Tube to Table

S2. Ep. 27: Tube-Fed Kids and Food: From Exposure to Opportunity

What if the goal isn’t to get your child to eat… but to help them want to?    In this episode, Jeni and Heidi unpack a powerful (and often overlooked) mindset shift in the tube weaning journey: moving from “exposure” to “opportunity.” It sounds subtle, but it can completely change how your child experiences food and how you show up as a parent at mealtimes.    So many families are told to “just keep exposing” their child to food. While well-intentioned, this advice often comes with little support or clarity and can unintentionally create pressure, disconnection, and even more resistance.    We’re talking about exposure versus opportunity.   * Exposure = doing something to your child to get them used to food   * Opportunity = creating space for your child to choose to engage with food   Exposure is often:  * Adult-led and outcome-focused (“getting them to eat”)   * Passive for the child and reliant on repetition   * Prone to creating pressure, even unintentionally   Opportunity, on the other hand:  * Centers your child as an active participant   * Focuses on the experience, not the outcome   * Builds safety, curiosity, and internal motivation   Opportunity can be simple. Your child might watch you eat, notice a sibling’s food, smell something new, or briefly touch it. They may also choose not to engage at all and that’s okay. Even observing food is meaningful. For tube-fed children, engagement isn’t about eating all the time. Instead, it’s about safe, pressure-free experiences with food.  This shift helps your child build self-regulation, learning to notice and trust their hunger, fullness, and interest. When pressure is reduced and children can participate in their own way, they stay connected to their internal cues and to you. It moves feeding out of a medical task and back into a more natural, connected relationship.  This isn’t about lowering expectations. Think about it as changing the path to get there.  When we move from getting to letting, and from outcomes to experience, we create the conditions for real, lasting progress. Real progress in tube weaning doesn’t come from more pressure. It comes from more connection, safety, and trust.    ** Please remember this podcast is NOT meant to replace the support and guidance of your child's medical team.  Consult with your doctor before starting the weaning process.*    Don’t forget to follow us on social media for more helpful information @Thrivewithspectrum on Instagram and Thrive by Spectrum Pediatrics on Facebook. You can also find out more information about the programs we offer at www.thrivewithspectrum.com

S2, Ep. 26: Feeding Progress When the Tube Needs to Stay

What if your child still needs their feeding tube… and that’s not actually considered a failure? What if progress doesn’t mean removing the tube, but learning how to move forward with it?    For many families, the goal starts as tube weaning. But along the way, some discover their child needs long-term support, or at least more time. For other families, you may know from the beginning that it's likely that your child will always need some form of support from the feeding tube.  This can feel like a confusing middle ground. You might wonder: Did we do something wrong? Are we stuck? The truth is, this space where tube feeds and oral eating coexist is not only valid, but it can be incredibly successful.      It starts with acceptance. Not giving up but getting grounded in where your child is right now. When you take time to build a stable, low-pressure foundation, feeding often becomes less stressful for everyone. From there, you can better understand:  * Your child’s strengths  * Areas that need support  * What realistic, meaningful progress looks like    One of the most powerful shifts you can make is focusing on autonomy and participation.  Ask yourself:  * Is my child actively involved in feeding in a way that fits their development?  * Do they have opportunities to make choices and engage?  This can look like:  * Letting them pass food, explore textures, or decide what goes on their plate  * Involving them in tube feeds (pushing a syringe, helping set up)  * Creating opportunities for real participation. Kids build relationships with food when they feel like active participants, not passive recipients.    It’s easy to fall into a performance mindset that includes counting bites, focusing on volume, or pushing exposure. But long-term progress is rooted in quality experiences, not just quantity.  Try to instead focus on:  * Low-pressure, positive mealtimes  * Curiosity over compliance  * Shared experiences, regardless of how much is eaten  Because a child who feels safe, interested, and included around food is more likely to keep moving forward.    Tube feeding and oral eating don’t have to be all-or-nothing. In fact, they work best when they’re flexible. Some options families explore:  * Eating by mouth during the day, with supplementation at bedtime  * Offering tube feeds after meals to reduce pressure during eating  * Adjusting timing based on school, energy, or appetite  The goal is to find a middle ground where your child:  * Has enough support to grow and feel well  * Still experiences hunger, fullness, and motivation to eat  It’s often a dance, not a fixed plan. And sometimes, increasing tube feeds as kids grow or eating becomes harder is exactly what supports long-term success. One common trap? Keeping the same plan as your child grows. But feeding needs change. Schedules shift. Development evolves.  Make space to regularly revisit:  * Tube feeding amounts and timing  * Mealtime structure  * Your child’s engagement and interest  Flexibility is key to keeping the plan aligned with your child—not where they used to be.    This journey can be longer than expected. And that can be hard. But staying on tube feeds while making progress with oral eating is not a step backward! It’s a thoughtful, responsive path forward. Pause when you need to. Adjust when it makes sense. Progress is still happening, even if it looks different than you imagined.    Your child’s story doesn’t have to be all-or-nothing. Growth can happen in the middle, in the space where support and progress exist side by side. Stay flexible, stay curious, and trust that forward movement is still possible… exactly where you are.    ** Please remember this podcast is NOT meant to replace the support and guidance of your child's medical team.  Consult with your doctor before starting the weaning process.**    Don’t forget to follow us on social media for more helpful information @Thrivewithspectrum on Instagram and Thrive by Spectrum Pediatrics on Facebook. You can also find out more information about the programs we offer at www.thrivewithspectrum.com

