RDs In Practice: Advancing Practice in Pediatric Nutrition – Management of Pediatric Feeding Problems

Girl holding a snack in her hand

RDs In Practice is an educational program aimed at advancing clinical knowledge and ideas in specialty areas of pediatric nutrition. Didactic lectures, question/answer sessions, and networking opportunities will allow time for attendees to discuss emerging topics, evidence based practice and solutions to practice dilemmas.

Date: June 21, 2016

More Information: Shonda Brown, RD at rdsinpractice@choc.org or 714-509-7829.

Continuing Education Units: 5 CPE/CEU units will be offered

This event was made possible by an unrestricted educational grant from Nutricia North America.

Program Objectives

Upon completion of this program, participants should be able to:

  1. Discuss medical risk factors, diagnosis, and medical management of children who have feeding problems.
  2. Learn effective strategies to improve the Parent-Child Feeding Relationship.
  3. Discuss nutritional intervention strategies to improve nutrient balance, increase caloric intake and optimize growth and development of children with restrictive diets.
  4. Identify diagnostic features of Avoidant Restrictive Food Intake Disorder (ARFID) and discuss appropriate treatment modalities.
  5. Understand therapeutic strategies used to effectively modify skills and behaviors during mealtimes in children who have feeding problems.


11:15 am – Registration/Lunch

11:50 pm – Introductions

12:00 pm – The Top 5 Medical Conditions which Interfere with Feeding & Essential Strategies for Gastrostomy Tube Weaning – Robyn Robinson, CPNP, MSN

12:45 pm – Nutrition Strategies for Children with Feeding Difficulties – Kim Milano, MS, RD, LDN

1:45 pm – Break/Network

2:00 pm – Effective Strategies to Change the Child-Parent Feeding Relationship – Leigh Volker, LCSW & Jennifer Raminick, MA, CCC-SLP

2:45 pm – Break Out Sessions

4:15 pm – Break/Network

4:30 pm – Assessment and Treatment of Children with Avoidant/Restrictive Food Intake Disorder (ARFID) – Cindy S. Kim, Ph.D., ABPP

5:00 pm    Behavioral Management of Feeding Problems – Kelli Rugless, Psy.D

5:30 pm     Closing Remarks/Adjourn


Breakout Session Topics

  1. The Trend to Blend: Tips for Implementing a Blenderized Tube Feeding Diet – Katherine Bennett, MPH, RD, CLEC
  2. Nutritional Considerations for G-tube Weaning in the Outpatient Setting – A Case Study – Kim Milano, MS, RD, LDN
  3. A Comprehensive Approach to Feeding Rehabilitation – Polly Chiu, MA, OTR/L, SWC & Annie Doan, MS, CCC-SLP
  4. Developmentally Appropriate Feeding in the NICU- Melina Ramirez, MA, OTR/L & Karin Mitchell, MA, CCC-SLP

Participants will divide into groups and have the opportunity to attend 3 of the 4 sessions. Each breakout session will have an expert leading a discussion on a specific topic. This will provide an opportunity for attendees to have a personal experience with experts in the field as well as network and share their thoughts and ideas with peers.

Target Audience

This program is intended for pediatric registered dietitians and clinicians who specialize in pediatric feeding problems. Registered dietitians working in other areas of practice, other clinicians (RN/NP, SLP/OT, Psych, SW, MD), and students are welcome to attend.

Program Faculty

Robinson, Robyn_0373Robyn Robinson, CPNP, MSN
Robyn has been interested in pediatric nursing since she was a teenage volunteer in a pediatric preadmission “Lemonade Party”. She completed a Bachelor of Science in Nursing at the University of Utah and then twenty years later a masters’ degree in Pediatric Nursing at California State University, Long Beach. Robyn has been a pediatric nurse practitioner at CHOC in Pediatric Gastroenterology for the past 15 years. Along with Dr. Mitchell Katz, she is a founding member of the Multidisciplinary Feeding Program and continues as the program coordinator.
Robyn has presented posters and podium presentations on pediatric feeding problems at local, regional and national conferences and currently serves on the national board of the Association for Pediatric Gastroenterology and Nutrition Nurses (APGNN). She has always passionately advocated for positive family mealtimes starting with her husband, four sons and three grandsons. Her interests include gardening, traveling and reading which can all be closely tied to food.

