ÃÛÌÒAPP

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.

Useful links and resources

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 ÃÛÌÒAPP. 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

Dietetics 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.

Complications of excess weight

Our service provides dedicated care for children and young people who are experiencing health complications related to excess weight.

We work closely with families to offer compassionate, practical support that helps make meaningful and sustainable changes. Your child will receive a tailored nutritional assessment and an individualised plan that fits your family’s needs, routines, and goals.

We focus on realistic behaviour-change strategies and offer ongoing support throughout your journey, alongside other team members including doctors, psychologists, and other specialists. We aim to provide joined-up care across consultant clinics, home, education and other community settings.

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 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:

General Paediatrics (Inpatient and Outpatient)

Our General Paediatric Dietetic Service provides assessment, advice and support for inpatients who are under the care of the General Paediatricians and also for infants, children and young people (0–18 years) in the ÃÛÌÒAPP area who have nutritional or feeding needs. We work closely with families, carers and other healthcare professionals to ensure children receive safe, appropriate nutrition that supports growth, development and overall health.

Who we see

We provide care for children with a wide range of conditions, including:

• Faltering growth (poor weight gain) or concerns about growth and development
• Nutritional deficiencies (e.g. iron deficiency, vitamin deficiencies)
• Food allergies and intolerances, including cow’s milk protein allergy
• Gastrointestinal conditions such as reflux, constipation

What we do

Our dietitians are registered healthcare professionals who assess and manage nutritional needs using evidence-based practice. We:

• Carry out detailed nutritional assessments, including growth review and dietary intake
• Provide individualised dietary advice and care plans
• Offer guidance on nutritional supplements and prescribed feeds
• Deliver education and practical strategies to families and carers
• Work with schools, nurseries and community services when needed
• Support children receiving tube feeding in hospital (at home, support is provided by the Community ÃÛÌÒAPP Enteral Tube Feeding team or the dietitian linked with your specialist team)

How we work

We offer appointments in a variety of settings, including hospital, community clinics and, where appropriate, virtual or telephone consultations. Care may be provided as one-off advice or ongoing follow-up depending on the child’s needs.

We work closely with paediatricians, health visitors and school nurses, speech and language therapists, occupational therapists, GPs and other community services.

Referrals

Referrals are usually made by healthcare professionals such as GPs, paediatricians or health visitors.

What to expect at your appointment

At your first appointment, we will:

• Discuss your child’s medical history, growth and eating patterns
• Review any concerns you or your child may have
• Agree goals and a personalised nutrition plan

Follow-up appointments may be arranged to monitor progress and adjust the plan as needed.

Supporting families

We recognise that families play a vital role in supporting children’s nutrition. Our service is committed to:

• Providing clear, practical advice
• Respecting cultural, religious and personal preferences
• Supporting positive mealtime experiences

If you have concerns about your child’s nutrition or feeding, please speak to your GP or healthcare professional about a referral to our service.

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.

Useful links and resources

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 ÃÛÌÒAPP 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.

Neurology

A paediatric neurology dietitian works with infants, children, and young people who have neurological conditions, for example:

• epilepsy
• cerebral palsy
• neuromuscular conditions
• genetic syndromes affecting feeding and nutrition
• brain injury or developmental disorders

Their role combines expertise in nutrition with an understanding of how neurological disorders affect growth, feeding, metabolism, and overall health. The dietitian will undertake a nutritional assessment (growth, dietary intake and feeding ability), calculate nutritional requirements, identify deficiencies or excesses, and support families and the clinical teams to develop suitable feeding plans. The aim is to optimise nutrition and growth in children with neurological conditions, while supporting medical treatment, development, and quality of life for both child and family. Neurological conditions can impact a child’s energy needs, muscle tone and metabolism. Children with neurological conditions often have feeding difficulties. The dietitian works with speech and language therapists to guide appropriate nutrition when considering food textures and fluid thickness linked with swallowing safety (dysphagia).

The dietitian works closely alongside paediatric neurologists, specialist nurses, speech and language therapists, occupational therapists, physiotherapists, and other health care teams. The dietitian can provide advice on oral feeding strategies, positioning during feeding, prolonged feeding times, poor appetite, and food refusal. For children who cannot meet nutritional needs orally, tube feeding may be recommended. Together with the family and clinical team, the dietitian advises on appropriate feeds (commercial or blended diets), feeding schedules (bolus or continuous), and monitors tolerance and complications (e.g. reflux, constipation, delayed gastric emptying). The dietitian will monitor growth and adjust nutrition to prevent undernutrition or obesity whilst supporting optimal growth and development, aiming to meet nutritional and fluid requirements whilst reducing complications.

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.

PICU

Dietitians are part of the team caring for critically ill babies, children, and young people. We provide specialist, personalised nutritional support throughout their stay, carefully assessing each child’s needs and creating tailored feeding plans to support recovery and growth. This may include tube feeding or intravenous nutrition when needed, with close monitoring as their condition changes. Working alongside doctors, nurses, and other healthcare professionals, we help manage complex medical conditions, prevent malnutrition, and support the best possible outcomes during critical illness and recovery. We recognise how difficult this time can be for families. We’re here to offer clear information, helping you understand and feel confident about your child’s nutritional care.

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.

Surgery

The paediatric surgical dietitian supports children and their families throughout their surgical admission. We provide expert, personalised nutritional care before and after surgery, focused on children getting the nutrients they need for healing, recovery, and growth. This may include specialist advice on diet changes, as well as support with tube feeding or intravenous nutrition if required. As part of the wider surgical team, we work closely with doctors, nurses, and other professionals to manage complex conditions, reduce the risk of complications, and achieve the best possible outcomes. We understand that this can be a challenging time for families, so we offer clear guidance, practical advice, and reassurance every step of the way.

How to access our services

Consultant Referrals

If you are under the care of one of our regional specialty teams (for example, oncology, renal, cystic fibrosis, inherited metabolic conditions), you may have access to a paediatric dietitian. Please speak to your consultant or clinical team about this who can refer you to their dietitian in a range of ways.

Primary Care Referrals

If you are not under the care of a regional specialty service, but live in the ÃÛÌÒAPP area, 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.

All referrals from Primary Care should be submitted via the NHS e-Referral Service (e-RS)
Service name: Paediatric – RAS – Dietetics General – (RVI Outreach) – ÃÛÌÒAPP FT – RTD
Notes: Outreach clinics are held at Cresta and Benfield