Maimonides Health Pediatric Feeding/Swallowing Services now offers Brooklyn’s most comprehensive diagnostic and therapeutic support for children with pediatric feeding and swallowing disorders (dysphagia). The program spans inpatient and outpatient care, beginning with NICU feeding therapy and support, and continuing through childhood and into early adulthood with services at Maimonides Rehabilitation Center on 65th Street.

“We created this program because Brooklyn families needed true access,” says Luis F. Riquelme, PhD, consulting director of speech-language pathology (SLP) and rehabilitation services. “A few hospitals offered limited services, but nothing at the scale or quality children with these conditions require. Our program is now the largest and most collaborative in Brooklyn.” 

The team includes specially trained pediatric speech-language pathologists and pediatric occupational therapists (OTs)—offering an evidence-based collaborative approach to care that strengthens outcomes for children with complex feeding and swallowing needs. All services are offered in collaboration with each child’s care team; physicians from different specialties, psychologists and other clinicians as needed. 

Conditions We Treat 

Maimonides’ program evaluates and manages the full spectrum of infant and pediatric feeding and swallowing concerns, including: 

• Coughing, choking, or a wet voice during feeding 
• Difficulty latching, breast or bottle refusal 
• Dysphagia of neurologic, medical, or structural origin 
• Gastrointestinal-related feeding challenges 
• Limited oral intake or prolonged mealtimes 
• Poor weight gain or failure to thrive 
• Problems transitioning to solids or textures 
• Sensory-based feeding aversion 
• Suspected aspiration risk in children 
• Tube dependence and support for weaning 

“Our goal is to identify the underlying cause and create a plan that meets the child’s medical and developmental needs,” says Justyna Kubicka, MS, CCC-SLP, one of the lead clinicians on the team. 

Inpatient Care: NICU, PICU, and Pediatric Units  

Maimonides delivers specialized inpatient feeding and swallowing evaluations and care across the NICU, Pediatric Units, and PICU. Pediatric-trained speech-language pathologists evaluate medically complex infants and children, support safe feeding, and coordinate tightly with medical and nursing teams to ensure appropriate progression through hospitalization.  

“Our clinicians understand the medical acuity of these children and support safe feeding from day one, with an emphasis on patient-centered care,” said Alexandra Soyfer, MS, CCC-SLP, director of speech-language pathology and rehabilitation services. “Our SLP and OT teams have developed a coordinated approach to inpatient care that accelerates recovery, improves patient outcomes, and elevates quality of care. While SLP leads swallowing and speech-language assessments, OT contributes by addressing functional, sensory, and positioning needs. This approach, along with strong collaboration with other members of our healthcare teams, results in improved outcomes for every child.” 

Key areas of impact: 

• Assessment and management – Evaluate oral-motor skills, swallowing safety, and readiness for oral feeding. 
• Individualized care planning – Develop tailored treatment plans that reflect each child’s medical status and developmental needs. 
• Multidisciplinary collaboration – Work closely with medical, nursing, and therapy teams to support nutrition, safety, growth, and development. 
• Caregiver education and support – Provide bedside coaching and training to guide families in safe feeding practices. 
• Continuum of care – Ensure consistent, developmentally appropriate interventions throughout the hospital stay. 
• Instrumental swallowing assessment – Perform modified barium swallow studies (MBSS) to evaluate swallowing function and guide treatment planning objectively.  

Outpatient Care: Ongoing Therapy and NICU Graduate Support 

The outpatient Pediatric Feeding/Swallowing Program at Maimonides Rehabilitation Center provides structured evaluations and therapy for children with a wide range of feeding challenges. The pediatric SLP and OT team supports safe nutrition, oral-motor development, and effective progression through feeding milestones, while helping families implement strategies into their home routines. 

“Parents no longer need to travel outside Brooklyn for specialized feeding and swallowing therapy,” Dr. Riquelme says. “Our team provides evidence-based care for children with sensory, developmental, and medically complex feeding needs.” 