Milano, KimKim Milano, MS, RD, LDN
Kim Milano completed her BS at Penn State University followed by a MS from the University of Kansas.  For the past 31 years, she has specialized in pediatric nutrition with emphasis on feeding difficulties in infants and toddlers.  Ms. Milano has been involved in feeding programs at Children National Medical Center in Washington, DC, Children’s Mercy Hospital in Kansas City, MO and several community hospitals.  In addition, she has developed programs to prevent pediatric obesity in Colorado and South Carolina.  Recent collaborative publications include, “A Practical Approach to Classifying and Managing Feeding Difficulties,” published in Pediatrics in February 2015 and “Sensory Issues and Feeding Difficulties in Children: A Clinical Perspective,” in EC Nutrition in November 2015.  Ms. Milano is currently a nutrition consultant in Geneva, Illinois.

LeighVolkerLeigh Volker, LCSW
Leigh is a Licensed Clinical Social Worker who has been serving families at CHOC for the past 10 years. She earned her Master of Social Work from Loma Linda University and Bachelor of Science in Human Services from California State University, Fullerton. Leigh works in the Gastroenterology Division, providing psychosocial assessment, supportive counseling, crisis intervention and resources to children and families with a wide array of GI diagnoses, including IBD. She is also an integral member of CHOC Multidisciplinary Feeding Program. Leigh has presented at both the National and California Speech and Hearing Association Conferences on topics including an intensive multidisciplinary model for complex feeding disorders and g-tube weaning, as well as changing the parent-child feeding relationship.  Leigh recently coauthored Successful Gastrostomy Tube Weaning Program Using an Intensive Multidisciplinary Team Approach in JPGN.

Jennifer RamamikJennifer Raminick, MA, CCC-SLP
Jennifer completed her master’s degree at California State University, Long Beach (CSULB).   She has worked as an inpatient speech and feeding therapist at CHOC Hospital since 2013, including her role as a feeding therapist on CHOC’s Multidisciplinary Feeding Program.  Collaborating with CHOC’s Gastrointestinal Physicians and Pulmonologist, Jennifer has been instrumental in streamlining the process of Modified Barium Swallow Studies performed at CHOC.  She is a national and regional speaker, presenting regularly at the California and American Speech-Language-Hearing Association’s annual conventions covering topics such as pediatric feeding disorders in the oncology population, congenital laryngomalacia, and AAC assessment for treatment of aphasia.  Jennifer has also served as a lecturer for post-baccalaureate students at CSULB.  Her interests include aerodigestive disorders & effects on swallowing.

Kim, CindyCindy S. Kim, Ph.D., ABPP
Dr. Kim is a board-certified clinical psychologist at CHOC Hospital with expertise in the areas of pediatric feeding disorders, autism spectrum disorder, infant and toddler assessment, anxiety, depression, and family and behavior therapy.
She earned a Ph.D. in clinical psychology from Rosemead School of Psychology at Biola University after receiving a bachelor’s degree in psychology from University of California, Riverside, and a master’s degree in clinical psychology from San Diego State University. Dr. Kim completed an APA-accredited internship and post-doctoral fellowship at USC/Children’s Hospital Los Angeles.  Dr. Kim is also board certified in clinical hypnosis and integrates mindfulness training, hypnosis, and biofeedback in her practice.  Dr. Kim has several ongoing research projects involving pediatric feeding disorders and has recently coauthored Successful Gastrostomy Tube Weaning Program Using an Intensive Multidisciplinary Team Approach in JPGN.

Rugless, Kelli, PSY.DKelli Rugless, Psy.D.
Dr. Rugless is a licensed clinical psychologist at CHOC Hospital.  As a member of CHOC’s Multidisciplinary Feeding Program, Dr. Rugless provides consultation and training to caregivers to improve the child-parent feeding dynamic as well as psychotherapeutic interventions to assist the child and family with anxiety and behavior management.  Dr. Rugless earned a Doctor of Psychology from Loma Linda University, Loma Linda, CA after receiving her bachelor’s degree in Biopsychology from The University of California, Santa Barbara.  She completed an APA-accredited internship and post-doctoral fellowship in Pediatric Psychology at Mt Washington Pediatric Hospital, Baltimore, MD where she specialized in Behavioral Feeding therapy and Inpatient Consultation/Liaison services. Currently, Dr. Rugless plays an active role in the outpatient Endocrinology clinic and the Psychology consultation/liaison service at CHOC in addition to her work on the Multidisciplinary Feeding Program.

Bennett, KatherineKatherine Bennett, MPH, RD, CLEC
Katherine Bennett is a Registered Dietitian at CHOC Hospital. She completed, her Dietetic Internship at the University of Virginia and began a career in the Neonatal Intensive Care Unit at St Joseph’s Hospital in Phoenix, Arizona. Looking for cooler weather, Katherine moved to California and continued her work in neonatology and pediatric nutrition at Miller Children’s Hospital in Long Beach. Katherine received her Master’s Degree in Public Health from UCLA and also completed her Certified Lactation Educator Counselor (CLEC).  Katherine currently works in the Gastroenterology and Nutrition Division in the outpatient setting. One of her special interests is blenderized tube feedings and has helped over 100 families transition to some form of a blenderized tube feeding diet. Katherine has also presented nationally at NASPGHAN and ASPEN on the topic of blenderized tube feedings.

