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Nutrition and Feeding Consultants

Dietitian

What is a dietitian?

A dietitian is a registered health professional with expertise in healthy eating and nutrition. Dietitians have special training in food, nutrition, and dietetics. Their work is focused on preventing and treating illness through dietary modification. The dietitians who work in hospitals are usually referred to as clinical dietitians.

Premature babies often need the support of a dietitian who can help ensure the best nutritional intake possible for the baby, by ensuring a well balanced diet and educating parents so that they can take the necessary steps to do the  same.

How can dietitians help premature babies?

Dietitians assess premature babies in the Neonatal Intensive Care Unit (NICU) to see if their nutrition and feeding are adequate. They focus in particular on those babies who are failing to thrive. The high-risk patients, those most at risk of poor growth and development, tend to be the most immature premature babies. Dietitians see babies who are graduates of the NICU in the Neonatal Follow-up Clinics. They also take referrals.

Dietitians sometimes work with occupational therapists if there are physical challenges to food or fluid intake. Specifically, dietitians can address feeding or hydration issues that come up due to prematurity or problems that may result after surgery. This is done under the monitoring of the neonatologist or paediatric surgeon.

How would your baby see a dietitian?

A doctor or nurse would refer your baby to a dietitian if there were concerns about your baby’s feeding ability or nutritional intake.

What are some of the common questions parents of premature babies ask dietitians?

Many parents want information on basic feeding strategies, specifically about:

  • when and how to start a baby on solid foods
  • how long to spend on feeding
  • how much children should be eating and drinking
  • evaluating and changing a feeding plan
  • how to breastfeed a baby who was premature
  • how to supplement breastfeeding
  • when and how to wean from breastfeeding
  • how to know if a breastfed baby is getting enough nourishment
  • how much weight a baby should be gaining

Some of these issues may seem straightforward, but they become more complicated when a premature baby has been very sick and the family is under the stress of that sickness. Some parents might have had the experience of raising other healthy children, but find the issues are different for their ill premature baby.

What does the dietitian look for?

When evaluating your baby, the dietitian will check your baby’s weight, height, calories, food intake, and fluid status. Growth charts help identify how normally your baby is growing. For example, a baby who is in the 90th percentile for height but the 50th percentile for weight would be considered underweight. A baby who is growing slowly or a baby that starts losing weight is also cause for concern.

How will the dietitian help your baby?

Depending on your baby’s condition, the dietitian may recommend boosting his formula or food with extra calories. She may help organize a feeding tube to help your baby get the nutrients he needs, if he cannot take in enough food by mouth or needs supplemental feeding. She can also arrange for special diets or special nutritional products, if your baby is taking certain drugs that affect nutrition intake or has a surgical complication like a shortened small bowel.

The dietitian can also provide guidance on how to feed your child appropriately at home.

Lactation consultant

What is a lactation consultant?

A lactation consultant is someone with expertise in the breastfeeding of newborns and young babies. They are part of the health care team. These health care professionals provide services to mothers who wish to breastfeed their newborn or young baby.

Why would your premature baby need to see a lactation consultant?

A lactation consultant might be asked to see you and your premature baby if you, your baby’s physician, or any other member of the health care team has concerns about your baby’s breastfeeding.

Andrew James, MBChB, MBI, FRACP, FRCPC

10/31/2009




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