My gratitude to those who joined me already this year, or will join me this month in Texas, on my final tour … all my remaining seminars are SOLD OUT.

Registration is closed. If you’d like to join a waiting list in the event of cancellations, please email me at pediatricseminars@gmail.com

Click here for Catherine Shaker Seminars 2026 Brochure

Click here for Site/Location Info

Pediatric Swallowing and Feeding: The Essentials…no other course like it….

  comprehensive 2-days of interactive learning covering essential information/skills for  pediatric practice and problem-solving

   neonates/premies through school age

   development of the swallow from birth on: impact on your therapy  

  oral-motor

   TOTs

   sensory, sensory-motor

    airway

   tools of the trade (bottles, nipples, spoons, cups, biters/tethers etc. and the “why” behind when to use them)

   tube feedings and how to wean

   trachs

  preemies: assessing and treating after discharge

  swallow studies: physiology to inform your day-to-day clinical decisions

  a wide variety of interventions and the “why” behind them

  latest research made practical

  whole infant/child family-focused approach

multiple learning levels for both highly experienced therapists and new grads

a bound handout for future reference with detailed PowerPoint and extensive reference list for you

I promise you a learning experience that you will always remember!

Click here for Catherine Shaker Seminars 2026 Brochure

Click here for Site/Location Info

 

I just returned from teaching in San Antonio Texas! What a beautiful and innovative part of the US. Engaged and passionate rehab professionals (SLPs and OTs)  from across the US and a wonderful Pediatric Pulmonologist from Qatar joined me for this practice-changing event.

• a conference center full of clinical wisdom and intellectual curiosity
• deep dives about the latest research
• critical thinking about our common clinical and professional challenges
• actively problem-solving complex clinical presentations
• and a sense of renewal … new lasting friendships ignited….

Here I am with some of the attendees, celebrating each other as lifelong learners, and a common thread…our passion for feeding and swallowing….and for the children and families who trust their care to us! 

Your final opportunities to learn along with me are in Fremont CA  (in September) or McKinney TX (in October)…my Dallas seminars are all sold out.

I promise you a learning experience that you will always remember!

Click here for Catherine Shaker Seminars 2026 Brochure

Click here for Site/Location Info

 

Sharing a link to the webinar I presented on May 5, 2026, for Dr. Brown’s:

Complex Swallowing/Feeding in the NICU:

Where’s Your Magic Wand When You Need It?

Catherine Shaker
M.S./CCC-SLP, BCS-S, NDT/C

Click on this secure link  to access the one hour webinar:

https://www.drbrownsmedical.com/webinars/complex-swallowing-feeding-in-nicu-wheres-your-magic-wand-when-you-need-it/

Overview

The journey to successful oral feedings for many preterm and sick infants and their families in the Neonatal Intensive Care Unit (NICU) can be arduous. This live interactive webinar is designed to capture the dynamic problem-solving process that underpins the infant’s journey to safe and successful feeding both in the NICU and beyond. There can be multiple roadblocks, such as sequelae from medical co-morbidities, well-intentioned actions that create risk, and worrisome clinical presentations that require a thorough differential, critical thinking, and consideration of risk-benefit at every juncture. Collaboration, especially with parents, and the entire care team is essential to truly support infant-guided feeding, and positive protective feeding experiences.

I hope you enjoy this learning opportunity~

Congratulations to our colleague, Jenny Reynolds SLP, for her recent publication  on dysphagia in preterms – such a wonderful addition to our evidence-base. Thank you, Jenny!

Reynolds, J., Suterwala, M., Desai, S. et al. Incidence and factors associated with dysphagia in infants born very preterm or very low birth weight. J Perinatology (2026).

Abstract

Objective

To determine the incidence of dysphagia and define the associated co-morbidities in infants born very preterm (VP) or very low birth weight (VLBW).

Study design

This is a retrospective cohort study evaluating 158 VP or VLBW infants born over two years. Forty infants diagnosed with dysphagia confirmed by flexible endoscopic evaluation of swallowing were compared to 118 infants with no dysphagia.

Results

The incidence of dysphagia was 25%. After adjusting for gestational age and birth weight, dysphagia was associated with morbidities such as necrotizing enterocolitis, bronchopulmonary dysplasia, and intracranial hemorrhage. Regression analyses indicated that dysphagia was associated with higher central line days and longer hospital length of stay. Feeds were thickened in 38 infants (95%) before discharge and 3 infants (7.5%) needed gastrostomy tube.

Conclusion

Dysphagia is an important morbidity affecting a quarter of the infants born VP or VLBW. Significant associations with other major morbidities were noted.

 

 

 

 

 

 

Hazkani, I., Valika, T., & Thompson, D. M. (2026). Congenital Laryngomalacia: Pathophysiology, Clinical Spectrum, and Holistic Management. Otolaryngologic Clinics of North America.

I hope that this just-published paper on congenital laryngomalacia informs your infant feeding practice and critical thinking like it did mine. It is from the amazing physicians at Lurie Children’s in Chicago. Reading the literature designed for our physician colleagues helps us speak from a perspective of knowledge when we advocate for the infants we care for.

