Feeding (dysphagia) services at Sydney Children's Hospital, Randwick

Children with feeding difficulties may be seen through a range of outpatient feeding (dysphagia) services at Sydney Children’s Hospital, Randwick depending on their level of need.

General Feeding Clinic

Clinic details

• Every Thursday morning
• Outpatients clinic, High Street entrance

The Feeding Clinic provides assessment and treatment for infants, toddlers and children who present with complex feeding problems and require specialised assessment, advice or interventions from a multi-disciplinary team. To qualify for the Feeding Clinic children must have concerns in the areas of feeding skills and growth/nutrition.

Services offered

• Consultation and in-clinic assessment of feeding and nutrition
• Multidisciplinary approach –Speech Pathologist and Dietitian, with Clinical Psychologist and Paediatrician as required
• Diagnostic investigation eg Modified Barium Swallow study
• Ongoing management  with referral back to local services as appropriate
• Tube weaning - inpatient or outpatient – offering admission to hospital, depending on support and required supervision. 

Feeding outcomes

Establishment of healthy nutritional status and safe oral feeding. 

Indications for referral

• Poor or limited oral intake with or without medical complications
• Medical conditions that place the child at risk of developing significant feeding issues
• Enteral feeds
• Food refusal
• Failure to thrive
• Choking or coughing during feeding
• Oral motor and sensory problems
• Swallowing in-coordination
• Excessive feeding times and any issues related to feeding problems
• Behavioural or interaction issues surrounding eating/food refusal including autism

Referral process

Written referral from the patient’s Medical Officer or regular doctor is required using the Feeding Clinic Referral Form. Referrals from community health nurses must be accompanied with a referral or recent consult letter from the child’s managing medical practitioner. Please return this form to the

• Feeding Clinic Intake Officer via the Allied Health Administrative Assistant
• Phone: (02) 9382 1021
• Fax: (02) 9382 1200

General Nutrition Clinic

Clinic details

• Selected Tuesdays and Thursdays
• Hours are 7:30-10:30 am, 10:30-13:30 pm and 14:00-17:45 pm.
• Outpatients department, High Street entrance

The clinic caters for children requiring nutrition assessment and dietary education.

Referral process

Referral from General Practitioner

GPs can refer their patients to the general nutrition clinic. The referral criteria for GP referrals to the clinic are:

The patient resides in postcodes 2000, 2010-2011, 2015, 2017-2036, and the patient meets the criteria below.

Referrals from either medical staff at SCH or from local general practitioners can be made using the referral form. Please note that this referral form is for use by SCH medical staff or general practitioners only and needs to be accompanied by relevant growth charts and/or laboratory results.

Referral from medical staff from Sydney Children's Hospital, Randwick

Medical staff can refer to the general nutrition clinic if the patient meets the referral criteria.

Referral criteria

• Growth Faltering - poor growth as shown on recent heights and weights plotted on a growth chart
• Vitamin or mineral deficiency - as confirmed by a recent blood test
• Above the 85th percentile for BMI and requiring an interpreter
• Above the 85th percentile for BMI and less than 4 years of age
• Enterally fed children

Speech Pathology Service

The Speech Pathology department provides a service to children whose nutritional status is stable but present with feeding difficulties arising mainly from oral motor and sensory difficulties in addition to other mealtime management issues.

Services

• Assessment
• Therapy
• Review
• Ongoing management  with referral back to local services as appropriate
• Modified Barium Swallow investigations as appropriate

Indications for referral

• Oral motor and sensory feeding difficulties
• Swallowing in-coordination
• Aspiration concerns
• Behavioural or interaction issues surrounding eating and/or food refusal including autism.

Feeding outcomes

Establishment of safe feeding practices and normalization of mealtime patterns

Referral process

To attend this clinic, written referral from the patient’s Medical Officer or regular doctor is using the Speech Pathology Department Feeding Referral Form, please return this form to;

• Feeding Team, Speech Pathology Department
• Phone: (02) 9382 1021
• Fax: (02) 9382 1200