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Complex Feeding & Nutrition

We provide consultative services, including medical management, nutrition counseling and feeding therapy, to children with complex feeding and nutritional issues that are difficult to manage.
Your Visit

Our Goals

The Complex Feeding and Nutrition Service (CFNS) is a comprehensive interdisciplinary team that strives to anticipate and respond to the needs of infants and children whose complex feeding and nutritional issues cannot be addressed by their community. We are committed to enhancing the health and well-being of these infants and children, as well as their families, by providing excellent family-centered clinical care. We are a knowledgeable, skilled and caring team and we will provide nutrition and feeding education and support to health care providers within the organization as well as the community.

Your Visit

During the visit, your child will be seen by the interdisciplinary team, comprised of a nurse, a pediatrician, a dietitian and, if required, an occupational therapist and a social worker. 

Teaching and counseling will be provided according to your child's and family’s needs. Reports will be sent to the health care professionals involved in the child’s care.

If further investigation is required, your child may be referred to the appropriate service or for diagnostic studies (Upper GI, Videofluoroscopic Swallowing Study, Endoscopy, etc.). 

If your child has a feeding impairment, we may ask you to bring some food so that we can observe your child eat.

Our Programs

Complex Feeding Clinic

We offer outpatient-based consultative services, short-term or ongoing nutrition counseling and feeding therapy to eligible children with complex feeding and nutrition needs that have not responded to ongoing treatment or are difficult to manage by local community supports. Our team consists of an occupational therapist, a dietitian, a social worker, and a nurse. When appropriate, we may also offer medical management.

At this time, we are unable to accept referrals for children whose feeding and nutrition issues are predominantly related to sensory issues (ex: autism spectrum disorder, sensory processing disorder) or to mental health issues (ex: ARFID, trauma / PTSD).

The Steps to Feeding - Tube Transition clinic 

We offer a two-week, outpatient-based, intensive feeding intervention designed to increase oral eating for children who are tube-fed and for whom traditional methods of tube weaning have not been successful. Our team consists of an occupational therapist, a dietitian, a social worker, and a nurse. When appropriate, we may also offer medical management.

Children's Intestinal Rehabilitation Program (CHIRP)

We provide inpatient- and outpatient-based services to children with or at risk for intestinal failure. Our team consists of a medical director, a surgical director, a pediatric gastroenterologist, a pediatric surgeon, a dietitian, a social worker, an outpatient occupational therapist, and a nurse. 

Our Team

The Complex Feeding and Nutrition Service is a part of the Division of Gastroenterology, Hepatology, and Nutrition at BC Children’s Hospital.

Medical director
Linda Casey, MD

Gastroenterologist
Vishal Avinashi, MD

Coordinator

Dietitians
Soleina Karamali, RD (on maternity leave)
Natalie Sousa, RD (temporary)
Debby S. Martins, RD

Nurse
(vacant)

Occupational Therapist
Rochelle Stokes, OT

Social Worker
Kathryn Urquhart, SW

Clerical staff
(604) 875-2345, local 7464










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