Children’s speech and language services

Inpatient

Trevor Mann Baby Unit

We assess and manage feeding difficulties caused by a wide range of factors, including prematurity, birth trauma, brain damage, and generalised feeding difficulties.

We support infants who cannot be fed orally while waiting for, or recovering from, complex surgery (eg gastroschisis). Babies are only followed up on discharge from the unit if they are transferred to the Alex or are seen as outpatients. No cover is available for the Princess Royal Hospital.

Royal Alexandra Children’s hospital

We assess and manage feeding difficulties from a wide range of etiologies, and often help with diagnosis of patients. A weekly nutrition round is attended as part of the inpatient service.

We are heavily involved in the neurodevelopmental team, which provides many recommendations to staff and parents around infant feeding and early neonatal development. The department is also a source of advice and support for therapists from neighbouring trusts.

Outpatient

We hold a number of feeding clinics, often alongside other members of the wider paediatric team.

Joint speech and language/dietetic clinic

We hold this joint clinic once a month for babies, infants and children within the Brighton and Hove catchment area. Most referrals are discharged inpatients, and children who are dependent on tube feeding for most of their nutrition. By joining the two clinics together we are able to maximise the child’s potential for growth and oral feeding. This also reduces the number of appointments the child needs to have with us.

Videofluoroscopy (assessment of swallowing using x-rays)

Held once a month and open to referrals within the south east. All referrals are seen in the pre-videofluoroscopy clinic to assess suitability and format for the assessment. Follow-up after the x-ray is only offered to those children within the Brighton and Hove catchment area.

Nutrition round

Held weekly, usually on the wards but also in the outpatients department and is led by the Gastroenterology team.

Bronchopulmonarydysplasia clinic (breathing disorder – lungs do not develop normally)

Multidisciplinary clinic held approximately every six weeks for babies discharged from the Trevor Mann Baby Unit with a home oxygen requirement. These infants are often born extremely prematurely, and tend to have ongoing feeding difficulties. We carry out assessment and management of feeding difficulties.

Group play therapy sessions

In partnership with the play team, we offer group therapy sessions for children who are weaning from tube to oral feeding or for children who do not want to eat, or does not want anything to touch their mouths and have restrictive diets. This is currently a pilot group for a small number of selected children.

Consultation clinics

These clinics are offered to other speech and language therapists who have children on their caseload with feeding difficulties which are not severe enough to meet the children’s hospital criteria. One-off joint appointments are offered, with recommendations made for the local therapist.

Phone advice

Our phone advice is offered to GPs, health visitors, play workers etc who require advice for mild feeding difficulties such as fussy eaters, refusal of lumpy foods, but do not meet the Alex criteria.

Referrals

Being a fussy eater or having trouble chewing lumps does not qualify for a referral to our services. In order to be referred to us your child will have some or all of the following:

• a risk of aspiration (food or drink going down the wrong way)
• significant problems regarding weight gain
• continual ill health
• a history of choking on food/fluids
• a diagnosis predisposing them to feeding difficulties

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