In this episode of Nutrition Pearls: the Podcast, co-hosts Megan Murphy and Jen Smith speak with Megan Horsley on her involvement with an intensive tube feed weaning program. Megan is a pediatric dietitian at Cincinnati Children’s Hospital Medical Center. She has 18 years of experience in pediatrics with a focus in cardiology and currently practices as a Lead dietitian as well as a cardiac float, serving all areas of cardiology (the Critical Cardiac Intensive Care Unit, the Acute Care Cardiology Unit and Outpatient Cardiology). Her most recent work has involved establishing a tube wean program in 2020 for heart patients which focuses on optimizing oral skills and getting them safely off their feeding tube.

She is a Certified Nutrition Support Clinician and in addition maintains her Certification as a Specialist in Pediatric Nutrition. She is involved in many projects, research, and quality improvement work, including the National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC), the Advanced Cardiac Therapies Improving Outcomes Network (ACTION) and the Pediatric Cardiac Intensive Care Society (PCICS). She has also served as a board member of the Congenital Heart Alliance of Cincinnati since 2017 and is a member of the Prolacta Clinical Advisory Board (PCAB) since 2019. Megan has eighteen years of professional practice in pediatric nutrition and twenty-one years of personal experience as a heart mom herself. She plans on continuing to concentrate her efforts on improving the nutritional care, experience and outcomes for all children affected by congenital heart disease.

Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.

Resources:

Tool Kit: NPC-QIC Tube Weaning — NPC-QIC

Kaskie, S., Horsley, M., & Marcuccio, E. (2024). Experiences in Tube Weaning Children with Congenital Heart Disease and Oral Feeding Aversion. Pediatric Cardiology. https://doi.org/10.1007/s00246-024-03515-8

Wong, J., Loomba, R., Allen, K. Y., Chan, T., Coolidge, N., Del Grippo, E., Horsley, M., Slater, N., Spader-Cloud, M., Steltzer, M., & Marcuccio, E. (2024). Structured Tube Weaning Using the Hunger Provocation Method in Infants with Single Ventricle Heart Defects: A Multicenter Study. Pediatric Cardiology. https://doi.org/10.1007/s00246-024-03558-x

Horsley, M., Hill, G. D., Kaskie, S., Schnautz, M., Brown, J., & Marcuccio, E. (2022). Evaluation of an Outpatient and Telehealth Initiative to Reduce Tube Dependency in Infants with Complex Congenital Heart Disease. Pediatric Cardiology, 43(7), 1429–1437. https://doi.org/10.1007/s00246-022-02864-6

Weaning from a feeding tube in children with congenital heart disease: A review of the literature: www.sciencedirect.com/science/article/abs/pii/S1058981321000801?via%3Dihub

Cardiology Feeding Tube Wean Clinic

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org

Episode 33 - Christy Figueredo - Navigating GLP-1 Use in Pediatrics

In this episode of Nutrition Pearls: the Podcast, co-hosts Bailey Koch & Megan Murphy speak with Christy Figueredo on the RD's role in patients on GLP-1 agonists. She is a member of the CPNP GLP-1 task force and shares her knowledge on managing pediatric patients on GLP-1 medications from her own clinical practice and the information gathered from the task force. Christy is a board-certified specialist in pediatric nutrition. She currently serves as the Dietitian for the department of Pediatric Gastroenterology, Hepatology and Nutrition at the University of Miami where she manages the unique nutritional needs of complex patients from infancy to adolescents in the outpatient setting. She is an invited textbook chapter author for Infant and Pediatric Feeding and speaker on an array of childhood nutrition topics from the local to national level. She is a staunch child health advocate. Appointed to both the Miami-Dade WIC and Public-School Wellness Advisory committees collaborating with local stakeholders in childhood health and nutrition to provide a more equitable built environment for all.

Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.

Resources:
The SCOFF Questionnaire

Binge Eating Disorder Questionnaire

Alliance for Eating Disorders - a great place for families or providers to start their search if they are unfamiliar with providers and support in their area.

Food insecurity questionnaire

Wadden TA, Chao AM, Moore MB, et al. The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities. Current Obesity Reports. 2023;12(4). doi:https://doi.org/10.1007/s13679-023-00534-z

Mechanick JI, Apovian C, Brethauer S, et al. CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES – 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS. Endocrine Practice. 2019;25(12). doi:https://doi.org/10.4158/gl-2019-0406

Almandoz JP, Wadden TA, Tewksbury C, et al. Nutritional considerations with antiobesity medications. Obesity. Published online June 10, 2024. doi:https://doi.org/10.1002/oby.24067

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Wharton S, Davies M, Dicker D, et al. Managing the gastrointestinal side effects of GLP-1 receptor agonists in obesity: recommendations for clinical practice. Postgraduate Medicine. 2021;134(1):14-19. doi:https://doi.org/10.1080/00325481.2021.2002616

