SERVICES : Tube Weaning Program

The Spectrum Pediatrics Approach to tube weaning was created to help children become happy and healthy eaters by eliminating their dependency on feeding tubes.

Philosophy – They key to ending tube dependency is correcting each child's relationship with food and as well as helping them recognize and respond to hunger. Being satiated, enjoying food, and enjoying mealtimes with family and peers are the natural reinforcers for learning to eat. We believe treating the whole child with respect and individualized care is essential to unlocking the drive to eat. Any child learning to eat should be doing so in the presence of hunger and in safe social settings and not under the stress of an unnatural clinical or institutional setting. 

Team – We are a group of trained professionals with decades of experience working with children with feeding challenges and feeding tube dependency. Our team consists of speech therapists and occupational therapists who are experts in child development and behavior and specialize in the treatment of feeding disorders and challenges. Other essential team members included the family and the child's existing medical team. Through collaboration we can create the safest and most successful plan for a child on the road to healthy and happy eating.

Method – Our approach consists of 5 phases:  Assessment, Preparation, Hunger Induction, Intensive Treatment and Follow-Up.  Through parent coaching, consultation with the medical team and child-directed therapy, we work to correct the relationship with food.  Through the systematic induction of hunger, the natural reinforcement provided by safe social experiences and the satiation of hunger we help children understand the purpose of food and regain both the desire to eat and the ability to do so safely.

Through consultation with medical team members and parent/caregiver coaching, we work first to eliminate things that may be damaging the child's relationship with food.  Well-meaning therapies and medical attempts to help children can, inadvertently, lead to aversion and create an unhealthy context for learning to eat.  We work to neutralize or improve a child's relationship with food.  This is a period when we reduce the pressure around mealtimes for both families and children.  We then, with the induction of hunger, under the care of a physician, help children experience hunger in a safe, loving and natural way.  After a period of hunger induction we work very intensively with the child and family in natural environments such as homes, parks and restaurants.  We base the work we do on existing best-practice evidence about how children should learn to eat in order to create and maintain lifelong healthy eating habits.  Visits with our trained professionals occur multiple times daily during this time and we are available by phone for coaching 24 hours a day outside of these direct visits.  Following the intensive phase of treatment children and families participate in a mandatory Follow-Up period of 6 months.  During this time we help the child and family continue to shape and normalize mealtimes and nutrition, especially during challenging times like illnesses, travel, etc.

Publications and Presentations

Spectrum Pediatrics' professionals have been published in peer-reviewed medical journals, presented at international conferences, taught health care and child development professionals, written case studies and authored blogs for parents and professionals.