Tube to Table

S2, Ep. 15: Growth in Tube Weaning

In this episode, Jeni and Heidi unpack a common concern in the tube weaning journey: growth. Fears about weight loss and strategies to facilitate weight gain all impact your child's ability to wean. While growth is important, Heidi and Jeni are here today to explore why it's essential to look at it in the context of the whole child, not just the number on the scale. 

 

Jeni and Heidi talk about how focusing only on weight can lead to confusion and even stall the weaning process. Attempts to “plump kids up” before a wean often set them up for sharper drops later. Growth charts, while useful at times, weren't based on kids with tubes or complex medical histories, and comparing your child to a chart made for someone else doesn't tell the full story. Instead, we encourage families and providers to track trends over time, compare children to themselves, and zoom out to see the bigger picture. 

 

Weight loss during weaning can feel scary, but it's often a necessary and expected part of the process. When carefully monitored, it’s a sign that the child’s body is learning hunger cues and beginning to build a more natural, responsive relationship with food. Trusting the process and staying responsive rather than reacting out of fear helps children build lasting skills and confidence as oral eaters. Ultimately, growth matters, but it's just one piece of the puzzle. When we prioritize quality over quantity, work closely with our team, and keep weight in perspective; children are better able to thrive both on the scale and at the table. 

 

** 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. 14: Hydration During Tube Weaning

In this episode, Jeni and Heidi dive into a topic that doesn’t always get the spotlight it deserves during the tube weaning process: hydration. Hydration is a crucial and separate process with its own cues, rhythms, and strategies. Understanding hydration and its importance separate from nutrition and supplementation can often lead to a safer and smoother wean. 

 

We talk about why hydration deserves focused attention, especially in the early stages of weaning when safety is the top priority. How do you know your child is hydrated enough if they’re no longer getting fluids through a tube? We unpack the signs beyond just milliliters—wet diapers, energy levels, tear production, skin quality—and why it’s so important to ask your medical team for individualized hydration parameters. You'll also hear why keeping a child well hydrated often helps the feeding process, rather than hurt it. Hydration supports energy, digestion, and the body's ability to regulate. 

 

Jeni and Heidi also explore when to start working on oral hydration, and why this usually comes a little later in the weaning journey. They’ll also talk about how to build safe, joyful routines around drinking, from modeling (hint: kids love drinking what you’re drinking!) to loosening our adult ideas of “the right drink.”  

 

** 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. 13: What Weaning Really IS

When we hear the term "tube weaning," it’s easy to assume it simply means switching from tube feeds to oral eating. But in this episode, Jeni and Heidi unpack why weaning is not just a one-time event or a quick fix—it’s a rich, layered process that unfolds over time. Tube weaning isn’t just about getting food into the mouth instead of the tube. It’s a developmental journey that involves emotional, sensory, and motor learning for the child—and often, a full family transformation. It’s not something that happens to the child, but something the child does. That shift in perspective is crucial. 

 

Jeni and Heidi explore how so much of the work in weaning is “under the surface.” It’s not just skill-building or hitting calorie targets. It’s about helping children learn to recognize new sensations like hunger, navigate unfamiliar emotions, and develop trust in their own bodies. Many of these kids have spent their early years enduring feeding, not initiating it. Becoming someone who chooses to eat is new—and that takes time, space, and support. 

 

We also talk about what this means for families. Tube weaning often requires shifts in routines, expectations, and even how caregivers relate to their child around food. There can be fear and uncertainty when stepping away from the structure and safety of the tube. But with the right environment—one that provides safety, autonomy, and patience—children can slowly build the self-regulation they need to meet their own feeding needs. Weaning isn’t about perfection. It can sometimes feel slow and non-linear. It’s not a 10-day program; it’s a months-long evolution. The key is to keep showing up, staying curious, and following your child’s lead. 

 

** 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. 12: Tube Use During Weaning

Welcome back! This week, Jeni and Heidi are talking about the role of supplementation during the tube weaning process—why it matters, how we approach it, and what it can look like when done thoughtfully and safely. 

 

Feeding tubes are incredible tools that support over 250,000 children in the U.S. They help kids grow, thrive, and heal—and the decision to use one is always made with the child’s best interest at heart. But just like any helpful tool, there may come a time when it's no longer needed and might even begin to create barriers—especially around oral eating, social life, travel, or day-to-day routines. We know that deciding to transition away from the tube is a big step. It often means the medical situation has stabilized or resolved. But the road forward requires careful thought. At THRIVE, we focus on two key ideas: honoring the role the tube has played and using it strategically as we move forward. 

 

What happens when a child is ready to wean? How do we make safe and effective supplementation decisions during this transition? 

