Feeding and Nutrition Referral

Referral steps

1. Assessment

   A patient must meet these criteria to be referred to the service:

   • Up to age 19 in the province of BC
   • Has a neuromotor or developmental impairment (i.e. cerebral palsy, developmental delay, genetic syndrome, or brain injury)
   • Concern for safety of swallow (risk of aspiration, risk of choking)
   • Nutritional concerns

   Exclusion criteria:

   • Patient is developing typically
   • Picky eating or selective eating with consistent growth
   • Questions regarding progression of feeding where there are no safety issues
   • Feeding difficulties are primarily related to sensory or mental health issues (e.g. autism, ARFID, eating disorders, trauma/PTSD) and the patient requires ongoing support for those issues

   We also provide nutritional support for patients with neuromotor disorders who are not currently followed by a registered dietitian and meet one or more of the following criteria: 

   • Multiple co-morbidities or involvement of multiple medical or therapeutic subspecialties at BC Children's Hospital
   • Significant positioning or mobility needs (e.g. cerebral palsy)
   • Movement disorders/tone that impact swallowing
   • Unable to be supported by a community registered dietitian (e.g. requires special growth measurement techniques or equipment, such as ceiling lift or knee height calipers)

   And who have an active nutrition issue, such as:

   • Malnutrition, stagnant or poor growth or inability to meet nutritional needs
   • FTT as defined by a downward change in growth by 2 or more percentiles
   • Weight divergence as defined by a crossing of percentiles in either direction

   To note: Sunny Hill registered dietitians (RDs) do not follow for weight management or tube feed support (where there is no community RD).

2. Complete a form

   Complete the referral form (PDF) and ensure all patient information is current. Include consults, reports and/or chart notes. See the referral form for the complete list of requirements.

   We will not process incomplete referrals.

3. Send the referral

   Fax completed referral forms to: 778-504-9768

4. Post referral

   We review referrals to assess whether they meet our criteria. Once we accept them, we send a receipt of the referral to the family. Our clinicians will perform intake, which involves speaking with the family, caregivers, community therapists and others involved in care. If a referral does not meet our criteria, we will send a decline to the family and referring physician.

   We then book based on priority of intervention, considering clinical needs and concerns.

5. Appointment with a provider

   Our booking clerk will reach out to families directly to book appointments. Depending on need and availability, this may be within four weeks or up to several months.

   Let us know if anything changes before the clerk books the patient's appointment, such as increased illness, improved skills and lessening concerns.