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org

Episode 32 -Heidi Quinn - Evaluating Nutrition in Children with Autism

In this episode of Nutrition Pearls: the Podcast, co-hosts Nikki Misner and Jen Smith speak with Heidi Quinn on nutrition in patients with Autism Spectrum Disorder. Heidi Is a registered dietitian working in the field of pediatric/young adult nutrition with special health care needs for 35 years across various settings which includes inpatient and outpatient settings at Franciscan Children’s Hospital (Brighton) , Boston Children’s Hospital, Early Intervention programs, schools for children with special needs, and specialty clinics ( feeding clinics, developmental disability programs) and Joslin Diabetes Center. Heidi currently works at Boston Children’s Hospital providing nutrition care in multiple clinics including the out-patient GI clinic, the Growth and Nutrition Program, Autism/GI clinic, Cleft lip and Palate program and the Endocrine department. It is her work in the Autism/GI clinic which will be the focus of this episode.

Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.

Resources:

How Food Chaining Therapy Works: A Solution for Picky Eaters

Autism Spectrum Disorder in Children and Adolescents: Complementary and Integrative Medicine Therapies - UpToDate

The Managing Medical Issues in Autism video series developed by Tim Buie, Co-Director of the GI and Autism Clinic, Sonia Ballal, Stacy Kahn, Howard Shane and Julia Carmody. All 5 videos are free to families, caregivers and professionals. Link to all the videos on the Boston Children’s Hospital YouTube channel: https://bit.ly/BuieVideos

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org

Episode 31 - Bonus Episode - End of Season 2 Year in Review

In this episode of Nutrition Pearls: the Podcast, all the hosts join to reflect on the second year of Nutrition Pearls: the Podcast and discuss what is to come in season 3!

Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org

Episode 30 -Toni Solari - Nutrition in the Child who Aspirates

In this episode of Nutrition Pearls: the Podcast, co-hosts Jen Smith and Nikki Misner speak with Toni Solari on nutrition in patients with aerodigestive diseases. Toni is a registered dietitian in the Aerodigestive Center at Boston Children's hospital where she specializes in blenderized nutrition and specialized diets for various gastrointestinal disorders. She earned her degree at UMass Amherst, and has been practicing as a pediatric dietitian for 11 years. When she is not working, Toni enjoys spending time, preferably outside, with her 3.5 year old son and 1.5 year old daughter.

Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.

Resources:

Aerodigestive Nutrition References: https://www.iddsi.org/standards/framework

Bolgeo T, Di Matteo R, Gallione C, Gatti D, Bertolotti M, Betti M, Roveta A, Maconi A. Intragastric prepyloric enteral nutrition, bolus vs continuous in the adult patient: A systematic review and meta-analysis. Nutr Clin Pract. 2022 Aug;37(4):762-772. doi: 10.1002/ncp.10836. Epub 2022 Feb 16. PMID: 35174544.

Hirsch S, Solari T, Rosen R. Effect of Added Free Water to Enteral Tube Feeds in Children Receiving Commercial Blends. J Pediatr Gastroenterol Nutr. 2022 Mar 1;74(3):419-423. doi: 10.1097/MPG.0000000000003308. PMID: 34560723; PMCID: PMC9531939.

Hron B, Rosen R. Viscosity of Commercial Food-based Formulas and Home-prepared Blenderized Feeds. J Pediatr Gastroenterol Nutr. 2020 Jun;70(6):e124-e128. doi: 10.1097/MPG.0000000000002657. PMID: 32443040; PMCID: PMC8530412.

Hron B, Fishman E, Lurie M, Clarke T, Chin Z, Hester L, Burch E, Rosen R. Health Outcomes and Quality of Life Indices of Children Receiving Blenderized Feeds via Enteral Tube. J Pediatr. 2019 Aug;211:139-145.e1. doi: 10.1016/j.jpeds.2019.04.023. Epub 2019 May 23. PMID: 31128885; PMCID: PMC6660979.

Jensen EA, Zhang H, Feng R, Dysart K, Nilan K, Munson DA, Kirpalani H. Individualising care in severe bronchopulmonary dysplasia: a series of N-of-1 trials comparing transpyloric and gastric feeding. Arch Dis Child Fetal Neonatal Ed. 2020 Jul;105(4):399-404. doi: 10.1136/archdischild-2019-317148. Epub 2019 Nov 4. PMID: 31685527; PMCID: PMC7453998.

Koo JK, Narvasa A, Bode L, Kim JH. Through Thick and Thin: The In Vitro Effects of Thickeners on Infant Feed Viscosity. J Pediatr Gastroenterol Nutr. 2019 Nov;69(5):e122-e128. doi: 10.1097/MPG.0000000000002470. PMID: 31449171.

