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WINTER NEWSLETTER
UPDATES & NUTRITION NEWS
February 7th-11th is Feeding Tube Awareness Week


Feeding Tube Awareness Week was created to help educate people on the role of feeding tubes as a medical intervention. There are many medical conditions that require a feeding tube to support healthy growth and development in children and it can come with many challenges.

At Feed to Succeed, our dietitians work with many children who require a feeding tube to meet their nutritional needs.

Our team has advanced certifications in nutrition support and experience working with complex cases and also specializes in helping with tube feed weaning.

Our goal is to work together with families to optimize the child's nutrition and growth.
Client Spotlight: Read on to learn about the success of this child and family's tube feeding experience at Feed to Succeed.
In mom's own words, Rucha discusses her experience with a child requiring tube feeds.

Aavir's mom Rucha experienced ruptured membranes during her 17th week of pregnancy. Aavir was born at 30 weeks and spent almost three months in the NICU. Initially, he was eating orally, but feeding became difficult. Aavir had an NG-tube for about six months, and later, a G-tube was placed.

In September, Aavir and his family started working with Betsy at Feed to Succeed to transition off the G-tube and eat by mouth. Early on, Aavir showed interest in feeding orally after watching his parents eat. Initially, oral feedings took longer and Aavir took high calorie pureed foods and experimented with self-feeding finger foods. Eventually, Aavir started consuming adequate nutrients orally and the G-tube feedings were stopped. Aavir is now eating, drinking, growing well, and making great progress!
Q: What led to Aavir's feeding tube being placed?
A: Soon after Aavir came home from the NICU, he was put on an NG tube. He had really bad reflux issues as a newborn and, therefore, would have large amounts of spit-ups after his feeds, which caused him to develop an aversion to a bottle. The NG tube was a good option to help Aavir get food in; however, he didn't seem to do too well on that either. He was still having a large volume of spit-ups and wasn't gaining the weight he needed. We then switched him to a G-tube, and things looked up from there.

Q: How old was Aavir when the feeding tube was placed?
A: Aavir was six months old when an NG tube was inserted and fourteen months old when the G-Tube was placed. 

Q: How did you initially feel about your Aavir having a feeding tube?
A: Initially, we were very hesitant to go with the NG tube and then even more with the G-Tube. The NG Tube placement seemed urgent at the time to make sure he was getting the nutrition that he needed. The G-Tube was an option, and we kept pushing further, even though our GI doctor suggested we make the switch right away after the NG tube was placed. I think we were hoping for bigger strides with the NG Tube, where we wouldn't even have to go the G-Tube route, especially since it required surgery. We ended up switching to the G-Tube, and it ended up being the best decision for Aavir. He was able to keep food down the best yet.

Q: What has been the hardest part of the feeding tube?
A: I think the hardest part of a feeding tube is seeing your child in distress and not making progress. We watched Aavir wailing as we repeatedly, almost daily, at one point, had to re-insert the NG tube because it came out during a spit-up. The G-tube was much better for him; however, the granulation tissue that appears often required medication being applied multiple times a day, and it seemed to irritate him when this had to be done. The problem with both feeding tubes is that we don't know for sure that they are placed properly. There are ways to test and make sure things are fine, but you just don't know for a fact that they're fine, and Aavir was so young that he can't vocalize anything.
Q: When did you start working with Betsy, and how did it change the way you were feeding Aavir?
A: We started working with Betsy when Aavir was nineteen months old. She became a great member of Aavir's team quickly. Her guidance really helped Aavir stay on track to increase his caloric intake with oral feeds while staying in a healthy window of weight gain. Betsy's expertise gave us the confidence to continue feeding Aavir the high-calorie items he loved while keeping his hydration levels on point as we proceeded to wean him from his G-Tube. 

Q: What pushed you to start a tube wean? What has that experience been like? 
A: Honestly, Aavir pushed us to start the tube wean. He was more and more interested in what we, as a family, were eating. He was ready to try all the different textures and tastes. It has been such a joy to see him enjoy food and actually be excited about it. The early days of having a tube seemed so scary, but coming this far and seeing the happiness on his face when eating is just the best feeling!

Q: Do you have any advice for other parents whose child has a feeding tube?
A: Advice that I have for any parent who has a child with a feeding tube is to work with a feeding therapist, don't give up, and follow your child's cues. Everything seems so hard and overwhelming, and there's constantly so much to learn, but it will be okay. It will take some children longer, while others progress quickly; however, cry the happy tears at each milestone your child hits. The first bite, the first sip, the first smile that appears when they take a bite of something and find it yummy...it's all amazing what your child is doing. Always be their support, which only helps them thrive.
Aavir recently passed his swallow study with flying colors! :)
Our Team Continues to Grow!
Welcome, Amanda Johnson, MS, RD, LDN our new Registered Dietitian!
Amanda always knew she wanted to work in the medical field. As a dietitian, she enjoys working as part of the medical team and helping patients with complex medical diagnoses through the science of food.

Amanda holds a Bachelor's degree in Dietetics from Bradley University and a Master's degree in Human Nutrition from the University of Illinois at Chicago.

Her greatest professional achievement was working at Lurie Children's Hospital for 6 years. She is also a proud mom to a 2-year-old son. She and her family love to travel, cook, exercise, and go to sporting events.
While working at Lurie, Amanda worked closely with patients with food allergies, genetic disorders, and those in the NICU. She is excited to bring this expertise to Feed to Succeed where she can build long-term relationships with families and build specialized plans that work for their unique needs. Amanda loves to work with NICU grads, tube feeders, and infants of all kinds!

