Intensive Feeding Program

Contact Information
To make a referral, please contact
Tracy Howell, RN, Clinic Coordinator: 205-638-7590
Fax: 205-638-7995

What We Do
As the only intensive feeding program in Alabama the Children’s of Alabama Intensive Feeding Program offers a spectrum of diagnostic and treatment interventions for children with a wide range of feeding difficulties. Our goal is to provide interdisciplinary evaluation and treatment so as to work with the child as a complete individual optimizing therapeutic gains and generalizing those gains into the home setting through caregiver training.

There are many causes to childhood feeding difficulties and all of them create increased anxiety and stress in the home setting, making meal times often a battle ground. Given that feeding is one of the most complex processes, we use a collaborative approach integrating the knowledge of physicians, psychologists, registered dieticians, speech and language pathologists, occupational therapists, and social workers in order to provide optimal therapeutic outcomes.

Who We Treat
Our integrated approach allows us to observe, evaluate, and treat your child’s feeding difficulties through the use of a model with behavior modification as the underlying foundation. We intertwine an intensive focus on oral-motor skill development with attention to nutritional markers for the most positive therapeutic outcome. This is achieved through empirically validated methods and we carefully track your child’s progress through standardized evaluation. Treatment changes are made based on your child’s progress and the team develops an individualized treatment plan for each child.

Our program addresses feeding difficulties including but not limited to:

  • Total food refusal
  • Oral aversion
  • Feeding tube dependence
  • Volume, food, and liquid intolerance
  • Challenges transitioning to age appropriate textures, consistencies, or utensils
  • Recurrent vomiting
  • Restricted eating patterns

Common medical conditions experienced by children in our program include:

  • Gastric esophageal reflux disease
  • Failure to thrive
  • Dysphagia
  • Gastrointestinal disorders including dysmotility, constipation, abdominal malformations
  • Neurodevelopmental challenges including Down Syndrome, genetic disorders, mitochondrial disorders
  • Pervasive developmental disorders including Autism
  • Behavioral challenges

Your First Office Visit
The evaluation clinic is the first place we will evaluate your child and his/her feeding difficulties in order to determine the best course of intervention. This evaluation is typically two hours in duration and will consist of:

  • An evaluation of your child’s medical history and physical exam
  • Nutritional history and evaluation of growth and nutritional parameters
  • Psychological assessment of your child’s development, cognitive, emotional, and behavioral functioning
  • Oral motor evaluation
  • Observation of a simulated meal/snack time
  • Psychosocial evaluation

Given the intensity of the evaluation session, we ask that you do not bring siblings to the clinic setting.

In order to obtain an evaluation, you will need a referral from your child’s primary care or specialty physician. Once the referral is received, an initial telephone interview will be scheduled. Following that interview, the evaluation session will be scheduled.

Physician Referral Information
Step 1: Visit the Patient Referral Forms Page and download The Referred Testing Order Form
Step 2: Then download the Intensive Feeding Program Supplemental Referral Form.
Step 3: Complete forms and fax to 205-638-7995 for Referreal.

Outcome From First Office Visit
During the evaluation session, multiple professionals will evaluate your child and talk with your family. The team will take a brief opportunity at the end of the session to round on your child and you will be provided feedback on the day of your evaluation regarding the teams’ impressions, recommendations, and plan for ongoing treatment of your child’s feeding difficulties. Recommendations may be made for additional medical evaluation, participation in traditional outpatient feeding therapy with a community provider, or participation in the Children’s Hospital of Alabama Intensive Inpatient or Day Treatment Feeding Programs:

Intensive Day Treatment Program: This outpatient program includes three to four therapeutic feeding sessions a day with a team member in accordance with the individualized treatment plan designed for your child. Our accommodations include an age-appropriate setting, playroom, and napping space for your child if necessary. This program is run 5 days a week, Monday through Friday from 8:00 AM to 5:00 PM, for approximately 6-8 weeks.

Intensive Inpatient Treatment Program: This inpatient program is similar to the Day Treatment Program, but is targeted for children who are medically fragile or at significant risk requiring 24 hour a day care. This program is housed in the new Benjamin Russell Children’s Hospital of Alabama and includes three to four therapeutic feedings per day, 7 days a week, for approximately 2-3 weeks. Once your child is stabilized, he/she will be transitioned to the Day Treatment Program and setting to complete a total of 6-8 weeks of therapeutic intervention.

Both Programs Offer Structured Support: Intensive feeding programs are intensive! Essentially, you and your family are committing to this for six-eight weeks, as a full time job. We will work right alongside you in order to achieve rewarding results with the highest outcome possible for your child. Our goals often include decreasing reliance on feeding tubes, reduction of problem behavior surrounding meal times, maintaining or improving your child’s nutritional status, and increasing volumes and textures of food and liquid consumed orally, while improving oral motor skill development when needed.

In both settings, the child and the family will be learning something new. Caregivers are taught to understand the rationalization for the interventions used and will learn how to support and maintain the feeding gains behaviorally, physically, nutritionally, and functionally. Caregivers will be provided an opportunity to demonstrate learning in the clinic setting, but also in the evening and over the weekends while admitted to the program. Generalization of skills outside of the clinic setting is essential and we will provide the tools to accomplish this. In order to obtain these goals, each feeding sessions is conducted by an Occupational Therapist or Speech and Language Pathologist. Often feeding sessions are co-treated with a Psychologist. In addition to feeding sessions each family will have:

  • Weekly one-on-one consultation from members of our interdisciplinary team including Social Work and Psychology.
  • Weekly conference with members from the team in order to discuss weekly progress and attainment of identified goals.

Meet Our Team

The feeding team consists of a dual board-certified gastroenterologist and neonatologist, clinical psychologist, nurse clinician, registered dietitian, occupational therapists, speech and language pathologists, medical social worker, billing and coding specialist,and dietetic technician.