All first appointments include a detailed dietary assessment, as standard, before considering any dietary treatment options.  Depending on the problem or symptoms, a dietary assessment will be tweaked to gather the most relevant information for the infant, child or teenager.    We discuss options to work through difficulties or symptoms, whilst optimising nutritional intake. Dietary assessment forms the basis for all advice. It is the first step in identifying nutrition gaps for key nutrients or energy; symptoms and their relationship to food or growth timeline;  preferences, limitations, feeding or eating experience. It is by nature very individual. Where there are any concerns about food allergy/sensitivity, an allergy focused history is integrated. For family consultations for weight management, please contact Carine to discuss your needs.

Assessing nutritional needs, food intake and diversity

A guided discussion about what, when and how much food and drink is consumed provides a good estimate of energy, protein, fluid and nutrient intake of the diet as a whole. Key nutrients such as calcium & Vitamin D; iron, B12 and Vitamin C; magnesium, zinc, iodine and Vitamins A, B and C are assessed. Also, the balance of the food groups from plant, animal, wholegrains, proteins, essential fats, roots, greens, fruits, sugars, snacks and drinks. Specific conditions, food-related behaviours and growth needs are taken into account.

Growth and physical activity

Measurements of growth are usually taken such as weight, height as part of the dietary assessment. Previous measures are always very helpful, perhaps from your community child record, otherwise known as the red book.  For infants up to 2 years of age, head circumference can be measured.  For older children and teens, calculation of percentage body mass index (%BMI) is the most sensitive measure of weight for height in growing children. I use UK-WHO 1990 growth charts, with comparison of the same age and sex, and a way to monitor growth over time for each child. Some young people have concerns about being weighed and measured, as such this is never mandatory. Physical activity and growth together are a good way to estimate an individual’s energy expenditure, or energy used in growth and activity.  This can be a helpful metric to support and changes in growth, weight gain or maintenance.

Digestive and Gut Microbiota Health

Food diversity is the most important nutritional indicator for life-long health, providing immune and gastro-intestinal benefits via the gut microbiota. Aspects of digestion, tummy sensations/symptoms, alongside elimination habits and quality of stools are discussed. Nice! Frequency, colour, texture, smell, ease of passage, sensation are all part of understanding this. Birth history, antibiotic use, medications, anxieties all contribute to gut microbiota health alongside food diversity.