Helping kids eat, thrive, and grow

January 24, 2013 Uma Pisharody, MD, FAAP

Is your child under the age of 6 and having problems with feeding or weight gain? Swedish’s GAINS program can help you and your pediatrician by doing a full assessment and providing specific recommendations. The Growth and Integrated Nutrition Service at Swedish (GAINS) is a multidisciplinary program, which includes doctors, nurses, dietitians, behavioral specialists, and feeding therapists.

There are many medical conditions that lead to growth and nutrition problems in children. We are experts at working with children with:

  • Feeding difficulties
  • Poor weight gain
  • Malnutrition
  • Failure to thrive
  • Prematurity
  • Children with feeding tubes
  • Aspiration
  • Breastfeeding Difficulties

Here are some frequently asked questions about the GAINS program:

What will an evaluation with GAINS involve?

Every child has a unique set of problems. Our intake coordinator will make sure that your child has a full evaluation with the specialists that will be the most helpful. For your convenience, we will try to arrange visits with all of your specialists on the same visit to Swedish. Parents and other family members involved in your child's care are encouraged to be present for the initial evaluation. During the evaluation your child will receive a health and nutritional assessment and a complete physical exam. Blood and urine samples may be taken for laboratory tests. Special XRAY tests may be ordered as well, depending on the needs of your child.

How long will the initial appointment take?

The first visit can last from two to three hours. It is important that you come on time for your appointment. Follow-up appointments will be shorter, lasting approximately thirty minutes to an hour. If you need to cancel an appointment, please call the program as far in advance as possible.

What should I bring with me?

Upon scheduling your child's appointment, we will send you a packet with information about the program as well as an Intake Form, and a Food and Beverage Diary. We ask that you fill both these forms out before your initial visit and bring them with you to your child's appointment. It is also a good idea to bring some toys to entertain your child during this longer first visit. Please also remember to bring your insurance or Medicaid card, and any additional information you think will help our clinicians better understand your child's eating patterns.

What will happen after the evaluation?

As the evaluation progresses, impressions and results of medical tests will be shared and discussed with you. When the assessment is complete, you and your team of providers will create a customized treatment plan. This plan may include return visits to Swedish. At the end of the visit you can expect to take home written recommendations to help you follow this plan. A written summary of the evaluation will be sent to your child's primary doctor.

How will I pay for my child's care?

If you have Medicaid or an insurance plan that includes doctor visits, you will not have to pay for care other than the usual copay. If your insurance does not cover visits, please discuss this with our staff members before your first visit.


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