Amanda's favorite part of working in pediatrics is helping her clients meet developmental milestones. She believes the most important part is working as a team with the family and empowering them through difficult situations.
Welcome, Elizabeth Culver, our new Billing and Financial Coordinator
Elizabeth graduated from the University of Illinois at Urbana-Champaign with a degree in economics and finance. Before coming to Feed to Succeed, she worked for Blue Cross Blue Shield for 14 years.

Elizabeth is a proud mom to 2 kids ages 4 and 8. Her family has 2 cats and a dog, and they love to spend time outside.
Tune in to the Feed to Succeed Podcast
Is Your Child Getting Enough Vitamin D?
Betsy Hjelmgren, founder of Feed to Succeed, and Jen Karakosta discuss Vitamin D–sources, supplements, benefits, and more.

Listen to the episode "Yes, you DO need vitamin D!" to learn more.
No time to listen? Here's a quick summary:

Vitamin D is known as the sunshine vitamin. But, spending time in the sun is usually not enough to meet your vitamin D needs. Getting enough vitamin D from food can be hard, especially for kids.

In the midwest, vitamin D deficiency is very common! Your child's Pediatrician can order a blood test to check. Supplementation is usually the best way to meet your child's needs.

Why is vitamin D so important for kids?
Your body needs vitamin D to absorb calcium and support strong bones. For kids, a deficiency can interfere with proper bone development and negatively affect their growth.

Vitamin D is also shown to support a healthy immune system.
Multivitamin Supplementation Recommendations for Children
      Our children generally meet all their needs when it comes to essential vitamins and minerals, eating a well-balanced diet full of fruits and veggies, whole grains, and lean protein sources. However, sometimes, our kiddos may benefit from a boost from multivitamin supplements to help meet their individual nutrient needs. At the same time, we continue to support the development of their feeding abilities, diet variety, and general acceptance of foods. The end goal would be to maximize food variety and consume plenty of fruits and vegetables to reap the endless benefits. Meanwhile, parents may provide their kiddos with a quality multivitamin that ideally is free of artificial colors, sweeteners, flavors, high-fructose corn syrup, and high amounts of sugar. If your child has severe food allergies, please be mindful to select an allergy-friendly multivitamin. Multivitamins can come in different forms, such as gummies, chewable tablets, liquids, and powders. Generally, older children may do better with tablets, gummies, and infants with liquid forms.

      Essential nutrients to keep in mind when selecting multivitamin supplements include calcium and vitamin D for bone health, zinc and vitamin C for immune function and iron for brain development and anemia prevention. Keep in mind that many multivitamins do not contain iron as it can decrease the effectiveness and absorption of the other nutrients. However, if needed, supplements that specifically provide iron are available.

We recommend the Flintstones Complete Chewable tablets for children two years and older as they are free of high fructose corn syrup, artificial colors and flavors, and common allergens. This multivitamin contains critical nutrients like calcium, vitamin D, iron, and zinc in suitable amounts to supplement your kiddo’s diet. Children ages 2-3 should take ½ a tablet, and 4+-year-olds should take one tablet daily.

For infants and toddlers ages 0 - 3, we recommend the NovaFerrum Multivitamin with Iron, which comes in liquid form. This multivitamin is intended to support your child when transitioning to solid foods. It contains vitamins A, D-3, E, B1, B2, B3, B6, B12, and iron. For infants and children six months – 4 years, the dose is 1 mL per day. Kids may prefer this supplement as the Raspberry Grape flavor from natural fruit and sweeteners mask the not-so-pleasant taste of iron.

Overall, multivitamins can help support the growth and development of our youngest family members and are intended to be supplemental to actual food intake. If you have any questions regarding your child’s intake, nutritional adequacy, or dietary supplements, please reach out to us!
Ask Amanda: How to Get Kids to Eat Vegetables
Have you seen our "Ask Amanda" blog posts? Visit our website to learn more about common parenting nutrition topics like this one:

What are good recipes to get vegetables into picky eaters? The most important thing to remember is not to trick your kids!
Sports Nutrition Highlight By: Bailey J Jones MS, RDN, LDN, CSSD
Feed To Succeed Academy News:
Looking to receive CEU Credits? We are offering a series: TWW: Tube Weaning Webinar
In this three-part series, you will learn about:
  • Key aspects of tube feeding dependence and successful tube weaning
  • Parent perspective of tube feeding dependence and weaning
  • Case studies on tube feeding dependence and weaning
Continuing education credits are available with these courses!

TWW 101: 1.5 EI Credits, 1.5 CEUs for RDNs
TWW 102: 1.5 EI Credits, 1.5 CEUs for RDNs
TWW 103: 2.0 EI Credits, 2.0 CEUs for RDNs
We also offer a Low FODMAPs Course: Flourishing with FODMAPs Course

Are you struggling with IBS symptoms that do not seem to go away? If so, check out the Flourishing FODMAPs course which contains step-by-step information on how to do the FODMAPs elimination diet and helps you to discover your personal trigger foods. Inside the course, there are many resources like this recipe book which contains seventeen-FODMAP diet-approved recipes. Click on the link in the bio for more information on the Flourishing FODMAPs course.

Feed to Succeed Office Update
As a reminder, we are now using 'Patient Ally' for all records, documents, and appointments.

If you have not done so already, we request that all clients sign up for 'Patient Ally' prior to their first appointment if you have not done so already. Through 'Patient Ally', clients and their families can submit intake forms and insurance information, view appointments, send messages to their care team, and pay bills.
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