Refer a Patient to the Feeding and Eating Disorders Service

We welcome referrals from Paediatricians, NHS Mental Health Professionals and CAMHS Clinicians. We are unable to accept GP, private, or self-referrals or referrals from Community Dietetics.

• For children aged 10 years and above referred by their Paediatrician, it is necessary for the local CAMHS Team to be informed and to be in agreement with the referral.
• For children with a W4H of <80% we require that the child is open to their local Paediatrician and are being regularly reviewed for their low weight.

We consider referrals for children and young people who have a restricted food intake for various reasons, including:

• Fear of weight gain.
• Concerns about body image, weight, and/or shape.
• Specific fears (eg vomiting, choking) impacting eating.
• Sensory sensitivities.
• A lack of interest in food and/or eating.

We also consider referrals for children who have eating difficulties in the context of:

• Comorbid mental health or neurodevelopmental conditions (eg anxiety, ASD, ADHD).
• Comorbid medical conditions or complex medical histories.

In these instances, we carefully consider whether the severity of the eating disturbance exceeds that routinely associated with the comorbid condition. Comorbid medical conditions must be ruled out, prior to referral, as a direct cause of the limited intake and any ongoing physical health symptoms (eg vomiting, constipation, reflux) must be well managed.

We also consider referrals for children who are dependent on enteral feeding (eg nasogastric tubes) or nutritional supplement dependent, when this is no longer medically or dietetically indicated and a local intervention to tube wean has not worked.

Before a referral to our Team, an intervention locally needs to have been tried. For example, from a local Child and Adolescent Mental Health Service, Dietitian, Speech and Language Therapist and/or Occupational Therapist as appropriate.

We require a completed referral form and reports from previous interventions to support us to make a decision about suitability for our Team. Failure to do so will result in the referral being rejected. In 2021, we rejected 25% of referrals for incomplete referral information.

• Children aged between 0-16 at the point of referral.
• The child’s limited food intake is driven by:
  • A fear of weight gain.
  • Concerns about body image, weight, and/or shape.
  • Specific fears (eg vomiting, choking) impacting eating.
  • Sensory sensitivities.
  • A lack of interest in food and/or eating.

• Children aged 16+.
• Children and young people with acute weight loss or faltering growth presenting with significant physical or dietetic risk which requires more immediate medical and dietetic management by local healthcare teams (except patients with Anorexia Nervosa).
• Children with comorbid medical conditions or physical health symptoms which may be impacting food intake where investigations have not been completed to rule out a medical cause.
• Children who have persistent physical symptoms (eg reflux, constipation, vomiting) which are not well managed.
• Children with unmanaged dysphagia.
• Children with developmental delay in which the food intake is in line with their developmental stage (rather than their chronological age), who require time and support from local professionals to acquire developmental skills pertinent to feeding.

• We consider previous interventions and whether we can offer advice and/or intervention beyond what local healthcare professionals can provide.
• Feeding difficulties are very common for children with neurodevelopmental conditions (eg ASD). We carefully consider whether the limited diet is beyond what might be expected for children with neurodevelopmental conditions and therefore warrants additional advice and support.
• We consider the developmental stage and motivation of the young person to engage with us and make changes to their diets.

Please send the completed form via email to magdalena.lawrence@nhs.net  or by post to the below address:

Magdalena Lawrence

Service Coordinator
Feeding and Eating Disorders Service
Psychological and Mental Health Service
Level 4, Frontage Building
Great Ormond Street Hospital
London WC1N 3JH