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About Our Service

Feeding support within Wandsworth community is separated into two distinct services.

  1. Multi-Disciplinary Feeding Team; for children with avoidant and restrictive behaviours within mealtimes. Email: mdtfeeding@stgeorges.nhs.uk
  2. Community Paediatric Dysphagia Service; for children with swallowing difficulties when eating and/or drinking. Email: dysphagiaservice@stgeorges.nhs.uk

If you are concerned about your child’s feeding difficulties and are unsure about which service they would benefit from being under, please view the referral criteria below. You can also contact either team through the emails as above, one of the team members will be able to help answer any questions or concerns, or be able to send you to the right service.

Multidisciplinary Feeding Team

The Multidisciplinary Feeding Team (MDT) functions in a collaborative and transdisciplinary model to support families as they need, providing a service to deliver:

  • MDT Clinic appointments, inclusive of clinical psychology, dietetics, occupational therapy +/- speech and language therapy
  • MDT Groups, including “SOS” and “Food Scientist” groups using the SOS Approach to Eating
  • MDT Workshops for caregivers of highly selective feeders, and SENCos/LSAs
  • Parent Reflection sessions after receiving intervention
  • Individual therapy for complex and high-risk restricted feeders

Referral Criteria:

  • Families with a Wandsworth GP,
  • Aged 0-11 years
  • Children not attending a specialist educational provision

Acceptance Criteria:

  • Children with significantly restricted diets (less than 20 foods) or who show severe anxiety around mealtimes
  • Children struggling with weaning or transitioning through textures of foods
  • Stressful mealtimes
  • Concerns regarding faltering growth/weight loss
  • Children requiring enteral feeding, and multidisciplinary support for management

Exclusion Criteria:

  • The service is currently unable to provide a service for children aged 12-17.
  • Children who attend a special school provision – these provisions have specialist therapy teams on site
  • Children where there are concerns regarding body dysmorphia and related eating disorders such as anorexia or bulimia nervosa – these children should be referred to CAMHS
  • Children who are aversive feeders but who continue to struggle with unmanaged reflux symptoms – these children can be referred to the service once the reflux is medically managed

Community Paediatric Dysphagia Service

The Community Paediatric Dysphagia Service (CDPS) is run by Dysphagia trained Speech and Language Therapists, providing a service to deliver:

  • Assessment and management of unsafe swallowing; eating and drinking.
  • Individual management of needs – this is provided through clinic appointments and/or home visits dependent on need.
  • Support for breast/bottle feeding, weaning, tube (enteral) feeding, and every day eating/drinking.
  • Liaison with dietetics re. weight and growth management
  • Liaison with Occupational therapy should specialist seating be required for safe feeding.
  • Liaison with wider MDT (e.g. respiratory consultants, neurodisability team) to ensure holistic health outcomes.

Referral Criteria:

  • Families with a Wandsworth GP,
  • Aged 0-11 years, however, spot commissioning can be sought for those who are 12-17

Acceptance Criteria:

  • Children who have a history of chest symptoms / infections / pneumonias where there are concerns about the safety of their swallow and the contribution this may be having to chest health
  • Children with reported signs of aspiration / difficulty feeding to include choking, coughing, wet breathing / voice, weight loss or static weight gain, changes to colour or breathing when feeding
  • Children who require specialist seating assessments and provision of equipment for safe feeding
  • Concerns regarding faltering growth/weight loss
  • Children requiring enteral feeding.

Exclusion Criteria:

  • Children who attend a special school provision – these provisions have specialist therapy teams on site to manage dysphagia need.

Referring to us

Please note: we only accept referrals from medical, nursing, allied health professionals, and SENCOs.

