tailored to your family and feeding questionnaires.
- These and other tools help us track your child’s progress and refine their treatment to make it a success.
- Our program does research to learn more about the best ways to help children and families with feeding disorders. We meet with and teach other healthcare providers about feeding disorders and treatment.
Conditions We Treat
We treat all types of complex feeding concerns. Our program can help children with a range of concerns, such as children who:
- Weigh less or gain weight at a slower rate than is typical for their age.
- Do not want to eat or refuse to eat (feeding aversion).
- Have trouble moving to solid foods.
- Eat only certain food types or textures.
- Get some or all of their nutrition through a tube in their stomach or bowel (G tube, J tube or NG tube).
- Are ready to transition from tube feeding to eating by mouth.
- Struggle with the oral motor skills they need to chew, swallow and eat or drink safely.
- Have sensitivities that make it hard for them to eat a wide range of food types and textures. For example, they might struggle with the way eating or drinking feels or with the taste, smell, texture, bite size or sight of food.
- Learned that eating is unpleasant or difficult.
- Have severe anxiety about mealtimes linked with challenging behaviors. These may include refusing to come to the table for meals, not following directions during meals, having tantrums and being aggressive.
- Have a condition called avoidant restrictive food intake disorder (ARFID).
Children who need feeding and swallowing evaluation and treatment may be seen by Occupational Therapy or Speech and Language Services if they do not need the full team of the Pediatric Feeding Program.
Feeding problems are different from eating disorders, which are serious medical and behavioral problems like anorexia nervosa. Seattle Children’s has an Eating Disorders program to help with these problems.
Services We Provide
Intake and evaluation
We meet you and your child to assess your child’s feeding concerns and to see whether our program is right for your child and how we can best help them. An evaluation involves watching your child eat so we can see their challenges and skills. We want to make sure we understand your goals for treatment. We also check if your child is medically ready to take part in treatment.
At the end of the evaluation, our team gives you feedback about the best next steps for your family. We may:
- Recommend treatment within the Pediatric Feeding Program.
- Recommend services through other Seattle Children’s programs or clinics.
- Refer you to services in the community.
- Discuss your child’s evaluation with the provider who referred you. If your referring provider has questions, we are happy to talk with them.
We offer a range of services, including monthly check-ins, weekly visits and intensive feeding therapy, which is every day for 2 to 3 weeks. The services and how often your child has appointments depend on your child’s evaluation.
Your child will see the experts from our team who match your child’s needs. We will teach you strategies to use at home.
As your child’s main feeding partner, you will play an active part in preparing your child’s food and practicing the strategies we teach you. We may give you tools to track your child’s progress. At each clinic visit, we practice treatments and check progress together.
Visits may be:
- In person at Seattle Children’s Autism Center. (The Pediatric Feeding Program is located here. We see children with or without autism spectrum disorder.)
- Via videoconference. You can take part in video visits from a Seattle Children’s regional clinic, a home or a community setting like your child’s school. The video-visit option depends on factors like your child’s needs, the providers your child sees and your insurance. Read how our video-visit option saves time and travel for our patients.
Intensive feeding therapy
For children who need more intensive treatment, we offer an intensive program.
If we recommend this service for your child, your child will come to Seattle Children’s with at least 1 parent or caregiver from 8 a.m. to 4 p.m. every day, Monday through Friday, for 2 to 3 weeks.
During this time, your child’s care team will:
- Work with you and your child on focused treatment custom-made for you
- Provide one-on-one therapy for your child
- Teach you treatment methods to practice at home
- Give you tools to track your child’s progress
The goals of intensive therapy are to:
- Improve your child’s eating skills
- Increase your child’s intake of food and fluids
- Reduce their need for a feeding tube
Caregiver resources and education
No matter which services your child needs, we are here to answer your questions and connect your family with helpful resources. Supporting parents and caregivers is an important part of what we do.
We offer classes to help you understand feeding disorders in children and the first steps towards care. Classes are meant for families who are on the waiting list for an intake visit or feeding therapy services. You can take classes:
- In person at the clinic.
- Using a tablet, laptop or desktop computer that has a camera. You can take part from a home, workplace, school, library or wherever you are.
Learn about Feeding First Steps: Parent Education Class (PDF).
Based on your child’s health needs and where you live, we may connect you with feeding providers in your community to provide treatment and support, including long-term services, if your child needs this. We help you find providers close to you so care is easier for you and your child.
Scheduling an Appointment With the Pediatric Feeding Program
- To schedule, you need a referral to the Pediatric Feeding Program from your child’s primary care provider. If you would like a referral, talk to your child’s primary care provider. If you already have a referral, please call 206-987-0008 to schedule an appointment.
- If you already have an appointment, learn more about what to expect and how to prepare.
- Learn about Pediatric Feeding Program resources such as useful links, videos and recommended reading for you and your family.
Participate in Research
You can help us answer questions about childhood health and illness and help other children in the future. Learn more about clinical trials and research studies at Seattle Children’s.
Providers, see how to refer a patient.
- Autism Center
- Clinical Nutrition
- Occupational Therapy
- Psychiatry and Behavioral Medicine
- Speech and Language
- Applied Behavior Analysis: A Parent’s Guide (PDF)
- Autism 204: Helping Children With Autism and Restrictive Eating (Video)
- Food Challenges and Children With Autism
Read the Autism Blog
Keep up with the changing world of autism spectrum disorders, and engage with experts from Seattle Children’s Autism Center.
For Healthcare Professionals