Who We Are
Welcome to Growing Independent Eaters, a woman-owned business with over 40 years of combined experience in tube-weaning. Our team of feeding specialists, dietitians, social workers, and parent coaches are available to families globally to provide personalized planning, insights, and advice on weaning from a feeding tube.
Our founders have lived the feeding-tube journey themselves, and we understand the need for passionate experts to support families through their questions, concerns, fears, and ultimate triumphs. Our goal is to provide parents of tube-fed children a path towards joyful, relaxed oral eating while providing the support their families need throughout the process: whether you're just beginning, in the middle or near the end of a wean, we are here to help you succeed.
According to the Association for Healthcare Research and Quality, throughout the United States 165,000 enteral and parenteral nutrition procedures were performed on children in 2009, and there is no indication that number is decreasing. The majority of children are tube-fed in order to support them through serious, but temporary, medical situations. However, once medically stable and ready for oral feeds, many children and their families face a lack of thorough, competent care in order to transition from tube to family table.
Because there is no “standard of care” around feeding tubes, and certainly not around weaning, tens of thousands of children – and their families – remain on feeding tubes beyond medical necessity. Those who receive therapy discover that the approaches used on tube-fed children are too often ineffective, incomplete, or even harmful.
One significant deficit in current feeding therapy is the lack of recognition that the act of eating and the presence of appetite are intricately linked. The majority of approaches attempt to persuade full children to take in oral calories, or try to “desensitize” an averse and unwilling child through additional exposure, or even separate children from parents in order to instill desired mealtime behavior.
Clinics that recognize appetite and children’s trust as a foundation for eating are few, and do not reach the majority of families. A leading pediatric hospital, whose innovative child-first, appetite-based program enjoys great success, estimates that they are able to wean a mere 2% of their eligible feeding-tube patients.
While feeding tubes are life-saving interventions, they come with significant costs, including psychological, developmental, and physical side effects. The need for effective, compassionate feeding counseling is large, and is the reason for our company. Once a child is medically stable and no longer needing the life-support of enteral feeds, Growing Independent Eaters is available to advise parents on moving to family mealtimes: our approach of combining a child’s own hunger instincts with a de-medicalization of the feeding experience, as well as providing strong, psychological support, has shown tremendous effectiveness in leading to healing for the entire family.
(see reference below)
Children always have a reason for not eating. It is our job to figure out what that reason is, and then remove the obstacles to oral eating with compassion, skill, and joy.
A fundamental block to oral eating is fullness on the tube, and we provide guidance on reducing tube calories in a safe, controlled, but effective way to create appetite.
Appetite is not the only requirement for oral eating. Many kiddos have gone through medically traumatic experiences, and food and swallowing are scary and reminders of pain. We work with parents on creating safety and trust around food, and use the Division of Responsibility method.
Safety is foremost. Children need to be medically stable. They need to feel physically safe, through appropriate eating environments and eating methods: we have a wide range of approaches and tools to recommend. Children need to feel emotionally safe: we counsel the entire family on creating non-stress mealtimes. Children need to be safe from excessive weight loss, vomiting, and nausea: we never recommend weaning at any cost, we set weight loss limits, and ask parents to partner with a trusted medical provider.
- A child who can experience appetite, in a warm and safe environment, without pressure, and with parents who are supported in creating family mealtimes (often for the first time), can typically transition from a feeding tube and to family meals. We want you to have happy eaters at your family table.
Division of Responsibility (DOR): The fundamental idea is that the parent chooses the food, presentation, and time, while the child decides how much and whether to eat – this is a process of returning autonomy to the child, within the family’s unique mealtime culture. This approach was first described by renowned feeding expert Ellyn Satter. You can read about DOR on the Ellyn Satter Institute website www.EllynSatterInstitute.org.
Reference: Healthcare Cost and Utilization Project. Statistical Brief #118: Hospital Stays for Children, 2009. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb118.jsp