The Role of Nutrition in Pediatric Health

High-quality nutrition during childhood years is important to healthy growth and development. Pediatric health care is unique to each patient, as every child grows and develops at different rates and requires individualized care from medical physicians and other healthcare professionals. Every child also has individualized nutritional needs in order to maximize their growth and health, and Registered Dietitians are crucial to helping each individual child meet their needs through their diet. 

Nutrition needs vary throughout the stages of childhood based on age, growth rate, etc. These needs are patient-specific based on multiple factors and can include whether an infant is breastfed or formula-fed, the presence of food allergies, such as peanuts or milk proteins and certain diagnoses of conditions or diseases, such as asthma or diabetes. However, there are generally foods and nutrients of concern that Registered Dietitians focus on with the pediatric population:

• Overall energy intake
• Protein
• Vegetables and fruit
• Vitamin D and calcium
• Iron

How Registered Dietitians (RDs) Make an Impact in Pediatric Health Care Outcomes

The goals of nutrition counselling in pediatric health care are to help patients and their families ensure that they are properly fuelling their growth and development through healthy and appropriate food choices, to meet energy and nutrient requirements and identify and overcome barriers and obstacles to adequate growth and nutrition. 

Registered Dietitians work with clients, caregivers and other health care professionals in addressing health-related issues in a collaborative way. Consulting an RD becomes highly important when dealing with vulnerable populations, such as pediatrics, and can be utilized in many ways to help minimize various nutrition-related issues in the pediatric population.  

Nutrition Education & Coaching for Parents

First-time parenting can be an experience of confusion and apprehension, and as each child is unique, even experienced parents can be faced with nutrition-related issues. Registered Dietitians help teach parents the steps and precautions that need to be taken when feeding their newborn and introducing new foods into the diet, as well as ensure that their child is getting all of the necessary nutrients for proper growth and development.  RD’s can help parents find new ways to incorporate different foods into meals, create healthy food habits for their child and teach them how to make healthy lifestyle changes for their family. They also help in certain decision-making processes by providing unbiased and helpful scientific information for the parents to consider when deciding how to feed their child. For example, choosing whether or not to breastfeed their child and how to optimize nutrients based on their choice.

Breastfeeding & New Mothers

There is ample scientific research that suggests that breastfeeding is the healthier option to feeding a newborn baby, however this decision may be difficult for a new mother. Education on breastfeeding and its impacts on both the mother and the infant is another role of the RD in pediatric nutrition. Consulting a dietitian can help new mothers who are deciding whether or not to breastfeed make the best choice for themselves and their baby while remaining unbiased and supportive. In addition, exclusively breastfed babies require vitamin D supplementation and RDs can help to advise parents on the best type and dose. 

Growth & Development

Since childhood is a period of rapid growth and development, a child’s energy and nutrient intake is vital. Inadequate nutrition can impair physical, mental, emotional and behavioural development, which can have long-term effects on the patient’s wellbeing. Consulting an RD ensures that the patient-specific nutrient needs are being met. Registered Dietitians are experienced in using the Pediatric Nutrition Guidelines and growth charts. These are used to monitor for certain milestones that should be met based on the child’s age, as well as the presence of “red flags.” For example, attempting to use a spoon or trying to spoon-feed oneself is a milestone that should be met by age 9-12 months. Failure to meet these guidelines or the presence of “red flags” (such as forced feedings by 9-12 months) may suggest inadequate development of the child’s relationship to food. They are educated on the fluid and food guidelines that should be followed as the child grows to ensure that this relationship develops properly. RD’s can also contribute to helping patients that have specific dietary restrictions, such as vegetarianism or food allergies, ensure that they are maintaining adequate nutrition for growth. 

Allergies & Intolerances

Many allergies and intolerances develop when the patient is young and may over time diminish, or they may remain with the patient as a lifelong allergy/intolerance. Both situations can be challenging for both the patient, as well as their family. RD’s can help clarify which foods or types of foods must be avoided in order to prevent an allergic reaction or symptom flare up of the intolerance, while also ensuring that the patient is not deficient in the nutrients that these foods would provide. They can also provide advice for the family when learning how to adapt to this new dietary restriction within the household as it may require changes in diet from all members of the household, not only the child with the allergy or intolerance. 

Picky Eating

A common issue among the pediatric population is “picky eating.” Children learn through various sources (parents, peers, media, etc.) that certain foods should be avoided, while others should be consumed. However, a picky eater’s diet may be lacking in the nutrients that these foods would provide. RD’s can help the patient broaden their perception of foods that they do not want to eat and welcome more healthy options into their diet. They can also work with the patient’s family to incorporate these foods into meals in ways that the patient may enjoy or may not even notice, ensuring that the child is getting the adequate nutrients that they need for healthy growth and development.

Supplementation

Nutrient supplementation requires a patient-specific assessment to determine if supplements are required. Exclusively breastfed infants require vitamin D supplementation. RD’s discuss with the parents the best type of supplementation (Ex. drops) and determine the required dosage for the infant. Some children may also benefit from a multivitamin or iron supplement, depending on their needs and diet to help prevent deficiencies. Additionally, various probiotics have been shown to increase health, decrease digestive issues and improve immune function.