Pediatric Growth & Integrated Nutrition (GAINS)

For questions or information about the Pediatrics/GAINS Program, please call 206-215-6005.

The Growth and Integrated Nutrition Service at Swedish, known as GAINS™, is a multidisciplinary program, which includes doctors, nurses, dietitians, behavioral specialists, and feeding therapists. If your baby or child under the age of six has feeding problems or has trouble gaining weight, we can help you and your pediatrician by doing a full assessment and providing specific recommendations.

Watch the Swedish Pediatric GAINS Program video.

Conditions We Treat

There are many medical conditions that lead to growth and nutrition problems. At the GAINS program, we are experts at working with children with:

  • Breastfeeding difficulties
  • Malnutrition
  • Failure to thrive
  • Slow growth
  • Low birthweight
  • Prematurity
  • Feeding tubes
  • Feeding difficulties
  • Aspiration

Our Expertise

Each provider in the GAINS program has advanced training in one or more of the following specialties:

Feeding Tube Weaning Program

At the GAINS Feeding Tube Weaning Program, our goal is to improve the feeding experience for children who eat with feeding tubes. We believe eating should be a pleasurable part of every child's life. Depending on your child, success may include removal of the feeding tube and complete independence, or a combined oral and tube-feeding plan. We can help you find the best combination to support your child's growth and feeding enjoyment.


Every child has a unique set of problems. Our intake coordinator will make sure that your child has a full evaluation with the specialists that will be the most helpful. For your convenience, we will try to arrange visits with all of your specialists on the same visit to Swedish. Parents and other family members involved in your child's care are encouraged to be present for the initial evaluation. During the evaluation your child will receive a health and nutritional assessment and a complete physical exam. Blood and urine samples may be taken for laboratory tests. Special XRAY tests may be ordered as well, depending on the needs of your child.

The first visit can last from two to three hours. It is important that you come on time for your appointment. Follow-up appointments will be shorter, lasting approximately thirty minutes to an hour. If you need to cancel an appointment, please call the program as far in advance as possible.

Upon scheduling your child's appointment, we will send you a packet with information about the program as well as an Intake Form, and a Food and Beverage Diary. We asked that you fill both these forms out before your initial visit and bring them with you to your child's appointment. It is also a good idea to bring some toys to entertain your child during this longer first visit. Please also remember to bring your insurance or Medicaid card, and any additional information you think will help our clinicians better understand your child's eating patterns.

As the evaluation progresses, impressions and results of medical tests will be shared and discussed with you. When the assessment is complete, you and your team of providers will create a customized treatment plan. This plan may include return visits to Swedish Hospital. At the end of the visit you can expect to take home written recommendations to help you follow this plan. A written summary of the evaluation will be sent to your child's primary doctor.

If you have Medicaid or an insurance plan that includes doctor visits, you will not have to pay for care other than the usual copay. If your insurance does not cover visits, please discuss this with our staff members before your first visit.

  • "SOS! Help for Parents: A Practical Guide for Handling Common Everyday Behavior Problems," by Lynn Clark
  • "The Challenging Child," by Stanley Greenspan
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  • "Just Two More Bites! Helping Pickey Eaters Say Yes to Food," by Linda Piette