Speech Pathology (for infants) - Royal North Shore Hospital

We provide multidisciplinary treatment for babies post-neonatal intensive care unit (NICU) admission with complex swallowing and feeding difficulties and disorders.

We care for and treat babies with complex swallowing and feeding difficulties and disorders.

Who can access the clinic?
Children must have a combination of both feeding and nutrition/growth issues to be eligible for the feeding clinic. This may include, but is not limited to:
o    Faltering growth and/or poor weight gain
o    Enteral Feeding and tube weaning 
o    Food refusal/oral aversion
o    Swallowing difficulties, including management of aspiration 
o    Extended feeding times/ poor intake
o    Oral motor or sensory problems (this includes ‘weak suck’ or difficulty transitioning to solids/ textures 
o    Developmental delay impacting on feeding
 

Plese bring:

• any feeding equipment your child uses such as bottles, teats, nipple shields
• formula/expressed breast milk for bottle assessments
• if your baby is also on solids, you will need to bring foods (what you offer at home) and equipment such as spoons

You will be advised by your child's doctors (e.g., paediatrician, ENT) or by another health professional (e.g., Speech Pathologist, Dietitian) if your child needs a Speech pathologist at RNSH.

All referrals should clearly state the reason for referral including the current communication and swallowing status and any history of the signs and symptoms.
If you have a scheduled appointment, you will receive a reminder text message a few days prior. Please note that phone calls from the hospital will appear as a blocked number.

Please allow ample time for your appointment. Some patients require longer reviews and unplanned delays may occur.

Referrals
New patients for initial assessments are accepted to the clinic with a specialist referral only. Thereafter a GP referral is adequate. They are to be faxed to the clinical nurse on FAX. Referrals must include a brief outline of the feeding and weight gain issues and any investigations which have already occurred. The feeding clinic referral form can also be used. Referral Form 

A referral is deemed appropriate for the clinic is the child has both feeding and weight gain issues. If a referral is not appropriate, the patient is to be booked into the appropriate health professionals outpatient clinic by their own department’s secretary. A letter will be sent to the referrer who will be responsible for linking the patient with a more appropriate service

Triaging
The team will meet at 8.30 prior to the feeding clinic on a Wednesday every fortnight. All new referrals will be reviewed to determine both the appropriateness and the urgency of referrals, and whether any further information is required. The urgency of a referral and how soon a patient should be scheduled will be determined by the feeding team, not the referrer. The feeding clinic is not an acute service and as such, cannot guarantee referrals will be seen in a timely manner if there is a waiting list. The clinical nurse will advise the feeding team prior to each Wednesday feeding clinic how many referrals are for discussion and the patients who are booked in for the clinic

Referrals will be triaged on a 2 point system where:
1. Patient should be seen ASAP. The patient will be scheduled in the next available and put on the cancellation list to be moved to a sooner appointment where possible
2. Patient should be scheduled in the next available
If appropriate for feeding clinic, the clinical nurse support will:
1) ring the patient to make an appointment into the feeding clinic and scheduled online
2) send out a feeding clinic package to the patient, including an initial assessment letter and food chart.

Appointments:
The clinic consists of 4x 45 minute appointments. If a patient presents late for their appointment, the patient will not receive their full 45 minutes. As the clinic runs to schedule, if the patient arrives 20 minutes or later than the scheduled appointment time, their appointment will be cancelled and they will booked in to the next available appointment.

Our team

Dr Joanne Smuk  - Peadeatrician

Krystal Furey - Speech Pathologist

Team Dietitian