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Making a Mark
Making a Mark is published bi-annually by the CHOC Foundation. It features CHOC and children?s healthcare news, patient highlights, hospital updates, board member spotlights, and community involvement stories and is mailed to donors who support CHOC with a gift of $250 and more.

CHOC's Feeding Program: When Children Aren't Just Being Picky Eaters

Coaxing a stubborn child to eat is an all-too-familiar mealtime scenario. Usually, a child who doesn’t want to eat is labeled as a picky eater, but some children have medical or psychological issues that cause them to reject food almost completely. At CHOC, there is hope for families and children with feeding disorders.

The Pediatric Feeding Program at CHOC was established to evaluate and treat children who have significant feeding problems. Children who participate in the program typically have failed outpatient feeding therapy and have a G-Tube (feeding tube) or are at risk for G-Tube placement.

According to Dr. Mitchell Katz, medical director of Gastroenterology at CHOC, “we all argue about eating with kids—it’s a magnitude greater when there’s a feeding problem. When you have kids who come to you in desperate need of eating, and they leave here eating, it dedicates you to your mission all over again.”

Robyn Robinson, nurse practitioner in the CHOC Feeding Program, agrees. “The treatment we provide is lifesaving for families. Imagine trying to take a child with a G-tube to a restaurant, a theme park, or school. We use positive, child-centered therapy to change the feeding behaviors of children who won’t or can’t eat,” she says.

“It costs $200,000 to feed a child through a G-tube for five years.”

Children seen in CHOC’s Feeding Program have a range of medical and developmental problems, including cerebral palsy, seizure disorders, genetic disorders, oral motor dysfunction, food allergies, or behavioral disorders. “Many of our patients were born premature, so they never learned to coordinate breathing, sucking and swallowing,” Robyn explains. “They literally do not know how to eat.”

CHOC’s Feeding Program provides screening, outpatient feeding evaluation, behavioral consultation and an intensive three-week inpatient feeding program. After each stage, recommendations are made to best meet the patient and family’s goals for better feeding skills.

The goal of the inpatient program is to develop feeding techniques and strategies that are effective for the individual child. “The first week is spent with the therapist undoing bad habits. The second week, we transition the therapy to the parent. The third week, the parent becomes the therapist. It’s crucial that parents are able to continue the skills they learned in our program so their children will continue to be successful,” Robyn explains.

“One of our patients was an 8-year-old boy who was still feeding from a bottle. After participating in our program, today he is able to eat a good variety of foods by mouth,” Robyn recalls. “Another of our patients couldn’t even be near food without vomiting. The day after finishing our program, the patient’s mother called to let us know her daughter had eaten lunch with her kindergarten class.”

“We are here to nurture, advance and protect the well being of children. That means until they are completely well; normal isn’t having a G-tube in your stomach.” Robyn robinson, nurse practitioner

Following discharge from the inpatient feeding program, children typically continue to receive outpatient feeding therapy to ensure that the achievements made in the program carry over to the home setting.

“As leader of the CHOC feeding team, I have never seen people work with so much dedication one-on-one with kids,” says Dr. Katz. “We built this program from the ground up. We have the structure, the capability and the passion. We can be one of the top feeding programs in the country, if not the world.”

What Is a Feeding Disorder?
A child is considered to suffer from a feeding disorder when he or she refuses to consume a sufficient amount or variety of food to maintain proper nutrition. Feeding problems can range from occasional missed meals to severe malnourishment and failure to thrive, and affect both normally developing children and children with developmental disabilities.

In severe cases, children may become dependent on feeding tubes for supplemental feedings. Left untreated, long-term feeding disorders can lead to severe health problems as well as parent/ child conflict, mental health problems, increased risk of eating disorders (i.e. anorexia) and increased healthcare costs.


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chocChildren's Hospital of Orange County | UCI University of California, Irvine

Children's Hospital of Orange County is affiliated with UC Irvine Healthcare and UC Irvine School of Medicine

CHOC Children's - 1201 W La Veta Ave, Orange, CA. Phone: 714-997-3000. .