A team approach to successful feeding
The Thrive Program at Bethany Children’s Health Center is designed to provide ongoing medical support and developmental evaluation for infants with feeding delays. Most of these infants have come from a Neonatal Intensive Care Unit (NICU).
Speech Language Pathologist, Meg Gutman explains, “Infants admitted to the Thrive Program may have been born prematurely with bronchopulmonary dysplasia (BPD) or lung disease causing difficulty with coordination of Suck-Swallow-Breathe synchronicity. They may have oral abnormalities that cause feeding difficulties, or gastrointestinal concerns that make feeding uncomfortable.”
Speech language pathologists work as a part of a team with occupational therapists, nurses and physicians to evaluate and treat patients to improve feeding skills. The interdisciplinary team collaborates with caregivers to provide a comprehensive plan of care specific to each patient’s abilities, needs and goals.
Speech Language Pathologist, Heather Jarvis says, “This team is centered around these little babes. Ultimately, the mission of the program is to support growth and development of the infant by taking each team member’s expertise and skill to really listen to these tiny humans who communicate effectively if you take the time to observe and read their cues. We utilize all resources available to ensure success for these infants within our hospital walls and beyond.”
The physicians support the team in their assessments and make suggestions or changes to augment treatment or address issues based on feedback from the therapists. “For example, we work with the dietitian to make possible formula changes (type, concentration, volume), suggest further imaging or consults or suggest medication changes to help address any problems reported by the therapy team,” says Dr. Laura Finlayson, Medical Director of Hospital Medicine.
Additionally, many of the infants in the program receive early screening for cerebral palsy by trained occupational and physical therapists. “Prolonged hospitalization can often lead to developmental concerns that sometimes go unnoticed,” says Occupational Therapist, Brittany Essaili. “By screening these patients and catching concerns early, we are able to connect them with the right referrals and specialists to help them thrive developmentally beyond their stay at Bethany Children’s.”
While babies are in the NICU, the main focus may be on medical stability. This is a very different journey than what most parents have envisioned.
“Babies are often whisked away from parents at birth to receive necessary medical care,” says Brittany. “Parents don’t have the opportunity to immediately bond with, hold or feed their baby. Once the infants are here at Bethany Children’s they are medically stable, and we want parents involved in their care as much as possible.”
Speech Language Pathologist, Ryley Hoch credits the program’s success to the team collaboration in which parents play a huge role. “It’s amazing to work alongside passionate doctors, therapists, dietitians and parents who are striving to help these babies become successful oral feeders. We work very closely with the parents to provide education, training and resources to best set our families up for success prior to discharge. We want to help guide caregivers on how to best provide oral feedings to their little one and make sure they feel comfortable and safe doing so.”
Meg adds, “This team is innovative, determined and family-driven in helping these children succeed. We work closely with therapists at other facilities for a smooth transition of care. Although the goal is often removal of the feeding tube, successful feeding means the infants are calm, content and alert while feeding.”
She reports that quite a few patients have left Bethany Children’s without a feeding tube. “It is rewarding to see our patients and families succeed, and it’s also rewarding to watch this team succeed. It is such a special dynamic when we all collaborate and work toward successful discharges.”