Feeding difficulties are common in this population, and often include color change, inspiratory stridor, wheezing and recurrent respiratory infections. Depending on the setting of their co-morbidities, these infants are often worrisome for silent aspiration as a consequence of co-occurring anatomic and neuromuscular differences and inflammatory mechanisms. There is an interactive relationship between the infant’s dynamic airway obstruction, resulting changes in pressure gradients throughout the aerodigestive system, and altered respiratory regulation that combine to disrupt the swallow-breathe interface swallow-breathe interface. Resulting crying and physiologic stress provoke further risk for airway invasion. Multiple papers have reported a resulting high risk for aspiration, often silent, and chronic airway inflammation. The authors note that:  “Given the high prevalence of silent aspiration, the threshold for ordering swallow studies should be low, and dysphagia assessment should be incorporated into routine evaluation.”

KEY POINTS quoted from the abstract

• “Congenital laryngomalacia is a multifactorial disorder in which structural laxity, neuromuscular immaturity, and inflammation interact to produce dynamic supraglottic collapse and feeding–airway discoordination.
• Clinical severity reflects the combined burden of airway obstruction, dysphagia, and aspiration risk, with comorbidities significantly influencing outcomes.
• Given the high prevalence of silent aspiration, the threshold for ordering swallow studies should be low, and dysphagia assessment should be incorporated into routine evaluation.
• Flexible laryngoscopy remains the diagnostic gold standard, while instrumental swallow studies and laryngoscopy and bronchoscopy provide essential adjunctive evaluation in complex or atypical presentations.
• Conservative therapy, particularly feeding modifications, is effective for most infants; acid suppression lacks evidence of benefit and should be used selectively.
• Supraglottoplasty yields rapid, durable improvement in severe cases, enhances feeding and family quality of life, and remains the cornerstone of surgical management”

 

Congratulations to our NICU colleague Deborah Levine-Kotin for her recent publication regarding positive impacts of reusable bottles versus disposable in the NICU. So many takeaways that inform our NICU practice. From the wonderful benefits of partnering with nursing authors to look at and improve practice, to improved LOS with predictable feeding experiences , and improved LOS with reusable bottles… these are all outcomes many of us have noted clinically that now have data to support them.

Haynes, A., et al (2026). Impact of reusable bottle nipples compared to dis posable bottle nipples on infant feeding outcomes in the NICU. Pediatric Nursing, 52(1), 7-12, 51.

From the Abstract: Research has shown that variability of disposable bottle nipples impacts infant feeding experiences. Negative feeding experiences impact time to full feeds and length of stay (LOS). At the time of this study, utilization of reusable bottle nipples from the initiation of oral feeds had not been examined in relation to infant outcomes. This study examined the impact of reusable bottles on time to full feeds, LOS, and feeding stability when compared to disposable bottles among infants born 28 to 35 weeks. Chart reviews were completed on a pre-intervention group of 50 patients and post-intervention group of 50 patients. Data were collected through chart reviews of the primary outcomes: time to full feeds, LOS, and feeding stability score (FSS). The repeating measure of FSS was collected on 25 pre intervention and post-intervention charts. Secondary outcomes included hospital costs and sustainability measures. When adjusted for gestational age, LOS in the post-intervention group was 3.59 days shorter (p = -0.13) than infants in the pre intervention group. Nipple change alone was not an indicator of decreased FSS or decreased LOS. Rather, infants with any bottle brand change during their stay regardless of group went home 2.4 days later (p = -0.06). Change to reusable bottles saved 1130 pounds of plastic waste annually. Findings from this study support the use of reusable bottles from the initiation of oral feeds to decrease LOS.   

• Feeding Stability
  • Score was based on use of Br Brown’s  IDF documentation
  • After a bottle brand change, infants had a 75% higher likelihood of having a decreased Feeding Stability Score. This makes sense given the unique designs and mechanics of each bottle brand
• Length of stay:
  • infants with any bottle brand change (disposable to reusable or one reusable brand to
    another)  during their hospital stay went home 2.42 days later than infants who used the same bottle brand throughout their stay.
  • infants who received a reusable bottle nipple from the initiation of oral feeds had on average
    went home 3.6-days sooner

Catherine’s Key Takeaways:

• For preterm infants in the NICU, consistency and predictability matter when it comes to learning to orally feed

• The impact of nipple flow changes was not explored in this study but is a critical dynamic in supporting safe and successful PO feeding in the NICU and  after discharge. Its potential to alter the swallow-breathe-interface and airway protection is worrisome.

• Data continue to reinforce  the multiple benefits of Dr. Brown’s nipples for neuroprotective  infant-guided feeding for preterm infants.

Join Catherine in 2026 on her final tour…….

for advanced clinical learning opportunities….in the remaining locations 

 Fremont CA, San Antonio or McKinney TX 

• Advanced Infant/Pediatric Dysphagia: Problem-Solving Complex Patients and Practice Issues
• NICU Swallowing and Feeding: In the Nursery and After Discharge in EI
• Pediatric Swallowing and Feeding: The Essentials
• Pediatric Video Swallow Studies: From Physiology to Analysis

An interactive welcoming learning environment……with multiple planned times for dialogue and questions, problem-solving your patients, sharing our collective wisdom, discussing the evidence-based research…and our shared clinical challenges.

Our discussions will include critical thinking for all our patients, no matter the age. It’s not just learning “what to do” clinically but thoughtfully considering what not to do and why.                                           Because every feeding experience matters………

Click here for Catherine Shaker Seminars 2026 Brochure

Click here for Site/Location Info