Chiu, PollyPolly Chiu, MA OTR/L, SWC
Polly received her M.A. in Occupational Therapy from the University of Southern California, and B.S. in Cognitive Science with a secondary focus in Psychology from the University of California, San Diego.  In addition to being involved with CHOC’s Multidisciplinary Feeding Program, she has been an active member of CHOC’s outpatient rehabilitation department and Early Developmental Assessment Clinic since 2012.  She has worked closely with patients and families impacted by a variety of feeding limitations including dysphagia, oral motor delays, sensory based feeding problems, as well as behavioral feeding issues. Prior to her career as an occupational therapist, Polly received extensive training in behavioral modification and had the opportunity to serve the ASD community as a behavioral interventionist.

Doan, Anh-AnnieAnnie Doan, MS, CCC-SLP
Annie is a board certified speech-language pathologist.  She received her BS in Psychology with minors in education and linguistics at the University of California, Irvine.  She later received her post baccalaureate and MS in Communication Sciences and Disorders at Chapman University.  As an active member of CHOC’s Multidisciplinary Feeding Program, Annie leads daily therapeutic feeding sessions and provides parent training to facilitate improved mealtime interactions.  Her interests include autism spectrum disorders, pediatric feeding and swallowing, and multiculturalism.  Annie is an advocate for multilingualism and provides therapy in English, Vietnamese, and Spanish.

Ramirez.MelinaMelina Ramirez, MA, OTR/L
Melina has practiced in school-based, private clinics and hospital-based settings in the area of pediatrics since 2002. Melina began practicing in a private sensory based clinic at The Children’s Therapy Center in Garden Grove, CA.  In addition, she provided in-home therapy and on-site developmental treatment at Good Shepherd School for Children in St. Louis, MO and Neurodevelopmental treatment (NDT) and Sensory integration (SI) at Sparrow Hospital in Lansing, MI.  Her areas of expertise are in sensory integration (SI), feeding and swallowing, and developmental treatment.  She has worked at CHOC Hospital since 2007, with a current primary focus in the Neonatal Intensive Care Unit since 2009.  Melina is an active participant in various hospital committees at CHOC, including the Developmental Care Team and Nutrition and Breastfeeding Coalitions.   Melina is certified in the use of Therapeutic Listening, VitalStim®, Certified Lactation Educator Counselor, as well as Physical Agent Modalities and Swallowing Assessment, Evaluation and Intervention with the state of California.

Karin Mitchell, MA, CCC-SLP
Karin received her BA in Communication Disorders at Biola University, La Mirada, CA and her MA in Speech Pathology at California State University, Fullerton, CA. Karin has been practicing as a pediatric Speech Pathologist since 1995 and currently serves as the one of the lead therapists for the NICU and Feeding Team at CHOC Hospital in Orange, CA. She has a strong theory base in Neuro-developmental Treatment (NDT) and Sensory Integration (SI), and has received certifications in Neonatal Oral-Motor Assessment Scale (NOMAS®) and VitalStim®. As an active member of numerous quality improvement committees, Karin has helped develop unit protocols and care plans for appropriate developmental care in CHOC’s Small Baby Unit. She speaks nationally on pediatric feeding and swallowing analysis and has developed online education opportunities with a focus on modified barium swallow studies. She is a strong advocate for breast-feeding and speaks at local associations to support breast-feeding for the medically fragile infant.


CHOC Hospital
1201 West La Veta Ave.
Clinic Building (CHOC West)
Harold Wade Education Center-2nd floor
Orange, CA 92868

Phone: 714-509-7829 or email: rdsinpractice@choc.org


Travel Information

Hotel Accommodations:
A block of rooms has been reserved at a discounted rate with the Hilton Garden Inn Anaheim/Garden Grove (4 miles from CHOC Hospital) 11777 Harbor Blvd, Garden Grove, California, 92840 TEL: 1-714-703-9100

Airport Information:
(Distance to CHOC Hospital): *John Wayne Airport (SNA), Santa Ana, CA; 10.6 miles (20 + minutes) *Los Angeles International (LAX), Los Angeles, CA; 38 miles (60+ minutes) *Long Beach Airport (LGB), Long Beach, CA; 19 miles (40 + minutes)

*A complimentary shuttle will be provided to and from the Hilton Garden Inn and CHOC Hospital *SUPER SHUTTLE is available from John Wayne Airport and Los Angeles International