Key areas of impact: 

• Sensory-based feeding therapy – Address picky eating, feeding aversion, and limited food repertoires. 
• Tube-dependent care – Support oral feeding advancement and GT/NGT weaning for children with feeding tubes. 
• Feeding management of complex medical needs – Serve children with gastrointestinal, airway, or neurological challenges. 
• Developmentally appropriate progression – Guide advancement through feeding milestones, from purees to solids. 
• Family-centered care and education – Equip caregivers with strategies and training for safe, positive mealtime experiences. 
• Interdisciplinary collaboration – Work closely with pediatric medical and therapy teams to ensure cohesive, individualized care.  

Diagnostic Capabilities for Feeding and Swallowing Conditions 

Accurate diagnosis guides treatment decisions, especially when we suspect aspiration, neuromotor issues, or structural concerns. Maimonides provides a full range of clinical and instrumental evaluations to help determine the safest and most appropriate feeding plan. 

Clinical and diagnostic tools include: 

• Bedside/clinical feeding and swallowing evaluations 
• Modified Barium Swallow Studies (MBSS) offered on site in collaboration with pediatric radiology specialists 
• Environmental and behavioral assessments 
• Oral-motor and sensory evaluations 
• Readiness assessments for instrumental studies 
• Swallow safety reviews 

“Our clinical evaluations help determine when a child needs instrumental imaging and how to prepare them for it,” Soyfer says. “We want each test to be meaningful and safe.” 

Interdisciplinary Collaboration Across Specialties 

Maimonides partners with a wide range of pediatric divisions—including Maimonides’ novel aerodigestive medicine program, gastroenterology, pulmonology, ENT, neonatology, the PICU team, general pediatrics, occupational therapy, physical therapy, and behavioral health services—to evaluate the medical, respiratory, gastrointestinal, and structural contributors that influence a child’s ability to feed safely. 

“Because feeding is inherently interdisciplinary, we coordinate care with any specialty involved in a child’s medical or developmental needs,” said Soyfer. “As more pediatric specialists join our medicine and nursing teams, our ability to support complex cases only grows.”

Program growth plays a major part in that evolution. Services have expanded significantly since 2022, moving from limited per-diem coverage to a fully staffed pediatric team. Maimonides hired its first full-time pediatric speech-language pathologist in 2022, and the team now includes three full-time pediatric SLPs. The first pediatric occupational therapist joined last year, and the program expects to add pediatric physical therapy to further strengthen continuity of care. 

“Maimonides has a Children’s Hospital and a trauma center,” Dr. Riquelme says. “An investment in a skilled pediatric rehab and speech-language pathology team improves outcomes for the long-term success of patients who receive care here for a variety of conditions.” 

When to Refer: Clinical Red Flags for Feeding and Swallowing Disorders 

Refer a child for evaluation when any of the following occur:

• Behavioral distress during feeding 
• Coughing or choking during feeds 
• Difficulty transitioning to solids 
• Long mealtimes (over 30 minutes) 
• Persistent refusal of age-appropriate textures 
• Poor weight gain or feeding inefficiency 
• Recurrent pneumonia or concern for aspiration 
• Respiratory symptoms that worsen during meals 
• Suspected oral-motor weakness 
• Tube dependence without progress toward oral intake 
• Wet or gurgly voice after swallowing 

Why Refer to Maimonides 

“Our program offers the most comprehensive diagnostic and treatment model in Brooklyn,” Dr. Riquelme says. “Families don’t need to travel outside the borough for high-quality feeding and swallowing care—they can often receive care right in their own neighborhoods. Our child-first philosophy and multidisciplinary approach set us apart, and we continue to expand as more pediatric specialists join the team.”

Referring providers gain a coordinated inpatient-to-outpatient continuum supported by pediatric-trained speech-language pathologists and occupational therapists, with access to multispecialty evaluation for medically complex children. The program delivers the highest level of expertise without requiring families to leave Brooklyn, maintaining reliable communication and clear progress updates, so community clinicians stay connected to each child’s plan of care.  

Learn more about Pediatric Rehabilitation, Occupational Therapy, and Speech-Language Pathology Services at Maimonides. To refer a patient or request a consultation, please call 718-283-8961.