Eating, Drinking & Swallowing (Dysphagia)

We see children:

• from birth to 18 years of age (19 years if they attend a Special School)
• who have complex needs which affect their eating and drinking
• who have structural problems which affect their eating and drinking
• who have developmental difficulties which affect their eating and drinking
• whose medical problems or past medical problems affect their willingness to eat
• who have a GP in Warwickshire
• As Inpatients at Special Care Baby Unit (SCBU) and MacGregor Children’s Ward, Warwick Hospital or SCBU at George Eliot Hospital, who have eating, drinking, or swallowing difficulties

Unfortunately, we don’t see

• We do not currently have a service to support children with purely sensory based feeding difficulties i.e., children who have age-appropriate chewing and swallowing skills but are selective about what they eat and drink particularly sensitivities associated with Autism. However, please see ‘useful websites’ in the section below for information you might find helpful.
• We do not see children about general weaning advice. However, please contact your Health Visitor if you would like support with this.

· Our leaflets:

• Dysphagia Service Leaflet
• Supporting Children with Sensory Feeding Difficulties
• Saliva Control for pre-school Children
• Developing Chewing Skills

· If you are concerned about your child’s ability to participate in meal-times due to their physical or sensory needs, then these advice leaflets available on the Paediatric Occupational Therapy website may be useful:

• My child is a Fussy Eater
• My child can’t sit upright to eat a meal
• My child can’t use a knife and fork
• Video on posture preparation – this video advises on how to help your child sit stably. The ability to sit stably is a very important stage to reach before being able to chew effectively and self-feed.

· Also our Dietitian’s leaflet:

• Helping your child to eat

General weaning advice and early years

• Start for life is a useful website offering trusted NHS help and advice during pregnancy, birth and parenthood. It has some great advice and videos around feeding your child which offer reassurance around what to expect and what to look out for along your baby’s feeding journey: https://www.nhs.uk/start4life
• Health for under 5’s is a useful website for parents. It has a ‘Feeding and Nutrition’ section which provides tips and advice ranging from starting solids to healthy recipes and guidance on portion sizes. https://healthforunder5s.co.uk/warwickshire
• The infant and Toddler Forum has practical evidence-based resources to support infant and children with feeding such as appropriate portion sizes and common difficulties that can occur, ‘Fussy and Faddy Eating in Toddlers’, https://infantandtoddlerforum.org/
• Some simple and practical tips for a healthy lifestyles, such as: fussy eating, starting solids and creating a happy family meal time can be found at: https://www.henry.org.uk/tips

Babies born premature or sick

• Bliss is a charity for babies born premature or sick. Their website has lots of practical information to support parents from the start of their journey in neonatal care through to later in childhood. It also has some useful information on feeding such as ‘How do I know if my baby is ready to wean https://www.bliss.org.uk/parents/about-your-baby/f...

Neurodivergent children: Autism, ADHD and extreme food refusal

We don’t provide a specific service for children presenting with purely sensory based feeding difficulties associated with Autism. Coventry and Warwickshire Partnership Trust and Warwickshire County Council, have produced a document to support Neurodivergent people and their families.

The link takes you to their information and advice which includes eating and difficulties associated with Autism including a video workshop presentation.

• Advice for Neurodivergent people and their families document: https://dimensions.covwarkpt.nhs.uk/Documents/Info...
• Below is a video on managing mealtimes with neurodivergent children.

If you have concerns about your child’s Eating and/or Drinking skills please complete our referral form and return by email to the address on the form.

· Referral form

Before making a referral, please consider

If you need advice/support with how to progress with weaning, or how to reduce your baby’s milk intake, or have concerns about general development please contact your Health Visitor in the first instance.

If you are concerned that your child is unwell or may have an underlying medical condition that you feel is impacting on feeding, such as Reflux or Thrush or problems with breathing, please contact your GP for advice in the first instance.

When we receive a referral, we will aim to see you and your child as soon as we are able, the timing of this is based on how urgent the difficulties are. Referrals are checked when they arrive and you may receive a phone call to discuss the referral further in order to help ensure we see your child in the appropriate time.

We may then offer you a virtual initial conversation and screening assessment and then, if necessary, if we feel a swallowing assessment is appropriate then a face-to-face home visit will be offered at a time agreed together.

We will need to see your child having something to eat and drink and will offer reassurance and/or advice or strategies on how to improve your child’s skills and discharge on first meeting or it may be that your child requires further assessment and on-going support. We may suggest further assessment before giving any further guidance.