S2, Ep. 25: Getting Ready for Tube Removal

You’ve spent months (maybe years) keeping your child safe, nourished, and growing with a feeding tube. And now… the moment you’ve been working toward is here! Tube removal. But instead of just relief, you might be feeling other unexpected emotions: uncertainty, sadness, even a little fear.  Jeni and Heidi are here this week to help paint a picture of what tube removal and next steps may look like.    Getting ready to remove a feeding tube is a huge milestone. It’s often the goal from the very beginning, but when you finally arrive, it can feel bigger and more emotional than expected. After all the effort that went into placing the tube, using it, and eventually weaning from it, many families are left wondering: What now? The truth is, there aren’t a lot of resources guiding families through this specific transition. So let’s walk through some key things to consider.    How do you know it’s time?  While medical providers ultimately guide the decision, here are some important readiness signs to reflect on:  * Growth & nutrition: Is your child eating enough by mouth to support their current growth in a way your team feels good about?  * Sustainability: Is eating mostly self-directed? Or are there still frequent power struggles, pressure, or bribing?  * Stability: Has your child made it through a stressor or big life change without using the tube? Things like illness, travel, transitioning to a new school, etc.  * Body basics: Are hydration and elimination (peeing and pooping) consistent and comfortable?  And one more that matters just as much:  * Are you ready?: That tube has likely been your safety net for a long time. Removing it can bring up more emotion than expected and that’s completely valid.    This isn’t just a medical transition! It’s also an emotional one. Take a moment to reflect on your family’s journey. The highs, the stress, the resilience. Many parents find that alongside the hard parts, there’s also growth. What you’ve learned, how you’ve adapted, and how deeply you’ve shown up for your child.    For your child, this experience may be harder to fully understand but it still matters. For some kids, the tube has always been part of their body. Letting it go might feel:  * Exciting and freeing  * Confusing or unexpected  * Completely neutral  Just like saying goodbye to a pacifier, some children, especially older ones may need time and support to process the change. You know your child and how they handle changes and transitions.  If they need a little more time and preparation to process you can help by:    * Talking about it ahead of time  * Inviting questions and feelings  * Creating a simple or meaningful “goodbye” (a story, drawing, or small ritual)    As you move forward, think about how you want to remember this chapter. Some families choose to:  * Keep a small piece of equipment as a memory  * Write a letter to their child about the journey  * Share their story to support other families  * “Paying it forward” by donating unused supplies or connecting with another family starting a similar journey.    It’s also so important to celebrate! This is a big deal. Whether it’s a quiet snuggle, a family celebration, or a simple moment of acknowledgment, try to pause and take it in. Your child has done something incredible. And so have you. Saying goodbye to the feeding tube isn’t just the end of something, rather, the beginning of a new chapter. One built on trust, growth, and everything your family has learned along the way. However it looks for you, make space for it. You’ve earned that.    ** Please remember this podcast is NOT meant to replace the support and guidance of your child's medical team.  Consult with your doctor before starting the weaning process.**    Don’t forget to follow us on social media for more helpful information @Thrivewithspectrum on Instagram and Thrive by Spectrum Pediatrics on Facebook. You can also find out more information about the programs we offer at www.thrivewithspectrum.com

