Dietetic service for children and young people

Allergy

Managing food allergy can be stressful and time-consuming for families. The dietetic allergy service at the provides support and guidance for children with food allergies as part of the paediatric allergy service.

We provide supportive written information, signpost to appropriate alternative products and offer reassurance and encouragement in the active management of food allergy in children.

Bone marrow transplant

Nutrition is important throughout bone marrow transplant treatment to secure a favourable outcome. The dietitians working as part of the children’s bone marrow transplant team see patients:

• At the point treatment is being considered and provide advice to optimise nutritional status prior to undergoing treatment.
• Throughout transplant treatment to preserve good nutritional status. This can include high calorie drinks and additional snacks, bespoke menus, nasogastric feeding or gastrostomy feeding or liaising with the medical team and pharmacy colleagues to provide appropriate total parenteral (intravenous) nutrition.
• While patients remain resident in Newcastle. This can include monitoring nutritional status and weaning off nasogastric feeds.

The dietitians secure local nutritional support (if required) when patients return to their home address.

Cardiology

Dieticians are is a key member of the children’s cardiology team, and provides highly specialist diet therapy and nutritional support pre and post heart surgery.

Nutrition support, which includes tube feeding and intravenous nutrition, may be needed if your child is unable to meet nutritional needs by mouth due to medical condition or feeding issues. If nutrition support is required, the Dietitian will recommend the appropriate regimen to ensure your child will meet their nutrient needs and continue growing.

Cystic fibrosis

In some cystic fibrosis patients, food cannot be digested and absorbed properly by the body and pancreatic enzymes may need to be taken.

The dietitian works closely with the children’s cystic fibrosis team, children and families in order to overcome the main nutritional challenges associated with the condition:

• Poor growth
• Increased requirements for energy, protein, vitamins and minerals
• Malabsorption as a result of undigested food

You can expect to see the dietitian at clinic appointments and visits to the hospital and at other times in between. The cystic fibrosis dietitian assesses and advises on the best treatment for each child according to their individual nutritional needs and circumstances including advice on the correct dose of digestive enzymes.

As children grow from infants to toddlers through school and teenage years, the dietitian continues to be an integral part of the cystic fibrosis team, advising on the changing nutritional needs for the child until transfer to adult services.

Endocrinology and diabetes service

Dietitians work within the children’s diabetes team to provide treatment for children and young people with type 1 and type 2 diabetes in particular, as well as other endocrine disorders or conditions such as cystic fibrosis related diabetes.

Dietitians provide education and support to the child and young person and their family/carer by:

• Supporting them to develop an understanding of nutrition and how it affects their diabetes to optimise blood glucose control
• Explaining how their diet should be based on healthy eating principles to reduce the risk of long term complications and support them in adjusting their food choices
• Ensuring their diet is nutritionally balanced to ensure optimal growth and development
• Providing carbohydrate counting education to those using either a multiple daily insulin injection regime or insulin pump therapy
• Working alongside other members of the team to support children and young people and their families in the use of technology in supporting their diabetes
• Tailoring advice to the individual’s needs and social and cultural considerations
• Providing support and advice regarding optimising their blood glucose control whilst doing sport and exercise at all levels

To achieve this, dietitians work both in the hospital and in the community setting to support children and families/carers at home as well as school, after school clubs and other places where food is served, working alongside other agencies as required.  

Gastroenterology

The dietitian is a key member of the gastroenterology team, assessing for any nutritional or growth issues that can relate to these specific diseases as well as providing advice on specialised diets that can help treat some medical conditions including:

Inherited metabolic disorders

Through diet we can manage faults in the metabolism of protein, fat and carbohydrates. Without this, a dangerous imbalance of chemicals in the body can occur, ultimately resulting in brain damage and disabilities. We provide a lifelong service from newborn babies through to adulthood.

We deliver a regional service for the North East and North Cumbria, including Tyneside, Teesside and Northumbria. We work closely with specialist consultants, clinical chemistry and genetics and are a resource to primary care, education and social services.

Ketogenic diet

The ketogenic diet therapy service look after children who require a ketogenic diet to control their childhood epilepsy. 

The ketogenic diet is very high in fat, adequate in protein and low in carbohydrate and can be eaten normally or given via a feeding tube. An individual dietary prescription is carefully calculated for each child and is dependent on their age, weight and activity level. The ketogenic diet mimics the effect of fasting as it involves the body using fat as the main energy source instead of carbohydrate, causing the body to produce ketones.   

There are three different types of ketogenic diet offered at the GNCH and a careful pre-assessment process takes place for each child to ensure that the most appropriate one for each child is chosen.

Some children become seizure-free and some children have fewer seizures when on the diet and this makes it possible to reduce or stop some anti-epileptic medications which can then result in them becoming more alert and able to make better developmental progress.  All children on the diet are carefully monitored for side effects by the ketogenic multidisciplinary team and regular dietary changes are required to manage the side effects and ensure each child is meeting nutritional requirements.

Neonates

Good nutrition in preterm infants is essential to prevent growth failure and secure optimal neurodevelopment. The neonatal unit at Newcastle cares for critically ill infants from around the region. The neonatal dietitian assists the multi-disciplinary neonatal team by attending ward rounds on the unit weekly, offering the team advice on how to optimise nutrition and growth of infants where there are concerns and securing local nutritional follow up for infants as appropriate.

Nephrology

The dietitian provides advice to support patients and carers that require dietary modification or nutritional support, in order to optimise growth and improve their quality of life.

Some of these patients may be on dialysis or require tube feeding to support them. The dietitian works closely within the children’s kidney team.

Oncology

Nutrition is an important part of supportive care which will enhance treatment, improve immunological status, decrease complications and improve quality of life.

The paediatric oncology dietitian at works as part of multi-disciplinary team, who have a holistic approach to patient care and family support.

Special feed unit

The special feed unit (SFU) is where specialist feeds and formula are made, by trained staff, for children and infants receiving care on our wards. Feed recipes are entered on a computer system which allows the nutritional content of the feed to be calculated and generates a recipe.

Powdered feed recipes are made with 70°C water which kills bacteria and then blast chilled (which means cooling rapidly to +3°C) to minimise bacterial growth prior to being delivered to the wards and being placed in specially designated ward fridges.

How to access our services

Your GP may be able to refer you to our service, for example, if you need support with cow’s milk protein allergy, or you are concerned that your infant or child is not growing as expected. Please speak to your GP about this.

If you are under the care of one of our specialty teams, you may be able to access a paediatric dietitian. Please speak to your consultant about this.