-Hydration vs. Nutrition: While hydration is vital, it doesn’t usually interfere with oral intake of food. So we keep hydration steady while adjusting nutrition. 

-Creating Room for Hunger: Before a child can eat more, they often need to feel more. We begin with what’s called “hunger induction”—a safe, stepwise reduction of tube feeds that gives the child space to connect with hunger and eating. 

-Using the Tube Strategically: We’re not pulling support away cold turkey. Instead, we use the tube like a floatie—something to keep them safe and supported while they’re learning new skills. That includes using the tube to reinforce effort ("You worked hard, and now you feel full!") or to offer relief when things get too hard ("Let’s give you a break today."). 

-Decision-Making in Real Time: Every child is different. Some might need more reduction to recognize hunger; others may need a little support to feel safe. We base our choices on energy, growth, health, and cues from the child. It’s not about finding the perfect number of ounces—it’s about tuning into your child’s needs. 

 

Progress doesn’t mean perfection. Many kids start with small bites or narrow food ranges. The tube helps bridge the gap while they build skills, confidence, and variety. Our goal is not long-term dependence but rather using the tube as a tool while independence grows. There’s no single “right” way to do this.  

 

** 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. 11: The Power of the Pause

In this episode, Jeni and Heidi dive into the often-overlooked but incredibly powerful concept of pausing both before and along the tube weaning journey. After months—or even years—of pushing through medical challenges, therapies, and constant decisions, many families reach a point where forward movement feels exhausting.  

 

Stepping back doesn’t mean giving up; it can actually create the space where the most meaningful progress happens. Pausing allows for emotional and physical repair—for both your child and yourself—and gives everyone a chance to find stability before pushing forward again. Jeni and Heidi explore how to recognize signs of tension or burnout (like dreading mealtimes), and why co-regulation—tuning into both your nervous system and your child’s—is such a vital part of this process. You’ll hear strategies for creating calm, pressure-free mealtimes, honoring your child’s need for space, and learning to trust the slow, sometimes messy path of tube weaning. We also reflect on the emotional work parents do—advocating, observing, supporting—and how important it is to give yourself credit and care along the way. This episode is a gentle invitation to trust that progress isn’t always about doing more, but about allowing space for healing, growth, and connection. 

 

** 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. 10: How Parents Protect Mealtimes During Tube Weaning

In this episode, Jeni and Heidi dive into how parents can play a powerful role in protecting and supporting their child’s journey from tube feeding to eating by mouth. When preparing, it’s easy to focus on the practical things like what foods to buy, which cup to use, and what’s the best bottle out there. What really matters is understanding what’s going on under the surface for both you and your child. 

 
For many kids, especially those with a history of medical challenges, food can be overwhelming. Even something as simple as a new texture or smell might feel scary. Recognizing that your child might not feel safe with food yet helps you meet them with more patience and empathy. Many parents carry emotional weight from past experiences around feeding. Stress, fear, and trauma—it’s real, and you’re not alone. Taking time to understand what you’re bringing into mealtimes can make a big difference. Getting support for yourself is not selfish—it’s essential. Feeding won’t always go smoothly, and that’s normal. What matters is having a plan for the “what ifs”: what if your child refuses food, or you feel overwhelmed? Giving yourself a break, asking for help, or having a different topic to talk about at the table can help shift energy in a healthy way. 

 

Instead of counting bites or measuring progress by how much your child eats, we need to shift our mindset around what we consider a success. In the tube weaning process, it’s important to focus on things like: Did my child feel safe? Did we enjoy time together? Was the food offered in a way that respected their needs? These are real, meaningful wins. Your number one job is to protect your child’s sense of comfort and safety at the table. With preparation, reflection, and a focus on connection, you’re creating the foundation for your child’s eating skills to grow. 

 

** 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. 9: Building a Team for Tube Weaning at Home

Welcome back! In this episode, Jeni and Heidi are talking about how families can form an effective and collaborative team to support their child through the process of tube weaning. Too often, parents find themselves feeling isolated on their child’s tube weaning journey. They are either waiting for a plan that never comes or are trying to piece it together alone. With the right information and questions, a supportive team can be built. As we discussed in last week’s episode, parents are not just bystanders in this process—they are essential members of the team. You know your child best, and your voice, insights, and presence are vital in shaping both the plan and the outcome. It is vital to a child's success in tube weaning to work with professionals who view parents as experts and partners, and who understand that feeding skill development and long-term outcomes are closely tied to the parent-child relationship. 