Referrals should be sent electronically:

  1. Multi-Disciplinary Feeding Team; Wandsworth Multi-Disciplinary Feeding Service Referral Form please send to: mdtfeeding@stgeorges.nhs.uk
  2. Community Paediatric Dysphagia Service; Community Paediatric Dysphagia Service referral form please send to: dysphagiaservice@stgeorges.nhs.uk
Team Title Info Document/Link
Community Dysphagia Team RCSLT Feeding and Swallowing Difficulties Overview of speech and language therapists role in feeding and swallowing, and the incidence of feeding and swallowing difficulties RCSLT Feeding and Swallowing Difficulties  (PDF)
What is Dysphagia Information on what swallowing difficulties are, what it can look like and how your speech and language therapist can help What is Dysphagia  (PDF)
IDDSI Paediatric Resources Links to documents regarding specific diet and fluid texture modifications to support safe swallowing https://iddsi.org/resources/

Under General Resources -> Consumer Handouts (Paediatric)

  Resource Thicken-Up Clear Thickening Instructions Preparation instructions for IDDSI Levels 1-4 https://www.youtube.com/watch?v=sXZQR-pFjYM

 

Multidisciplinary Feeding Team Dietetics
Assessing Changes in Growth at Home How to monitor your child’s growth without scales at home Assessing Changes in Growth at Home (PDF)
Food Selection by Texture Ideas on options to explore different foods using your child’s preferred textures Food Selection by Texture (PDF)
Food Selection by Colour Ideas on options to explore different foods using your child’s preferred colours Food Selection by Colour (PDF) Occupational Therapy
Understanding Sensory Issues and Their Impact on Mealtimes and Feeding Detailed information on different sensory difficulties and strategies to support children during mealtimes and feeding Understanding Sensory Issues and Their Impact on Mealtimes and Feeding (PDF)
Clinical Psychology
Self-Care for Caregivers Helpful guidance for parents/carers to reflect on your own self-care to be able to support your child and their feeding Self-Care for Caregivers (PDF)
Rapid Relaxation Exercises Quick ideas for parents/carers to use to support their own relaxation Rapid Relaxation Exercises (PDF)
5 Minute Relaxation Exercise A longer script to support relaxation 5 Minute Relaxation Exercise (PDF)
Mindfulness for Children Quick ideas for parents/carers to use to support their children’s mindfulness Mindfulness for Children
Triangle Breathing Simple guide to triangle breathing exercise for parents/carers and children Triangle Breathing (PDF)
What is Worry Worksheet for children and parents to use to reflect on feelings of worry and concern What is Worry (PDF)
How I Feel Worksheet Worksheet for children and parents to use to reflect on feelings and actions How I Feel Worksheet (PDF)
Rewards and Consequences How to use both rewards and consequences effectively with children Rewards and Consequences (PDF)
Weekly Goal Sheet Simple week-long goal sheet to track progress Weekly Goal Sheet (PDF)
SOS Approach to Feeding Parent Seminar 2 hour seminar by the founders of the SOS Approach to Feeding programme on restricted and aversive feeders, and how to help
Parent workshop when children won’t eat

Contact details

Locations:

Main Base:
Eileen Lecky Clinic, 2 Clarendon Drive, Putney SW15 1AA
Direct Line: 020 8725 8499

  • Outreach Sites:
    Tooting Cluster Hub (formerly Early Years Centre), 1 Siward Road, Earlsfield SW17 0LA
  • West Hill Enhanced Children’s Centre, 5 Merton Road, Wandsworth, London SW18 5ST

Tertiary Feeding Services for children ineligible for this service, requiring specialist-level support:

GOSH Feeding and Eating Disorders Service:

https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/department-child-and-adolescent-mental-health-dcamh/national-feeding-and-eating-disorders-service

Evelina London Feeding Service:

https://www.evelinalondon.nhs.uk/our-services/hospital/feeding-clinics/overview.aspx

Education Resources:

The NHS Eat Well Platehttps://www.nhs.uk/live-well/eat-well/the-eatwell-guide/

The SOS Approach to Feeding Picky Eaters vs. Problem Feeders Questionnaire: https://sosapproachtofeeding.com/picky-eater-questionnaire-parent/

NHS Information on Dysphagia and Aspiration: https://www.nhs.uk/conditions/swallowing-problems-dysphagia/

Infant and Toddler Forum – Weaning: Learning to Like New Textures: https://infantandtoddlerforum.org/babies-the-first-year/weaning/

Infant and Toddler Forum – Toddler Portion Sizes: https://infantandtoddlerforum.org/toddlers-to-preschool/portion-sizes-for-toddlers/toddler-portion-sizes-table/