How Do We Achieve Our Goals for Your Child?
Through the Use of Proven Techniques
- To increase food consumption on a consistent basis
- To meet nutritional, hydration and caloric needs as determined by a dietician
Data Collection
- Monitoring changes in your child's feeding behaviors
- Making adjustments to your child's protocol to provide the greatest chance of success through closely monitoring changes in your child's eating habits
Parent Training
- Parents and caregivers are trained to implement the treatment protocol with 80% or better integrity
Support
- After successful completion of the feeding program, our feeding therapists monitor the progress your child has made to see if it is maintained or can be improved upon in your child's home environment
Los Altos Feeding Clinic Advantages over Other Feeding Clinics
Successful Outcomes
Our success rate is 94% in meeting the feeding goals set at the onset of treatment. We compute success not only on the basis of meeting feeding goals during treatment, but also subsequent to treatment. To be considered a success feeding must continue effectively at home.
Flexible Treatment Strategies
One of the advantages at the Los Altos Feeding Clinic is our ability to be extremely flexible to make feeding treatment as effective and efficient as possible. We do not work with 10-20 intensive cases at a time. Our philosophy is quality over quantity.
Personalized Services
We do not have a huge team hierarchy working with your child, making bureaucratic decisions for your child's treatment behind closed doors.
At the Los Altos Feeding Clinic the case manager is the feeding therapist who designs, implements and makes appropriate changes to your child's feeding protocol. The feeding specialist who works with your child is the only therapist who works with your child from the beginning of admission through completion of therapy and follow-up.
Individualized Treatment
Our individualized approach allows us to work with families to find a feeding schedule that meets the child's needs, rather than fitting the schedule to the convenience of the clinic, which can compromise the effectiveness of therapy.
We work with your child, infant or toddler as much as needed to fix your child's eating problem. Your child's feeding specialist tailors feeding protocols according to the needs of your child, as well as to the parent. Every child is unique in displaying different types of mealtime behaviors and responding differently to each type of protocol.
Efficient and Effective Feeding Therapy
The more experience a child has with feeding issues, the harder the problem is to correct, so we work quickly to develop a well refined protocol for your child. Dragging out an admission can not only jeopardize treatment, but can also be extremely taxing for families.
Elimination of Feeding Tube Dependency
In regards to cases that involve a feeding tube, we have found that eliminating only some tube dependence is not effective. At the Los Altos Feeding Clinic, we strive to completely eliminate any tube dependence during feeding therapy so that all nutritional, caloric, and hydration needs are met orally. Anything less than complete elimination of feeding tube dependence after completion of feeding therapy is considered to be a failure at the Los Altos Feeding Clinic.
Setting Up a Program for Your Child and You
Initial Evaluation
A physician referral from your child’s pediatrician is necessary before the initial evaluation.
The initial evaluation is the first step in determining which feeding therapy program would be suitable for your child, infant or toddler. Your child is evaluated during a meal at the clinic to identify problematic mealtime behaviors and potential feeding goals to be achieved at the Los Altos Feeding Clinic.
This also serves as an interview for documenting your child's medical and feeding history. After the initial evaluation, your child will be assigned to either the day feeding therapy program or the intensive feeding therapy program.
Initial Evaluation for Families Traveling Long Distances
Families who come long distances from the clinic are urged to attend a comprehensive evaluation at the Los Altos Feeding Clinic. However if this is deemed to be too difficult for the family, an initial evaluation can be done via video footage and a phone interview. If you do live a significant distance away and cannot come to our facilities for the initial evaluation, please call us in order to receive instruction on the format of the video footage.
Day Feeding Therapy Program
In the Day Feeding Therapy Program, we typically see a child three times a week. Many feeding issues that children who are appropriate for this program have can be corrected in about 4-6 weeks. Some take less, some more. It all depends on the case.
Typically, children who are local and do not have a feeding tube are considered appropriate for the Day Feeding Therapy Program. Children who are failure to thrive or are scheduled for a tube placement would be appropriate for the intensive program.
Intensive Feeding Therapy Program
This program is 5 days per week with three to four meals per day. In rare instances a fifth meal is added. The program length is 4-6 weeks. The intensive feeding therapy program is customized to ensure that all feeding goals are met.
In some cases exceptions are made and a child or infant is seen 7 days a week (particularly in NG-tube (nasogastric feeding tube) cases). We do whatever is needed to correct your child's feeding issues.
Feeding Therapy Overview for Day or Intensive Feeding Therapy Programs
We work with your child one on one while you observe from the next room. We work with your child's particular feeding problems, while continually modifying your child's protocol for optimal feeding during each point in time. We do this until we reach our feeding goals (e.g. elimination of tube dependence, decrease in vomiting, eating a variety of foods, increased texture, decreased food refusal during meals, and/or self-feeding). We work one-on-one until your child reaches a period of stability, or the meal meets or exceeds our set goals.
Once stability is achieved in your child's eating, we then fade parents and caregivers into the meal, in order to train them according to a highly refined feeding protocol.
Training consists of learning your child's protocol, doing a mock session, and actually feeding your child according to your child's protocol with a feeding specialist present.
As parents or caregivers become more efficient and confident during feedings, the feeding therapist is faded out of the meal. Feedback regarding implementation of the feeding protocol is given during and after a meal.
Once meals are stable with the parents and caregivers feeding, meals are then generalized to other settings to increase the likelihood of a smooth transition to the home setting. Each admission is ended by doing meals in your home (locally), in order to problem-solve any issues that may come up at home during mealtimes.
Follow-Up
This is the most important part of both the day treatment and intensive programs. It is not enough for your child to be eating at the Los Altos Feeding Clinic according to the feeding goals set. Your child, toddler or infant, regardless of feeding issue, should eat in the same manner or better at home. That is why we emphasize follow-up through phone calls, webcam, and other video footage.
When the feeding therapy program is completed, we strongly encourage parents to call or email with any problems, concerns, or questions regarding feeding protocols, feeding problems at home, or advancing to other feeding stages, such as self-feeding or texture. There is somebody ready to return calls or emails seven days a week, day or night. Contacting us as soon as a problem occurs makes all the difference in keeping up the progress when you take it home. We are here to not only support parents during their admission, but also subsequent to feeding treatment.
Working with Other Disciplines
The first step to feeding therapy is always determining whether a child can safely eat. In order to do this several tests such as the MBS, endoscopy, allergy testing, nutritional analysis, etc. must be taken into account. Once these issues are resolved, the feeding therapist can structure meals to increase oral intake to meet the caloric needs determined by a dietician or nutritionist.
We have some of these disciplines in-house, and do work with specific outside professionals, such as pediatricians, pediatric GIs, and pediatric allergists/ immunologists. We also feel it is important to work with practitioners already following your child’s feeding history.
The feeding specialists design protocols to meet the specific feeding needs of your child. This of course is done taking evaluations of other disciplines into account.
Whether allergies, tube cuts, or aspiration: all variables play a part in how the protocols are designed to effectively higher PO intake in a safe manner, while decreasing problematic behaviors that hinder proper mealtime behavior.
Los Altos Feeding Clinic
2235 Grant Rd. Ste 2
Los Altos, CA 94024
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