Lancaster Physician Summer 2017 - 11

SUMMER 2017

Pediatric Feeding Clinic

oral, behavioral, sensory, and nutritional
approaches to help children with feeding
and growth problems. The clinic, similar to
WellSpan feeding programs offered in York
and Adams counties, treats children from the
age of 8 months to adolescence.
A variety of children have received services
through the clinic, usually attending weekly
sessions there for about three to six months.
Some have developmental delays-about 50
percent have been diagnosed with autism-
and may have problems with the mechanics
of chewing and swallowing. Some have
become indifferent or anxious about eating
due to problems with reflux, a condition
where acid from the stomach backs up in
the food pipe. And some kids are just the
epitome of "picky eater," that kid who eats
only chicken nuggets, French fries, candy,
and snack foods.
These children, who are referred to the clinic
by physicians, undergo a comprehensive assessment. If they need services, they participate
in treatment that focuses on the 32 steps of
tasting and eating. Those who need help with
the mechanics of eating learn how to bite food,
push food with their tongue toward their side
teeth, and then learn how to physically chew
it-things that are automatic to most people
but not to the 20 percent of children who have
feeding difficulties.
"Our goal at discharge is to have kids safely
eat healthy table foods routinely with their
families, including at least 10 different fruits
and vegetables, 10 different sources of protein,
and 10 different grains and starches, as well as
dairy products if tolerated," said Patty Fuehrer,
a speech and language pathologist who works
with children at the clinic. "We encourage
parent participation and training. Parents and
kids get homework or therapy meals to practice
outside of their family meals."
Play is a big part of the therapy, at home
and the clinic. For example, therapists will use
ham cubes to play games. Children stack the
cubes, make a wall from them or count them

Barlet Wilbert, occupational therapist, (left) and Patty Fuehrer, speech and language pathologist, incorporate games
and fun into feeding clinic sessions with Kevin Vazquez at the WellSpan Brossman Health Center in Ephrata.

into a cup. The therapists play games, getting
children to kiss a cube, lick it, hold onto it
with just their teeth and eventually place the
cube into their mouth.
The goal is for children to expand the
number of food tastes and textures, to become
more familiar and comfortable with new
foods, says Barlet Wilbert, an occupational
therapist who works at the clinic. This takes
time and patience.
"It can take 10 to 14 exposures for a child
to take a bite of something," Fuehrer said.
"I think the biggest thing we need parents
to understand is that we are not going to try
to trick their kids into eating, and the focus of
our sessions is NOT to put the food in their
mouths right away," Wilbert said. "The kids
have to WANT to be able to do so, once they
feel comfortable with the food."
Madison Day, 2, is a graduate of the feeding
program. Madison, who has developmental
delays, did not progress beyond eating pureed
baby food or eat finger foods as she grew.
Her mom, Tricia, was still spoon-feeding her
when Madison was more than one year old.

The therapists gradually introduced new
foods, as did her mom at the family's Adamstown home.
"They were good with techniques and trying
and being consistent," Day said. "For lunch,
she now will eat grapes, cheese, chunks of
bologna. She will eat the casserole I make for
dinner. She pretty much eats what a typical
kid her age does."
"It was a huge help," Day said. "I don't know
where we would be without the program.
Eating is not a struggle now. Oh my word,
it's night and day from a year ago. We're very
thankful for that."
Wilbert said parents are often very excited
when children are willing to try or be exposed to
foods that everyone else in their family is eating.
"They are more than willing to sit and
eat meals together AS A FAMILY! That is
a big milestone for a lot of our families,"
Wilbert said, "and one that I am happy to
help work toward."

Physicians who are interested in making a referral to the clinic, or anyone who wants more information, can call the

WellSpan Brossman Health Center at 717-738-7979.
LANCASTER

PHYSICIAN

Table of Contents for the Digital Edition of Lancaster Physician Summer 2017