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Infants and young children with severe feeding and nutritional problems, whether or not they require tube feeding. Children suspected of having a feeding disorder always undergo an outpatient diagnostic phase first. Following an outpatient assessment phase, it may be necessary to carry out an assessment of the feeding, nutritional or growth disorder, or of the conditions required for weaning off a feeding tube, on an inpatient basis.
Inpatient treatment for feeding disorders and weaning from tube feeding is carried out on an interdisciplinary basis in collaboration with paediatrics, speech and language therapy, dietary advice, nursing and child psychiatry. All these specialist areas play key roles in the therapeutic process and are in constant communication with one another.
Our treatment approach is family-centred and designed to support and promote the healthy development of early parent-child relationships. For this reason, parents are required to be present throughout the entire stay.
All stages of treatment are tailored to the family’s individual needs and discussed with them. A meeting is held every Tuesday at 11.30 am, during which the interdisciplinary team discusses the next steps. The family is then informed of the outcomes. The success of the therapy depends on good cooperation between the treatment team and the parents. A lack of cooperation on the part of the parents may lead to the treatment team discontinuing the therapy.
The treatment is based on fundamental principles such as clearly structured meals, no use of coercion, parents eating together with their children, and maintaining a regular daily routine.
As part of the treatment, the child’s body weight may decrease by up to 10%. The medical team continuously monitors the child’s health and can take early action should there be a significant deterioration in their general condition.
In-patient treatment of feeding and nutritional problems, with or without the need for tube feeding, at the UKBB is divided into three phases:
The first phase focuses on getting to know the child and their family – their mutual needs, challenges and resources – in as much detail as possible, so that the treatment plan can be tailored accordingly. During this phase, the discussion of the topics of „eating and nutrition“ should take place as stress-free as possible for everyone involved. Any hypersensitivity in the mouth and throat area, which may make eating difficult, is gradually reduced through desensitisation treatment carried out by our speech and language therapists. Eating should be (re)discovered as something interesting and enjoyable; experimentation with food is encouraged. As tube feeding has not yet been significantly reduced at this stage, eating does not yet need to be focused on satisfying hunger or maintaining weight
serve.
In the second phase, the volume of tube feeding is now reduced. Tube feeding is shifted to night-time hours as far as possible, so that the child can develop a sense of hunger as a motivation to eat during the day. Weight gain is closely monitored. The child and their family receive psychotherapeutic support, as the reduction in tube feeding during this phase can lead to weight loss of up to 10% of body weight.
In the third phase, when the child is now consuming a significant proportion or all of their food orally, the feeding routine is gradually structured. Rules regarding how families wish to organise mealtimes on an individual basis are discussed with them. It is also a matter of integrating the tried-and-tested steps used on the ward into everyday life at home, thereby bringing the ward’s daily routine as close as possible to the normality of everyday life at home. Planning for potential ongoing outpatient care also plays an important role in this phase.
The duration of treatment is usually between 2 and 4 weeks and depends on the patient’s progress and their cooperation with the multidisciplinary treatment team.
Admission takes place every Tuesday at 1.30 pm. The date for inpatient treatment is discussed in advance by the interdisciplinary team and set taking into account the capacity of Ward A and the patient’s family circumstances.
The rooms are designed to accommodate two families and allow one parent to stay overnight with their child. Meals for the child and the parents are ordered and prepared by the hotel. Nutritional advice is also usually sought.
Further information can be found on the website at www.ukbb.ch.
Compulsory basic health insurance covers the costs of treatment. The flat-rate treatment fee funded by health insurance funds covers only the child’s meals. Parents must pay for their own meals.
The decision on withdrawal is taken every Tuesday.
Following inpatient treatment, there is a relapse prevention and follow-up phase to enable any setbacks to be addressed at an early stage. In particular, having the child’s weight and height measured by their paediatrician is helpful. The family continues to receive outpatient support from the child psychiatry team or the dietary advice service.
The Medgate Kids Line provides quick and uncomplicated medical advice if your child is unwell. The medical team of our partner Medgate is available to you by telephone around the clock.
For emergencies abroad: Call the emergency number of your health insurance company. You will find this number on your health insurance card.
More information: On the Page of the emergency ward you will find everything you need to know about behaviour in emergencies, typical childhood illnesses and waiting times.
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