Pediatric Enteral Nutrition Series: Mastering Initiating, Weaning, Blending & Tube Site Challenges

Initiating & Monitoring Enteral Nutrition in the Pediatric Patient

⭐ Recording Now Available ⭐

Through 5 case studies, Katherine will provide you with a comprehensive overview of how to initiate and manage enteral nutrition in the pediatric population as well as highlight additional considerations with each patient case using current research and clinical practice guidelines.

In each case she will help you navigate formula considerations, how to develop a tube feeding regimen, estimating nutrition needs and special considerations for optimizing tolerance and ensuring adequate growth.

• Case #1: Term infant with reflux, oral aversion, needing tube feeding (short term)
• Case #2: Complex care child with neurological disorder requiring tube feeding (long term)
• Case #3: Child transitioning from nasogastric tube feedings to gastrostomy tube feedings (long term)
• Case #4: Malnourished child with limited oral intake requiring tube feedings (short term vs long term)
• Case #5: Child with ARFID requiring tube feedings (short term vs long term)

Working as a pediatric dietitian since 2003, Katherine Bennett has become a specialist in pediatric nutrition support, serving children of all ages through CHOC Children’s Hospital Gastroenterology and Nutrition program. Katherine is passionate about enteral nutrition support in the pediatric population and strives to make tube feeding as easy and normal as possible for clinicians, patients, and families alike.

She is a published author and has spoken on the local and national level on pediatric tube feeding and blenderized tube feeding, encouraging further education and support of real food-based tube feeding. Katherine is currently the principal investigator on a CHOC research project evaluating the impact of blenderized tube feeding on feeding intolerance and the gut microbiome in pediatric tube fed patients.

Want Tubie an Expert? Developing Expertise in Pediatric Enteral Tube Weaning

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This session will alternate between lecture-style presentations and practical exercises. The lecture portion will present evidence and describe best practice for enteral tube weaning in pediatrics. Students will have an opportunity to work through a case to identify opportunities to minimize tube dependence and/or wean and will develop a tube weaning plan.

• Define tube dependence
• Formulate care plans using the Pediatric Feeding Disorder framework
• Understand the value of weight-for-length in tube weaning
• Use hunger-induction and behavior modification techniques for tube weaning
• Follow weaning patients and monitor for complications

Dr. Julie Johnstone is a Staff Paediatrician and Hospitalist at the Hospital for Sick Children with a special interest in feeding and growth issues in the context of medical complexity. She supports decision making for children requiring enteral tube feeding and runs an outpatient Enteral Tube Weaning Program. She is the lead physician for the Durham Complex Care Program and works to support interdisciplinary teams in the care of children with medical complexity.

As a medical educator, Dr. Johnstone has a MScCH in Health Practitioner Education. She has a focus in assessment in residency training and the implementation of Competence By Design. She is the Director of Assessment and Special Projects and Competence Committee Chair for the Core Paediatrics Residency Training Program at the University of Toronto, the Director of Education for the Division of Paediatric Medicine at the Hospital for Sick Children, and the Faculty Lead for Post Graduate Medical Education Assessment at the University of Toronto Temerty Faculty of Medicine.

Mastering the Blend: Empowering Patients to Thrive on Tube Feeds

⭐ Recording Now Available ⭐

This session provides clinicians with a practical approach for helping patients transition to real food for tube feeding. Through hands on tips and tailored strategies for various patient scenarios, clinicians and patients will gain confidence they can successfully provide real food for tube feeding. This session aims to show a feeding tube is just another way to get nutrition into the body, and real food is not only safe, but provides so many amazing benefits.

• Foundational understanding: What is blenderized tube feedings, what is the history of using real food for tube feeding, the benefits, and criteria for eligibility.
• Practical skills: Learn how to set up for success, equipment needed, simple tweaks to improve digestion before starting and different blending strategies. Understand safe preparation, storing and feeding techniques, and how to introduce new foods.
• Navigate common challenges: How do you support parents in achieving long-term success and ensure optimal outcomes? Hilarie will go through navigating clogged tubes, consistency issues, nutrient intake and growth.
• Case Study: Progressing past recipe template handouts and applying the new knowledge to a case.

Hilarie Geurink is a Registered Dietitian and Certified Specialist in Pediatrics who has been helping families with tube feeding for over 8 years. She is the owner and founder of Blended Tube Feeding, a private practice dedicated to helping those fed by feeding tube incorporate real food into their routine so they can feel better and share in family meals. Prior to starting her private practice, she worked as a clinical dietitian at a children’s hospital in Michigan. She completed her dietetic internship at the University of California Davis Medical Center and her undergraduate degree at Michigan State University.

Tiny Tummies, Big Triumphs: Troubleshooting Pediatric Enteral Tube Site Challenges

⭐ Recording Now Available ⭐

In this session, you will explore crucial insights into handling and preventing complications related to enteral tube sites. Cynthia will teach you how to uncover the nuances of the healing process post-placement and identify potential complications at home then elevate your expertise with interventions for minor stoma site issues and unlock strategies to prevent these challenges. This information along with the case based examples will enhance your skills in managing common challenges associated with long term enteral access.

• Long term enteral access: Everything on site selection considerations, anatomy of tube placement and placement techniques. Understand normal healing and stoma maturation, gastropexy techniques and post procedure use.
• Tube basics: What are standard profile tubes vs low profile tubes vs balloon and non-balloon style tubes?
• Background, case examples and complication management: Uncomfortable with tube complications? Feel like this is outside of your scope? Cynthia goes over what you can do with yeast infections, hypergranulation, leaky tube sites, non-symmetrical balloon inflation, tube damage and fungal colonization of tubes.

Cynthia Reddick is a home tube feeding expert, educator and strategist having worked in homecare for over 25 years passionately facilitating patients’ successful transition from hospital to home on tube feeding. She works to promote positive clinical outcomes and believes a patient’s positive relationship with their feeding tube impacts adherence and quality of life. She developed her passion for nutrition support interning at the City of Hope National Medical Center in Southern California. In 2023, Cynthia received ASPEN’s HPEN Trailblazer Award.

Today, she works as a consultant to industry in the area of home tube feeding and enteral innovation and enjoys presenting round tables, clinical posters, webinars, and case studies in the area of home care tube feeding. She has been a guest speaker for the Oley Foundation, CMSA, NHIA, ASPEN and the Academy of Nutrition and Dietetics on a variety of topics related to home tube feeding.