Community based health professionals are well placed to provide timely support and management of children with feeding difficulties ranging from typical to more complex problems.

Mild feeding difficulties are typically managed as a matter of routine in the daily practice of many health professionals without the need for input from other professionals. However the management of more complex difficulties may require input from more than one health professional.  Indicators for referral will vary depending on the nature of the feeding difficulty, the health professional’s profession and level of experience.  Options for further input or referral might include:

• Consultation with a colleague or mentor for opinion on management strategies. 
•  Request for further opinion or additional assessment with primary ongoing care remaining the responsibility of the referring health professional.  For example a Speech Pathology referral for a swallowing assessment where no issues are identified, or a Dietitian referral for a nutritional or growth assessment where the diet and growth are assessed to be appropriate.    
• Request for further opinion or additional assessment with ongoing care and input from more than one health professional creating a model of interdisciplinary care.  For example when referral to another health professional identifies issues that require ongoing specialist interventions from that health professional.   In this instance it is essential that health professional’s work together to ensure consistent coordinated care.

The Feeding Development Framework is a useful tool for identifying areas of concern and hence the relevant health professions to which referrals are made.  Before making any referrals permission should be obtained from the family.

On some occasions referral for transfer of care may be indicated.  This may be indicated if:

• The needs of the patient are identified on initial assessment as being beyond the capacity of the health professional.
• The nature of the feeding difficulties and their impact on the child and or family are increasing, despite appropriate intervention strategies e.g. report of physical reactions to food such as urticaria or gastrointestinal symptoms, or increasing stress and anxiety associated with feeding.
• The needs of the patient fall outside of the organisation’s scope of service.