S2, Ep. 24: Getting Back On Track

Jeni and Heidi are back this week to talk about how to get back on track when things feel like they're falling apart. Tube weaning is rarely a straight line. If things feel off track, you’re actually right where many families find themselves at least once in their journey.  Tube weaning is often expected to be a simple shift: less nutrition through the tube and therefore more by mouth. In reality, it’s much more complex. Medical needs, sensory experiences, digestion, motor skills, and emotional safety all play a role. On top of that, families are navigating stress, fatigue, and the pressure that can come with wanting the process to go well. Because of this, most weaning journeys include a moment where things feel like they’ve stalled or gone off track. That doesn’t mean your child can’t do it. In fact, these moments are so common that in our program we expect them and plan for them.  When this happens, the goal isn’t to panic or assume the wean didn’t work. Instead, it’s about getting back on track by pausing and zooming out. Much like climbing a staircase, if you get winded you don’t go all the way back to the bottom! Instead, you might pause at the next landing. During tube weaning, that might mean adjusting support, reassessing your child’s needs, and working with your team to find the next stable step forward.  Responsive feeding encourages families to look beyond just volumes and bites and consider the bigger picture:  * Is the feeding experience a good sensory fit for your child?  * Does your child feel safe and supported at meals?  * What’s happening medically or developmentally?  * What was different during the days that went well?  Progress during tube weaning is often subtle. Small shifts might look like more comfort at the table, a few extra bites, increased curiosity about food. All of those are meaningful steps in learning to eat. If you find yourself feeling stuck, it’s okay to pause, reflect, and seek additional support. Sometimes getting back on track simply means bringing in another responsive feeding professional who can collaborate with you and your medical team to help guide the next step.  It's true that transitioning from the tube to oral eating can be messy, emotional, and unpredictable but that doesn’t mean you’re doing it wrong. Sometimes the most important step forward is simply pausing, zooming out, and finding the next place to begin again. You've got this and we're here to help!  ** Please remember this podcast is NOT meant to replace the support and guidance of your child's medical team.  Consult with your doctor before starting the weaning process.**    Don’t forget to follow us on social media for more helpful information @Thrivewithspectrum on Instagram and Thrive by Spectrum Pediatrics on Facebook. You can also find out more information about the programs we offer at www.thrivewithspectrum.com

S2, Ep. 23: Hunger, Appetite, and Tube Weaning

In tube weaning, we hear all the time, “We just need to create hunger.” But hunger isn’t a button you push. It’s a learning process and understanding that changes everything.    Hunger is the body’s physiological signal for energy. It’s driven by things like blood sugar and growth needs. Appetite is different: it’s the desire to eat, shaped by experience, interest, sensory input, and comfort. Both matter in tube weaning. For many tube-fed kids, hunger hasn’t been a consistent experience. Feeds are often delivered at the top end of calorie needs, which keeps children safe and growing but may leave little room to actually feel hunger. Sometimes what’s felt is relief from fullness, not true hunger.    What Gets in the Way?  * High tube volumes limiting hunger opportunities  * Stress or pressure around food  * Overwhelm (even from fun or exciting activities!)  * Trauma history affecting body awareness  * Sensory sensitivities or regulation challenges  * Neurological differences, medications, or day-to-day health changes    Every child, every opportunity, and every day is different.    What does it look like in tube-fed kids?  We often hear from families that when they first begin introduction periods of hunger into their child's day or eating experiences is that it doesn't look like it's "working".  It's important to remember that hunger is not an on/off switch. It develops through repeated, supported experiences over time. Early signs can be subtle:  * Sitting at the table longer  * Touching or smelling food  * Small shifts in mood  * Increased curiosity    Those moments count.  It's important to notice those and quietly begin to build on those successes by noticing how and when your child is responding and create situations that allow them to explore and expand at their own rate.     Give it time.  Skipping one feed doesn’t mean a child will eat that amount by mouth. It takes consistent, supportive exposure in the presence of manageable hunger. Too much hunger doesn’t help either. When a child is overwhelmed, learning stops. We’re looking for the middle: enough hunger to spark interest, not so much that it causes distress. Most importantly, we start with belief. Many children aren’t unable to feel hunger, they simply haven’t had the chance to learn what it feels like yet.    Instead of “flipping” hunger on, we carefully create space for it by:  * Gradually adjusting tube feeds with medical guidance  * Building manageable hunger without causing dysregulation  * Offering repeated, low-pressure exposure to food  * Supporting curiosity and motivation without expectation  Tube weaning isn’t about forcing hunger. It’s about creating safe, responsive opportunities for your child to experience their body’s signals and learn from them at their pace, in their way.    ** Please remember this podcast is NOT meant to replace the support and guidance of your child's medical team.  Consult with your doctor before starting the weaning process.**    Don’t forget to follow us on social media for more helpful information @Thrivewithspectrum on Instagram and Thrive by Spectrum Pediatrics on Facebook. You can also find out more information about the programs we offer at www.thrivewithspectrum.com