 

Jeni and Heidi also discuss the other key players on a strong tube weaning team: a medical provider who can set safety parameters around hydration, weight, and who knows your child’s medical history well; a therapist (often a speech or occupational therapist) who supports day-to-day progress through a child-led, strengths-based approach; and, of course, you, the parent, guiding and advocating every step of the way. Collaboration across all team members is crucial, even when it’s challenging. Jeni and Heidi offer practical guidance for asking the right questions, building trust, and planning for “what if” scenarios along the way. Tube weaning isn’t all-or-nothing—it’s a gradual, individualized process. With the right team in place, it can be safe, supported, and successful. 

 

** 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. 8: The Role of Parents in Tube Weaning

When we talk about tube weaning, we’re not just talking about transitioning from tube feeds to oral intake—we’re talking about creating or restoring joy, curiosity, and connection to eating and feeding. And at the heart of that process is YOU, the parent. Too often, parents find themselves in one of two difficult roles: either sidelined and treated as an afterthought or isolated, left alone to search for answers and support. We know and believe that parents are the experts on their children. Your insight, intuition, and involvement are not just helpful—they are essential. 

 

The feeding environment matters deeply. What makes your child feel comfortable, safe and secure? Maybe it’s sitting on a parent's lap during breakfast or being surrounded by siblings at the table. We must expand our definition of safety beyond a physical aspect, also considering emotional and sensory safety. Within the feeding environment, we need to also consider structure, not rigidity.  

 

And when we do offer food, let’s consider pleasure, too. The goal at first is positive, low-pressure, intrinsically motivated experiences. That could be a lick of a chip, a finger dipped in ketchup, or stealing a bite from mom’s plate. If they see you enjoying it, they might be more willing to try it. That joy is the bridge to variety and nutrition later on. Every child is different. Every family is different. This journey will evolve, and that’s okay. It’s not about getting it perfect—it’s about staying curious, responsive, and connected to your child. Tube weaning is a process of learning, for everyone involved. It takes time, flexibility, and trust. And when parents are centered and supported, children can THRIVE. 

 

** 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. 7: Sensory Implications for Weaning

How many times has a loving adult or professional told you that your child’s eating difficulties are a sensory based “problem”? Yes, feeding IS a sensory experience AND it’s bigger than that. We all interact with the world and situations using our own individualized sensory identities. The ways in which we receive, interpret, and respond to sensory information within that is also constantly evolving. Sensory preferences are our brain’s learned protection and reaction to lived experiences, whether positive or negative.  

 

The same sensory identities and associations are evolving in children who are learning to eat! While we’re working toward helping children become happy and healthy oral eaters, we must first devote time and energy to understanding WHO the child is and HOW they relate to the world through their sensory experiences before we try to change them. This is crucial to figuring out who your child is from a sensory standpoint. We must examine and consider the context such that we’re maximizing ease, comfort, trust, and peace BEFORE we increase the challenge or try to expand their diet/oral intake. 

 

This is where motivation and autonomy play a key role. Giving the child control over how and when something occurs (such as eating) can significantly influence how they perceive the experience and how prepared their body is to engage in it. It’s only once a child has learned that they can be safe, comfortable, and stable that they can expand and have new experiences to help override old ones. This is a CHILD led process, one where we continue to accept where they are, no matter what. It may take time on the front end but also helps with success in the longer term. 

 

** 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. 6: Why Getting Kids to Eat Backfires

In this episode, Jennifer and Heidi are diving into how certain feeding strategies, specifically when transitioning off feeding tubes, can backfire. There is a common phrase that we hear a lot as therapists: “I can’t GET them to do it or I can only GET them to have 2 bites”. As loving caregivers, parents often think that it is their job to get their child to eat a certain food or specific volume. While working to transitioning to oral eating, the focus should be less on what you can get your child to do and more on letting them have the space to do so (McGlothlin, Jenny: Definition of “Let to Get”). The parents should focus on providing the foods and setting up a positive mealtime routine, while the child’s role is to determine if they’re going to eat it and how much (Ellyn Satter – Division of Responsibility).  

 

Jennifer and Heidi discuss what specific feeding behaviors we often see in the traditional feeding therapy. These behaviors are often viewed as symptoms and then the focus tends to be on more behavioral strategies. Although there is some short-term research on those behavioral methods (praising, distracting, negotiating), we know that it has negative long-term effects on a child’s relationship with food. They will also review what we can do as therapists, and parents, to help create a solid foundation and address the relationship with food starting with the foundations. We will also review the evidence to support the responsive feeding strategies, specifically with tube-fed children.  

 

If you would like any of the research or studies mentioned in this article, please do not hesitate to email us at thrive@spectrumpediatrics.com and we can send it to you. 

 

** 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 and @tubetotable 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