Alyssa Courtney, Anne Bernard, Scott Burgess, Katie Davies, Kelly Foster, Vishal Kapoor, David Levitt, Peter D Sly; Bolus Versus Continuous Nasogastric Feeds for Infants With Bronchiolitis: A Randomized Trial. Hosp Pediatr January 2022; 12 (1): 1–10. https://doi.org/10.1542/hpeds.2020-005702

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org

In this episode of Nutrition Pearls: the Pediatric GI Nutrition Podcast, co-hosts Bailey Koch and Nikki Misner speak with Gina O’Toole, MPH, RD, CSPCC, CLEC. Gina O’Toole received her B.S. from Seattle Pacific University in Exercise Science and Physical Education and went on to receive her Master’s in Public Health and Nutrition from Loma Linda University. Gina is a Board Certified Pediatric Critical Care dietician and Certified Lactation Educator Counselor. Gina has been working in a Level IV Neonatal Intensive Care Unit (NICU) at CHOC Children’s Hospital in Orange, California for almost 15 years. She has been instrumental in the institutional development of care guidelines and human milk advocacy for preterm infants, infants with short bowel syndrome/intestinal failure and those with complex surgical diagnoses. When she is not working with the babies, she loves to spend time with her husband and 3 children Lola, Brooklyn and Ellis. You will find them outdoors gardening, at the beach, camping, hiking, climbing or biking!

Nutrition Pearls is supported by an educational grant from Mead Johnson Nutrition.

Resources:

American Society for Parenteral and Enteral Nutrition (ASPEN) - Parenteral Nutrition Resource

ASPEN Pediatric Intestinal Failure Section

Link to CPNP PN slide set: naspghan.org/nutrition-obesity

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org

Join us for a special bonus episode featuring Jaclyn Pederson, CEO of Feeding Matters, as she shares her own personal journey navigating Pediatric Feeding Disorder (PFD) with her son and the resources available for patients and professionals through the Feeding Matters organization. With a unique perspective as both a parent and a professional, she offers invaluable insights on overcoming the challenges of PFD, and provides advice for other families seeking support and guidance.

Nutrition Pearls is supported by an educational grant from Reckitt Mead Johnson Nutrition.

Resources:

Feeding Matters.org

Feeding Matters International Pediatric Feeding Disorder Conference: feedingmatters.org/conference

Feeding Matters Power of Two Parent Mentor Program: feedingmatters.org/resources-support/family-support/request-family-support

Feeding Matters Find a Provider: feedingmatters.org/resources-support/provider-directory/?gad_source=1&gclid=Cj0KCQiAqL28BhCrARIsACYJvke0HbZFwwWU4XW17M5NeQbckAN6FzE9ABkQagdWKQEHMXjaEmHlwcIaAuU5EALw_wcB

It’s Not Picky Eating: itsnotpickyeating.org

N2U site: naspghan.org/meetings-events/n2u

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org

In this episode of Nutrition Pearls: the Pediatric GI Nutrition Podcast, co-hosts Megan Murphy and Bailey Koch speak with Cuyler Romeo, MOT, OTR/L, SCFES, IBCLC. Cuyler is an Occupational Therapist and Pediatric Feeding Specialist serving as Feeding Matters’ Director of Strategic Initiatives and practicing as a NICU Feeding Specialist at Banner University Medical Center-Tucson. She holds a specialty certification in Feeding, Eating and Swallowing (SCFES) and is an internationally certified lactation counselor (IBCLC). She works to advance the system of care for pediatric feeding disorder and all who struggle to eat through the identification and execution of strategic projects and consensus actions. Cuyler also works with the feeding community at large by facilitating AOTA’s Mealtime Occupations: Feeding, Eating, and Swallowing Community of Practice and by serving as a member of the National Perinatal Association’s Developmental Work Group for Guideline Dissemination.

Resources:
Feeding Matters Website Links:
When to Refer (Infant & Child PFD Signs & Symptoms): www.feedingmatters.org/toolkit/when-to-refer-rack-card

ICFQ 6 Question Screener for Professionals: feedingmatters.org/toolkit/icfq-6-question-screener-for-professionals

Feeding Matters Infant and Child Feeding Questionnaire (for parents/caregivers): questionnaire.feedingmatters.org

It’s Not Picky Eating: itsnotpickyeating.org

Estrem, H. Pederson, J., Dodrill, P., Romeo, C., Thompson, K., Thomas, J. J., Zucker, N., Noel, R., Zickgraf, H., Menzel, J., Lukens, C., Goday, P., MacLaughlin, S., & Sharp, W. G. (in-press). A US-Based Consensus on Diagnostic Overlap and Distinction for Pediatric Feeding Disorder and Avoidant/Restrictive Food Intake Disorder. International Journal of Eating Disorders. DOI: 10.1002/eat.24349

Produced by: Corey Irwin

NASPGHAN - Council for Pediatric Nutrition Professionals

cpnp@naspghan.org