Children with nutrition needs are often complex. Some children have medical conditions that add layers to their clinical needs. Some children have psychiatric challenges that affect how they eat. Others have social needs that influence their nutrition. When these children and their families are working on nutrition, a pediatric dietitian is often not the only provider they need. Many of these children will be best cared for with a team-based approach. Different children will benefit from different members of their nutrition team. As a pediatric dietitian, here are some types of providers who my own patients see, and I collaborate with on their care.
Who Should be on My Child's Nutrition Team?
Not every child needs every one of these providers on their healthcare team. Take a look at the list below, and knowing your own child, you may find that some of these providers may be able to help your child with their nutrition. Besides for a pediatric dietitian, your child may benefit from working with some of these healthcare providers.
Pediatrician
Your pediatrician is crucial! This is the person who holds the big picture of your child's physical and mental health. They make sure your child gets appropriate screenings, and they recognize when your child should be referred to specialists. They also may know your child for the longest, so other providers working with your child can collaborate with them to make sure they understand the big picture of your child also. As a pediatric dietitian, I work closely with my patients' pediatricians and update them on the progress their patient has made with nutrition.
Endocrinologist
Children with diabetes, growth concerns, puberty concerns, or metabolic concerns often will see an endocrinologist. An endocrinologist will be able to advise you on what is normal for your child and what needs further medical tests. They can order lab test or other medical studies to evaluate your child's health. Sometimes seeing an endocrinologist can also help you know which of your own concerns for your child actually are things you can stop worrying about. Once the endocrinologist has clarified parents' concerns, as I pediatric dietitian, I can work with families to help children meet their nutrition goals.
Gastroenterologist
Is your child having GI symptoms that are not resolving with interventions your pediatrician suggests? If so, your pediatrician may suggest you see a gastroenterologist. After they hear your child's symptoms and examine your child, they can let you know if your child should have any further GI workup. After a diagnosis, your gastroenterologist can advise you on treatments, which can range from medications, to nutrition, to behavioral interventions. One great thing about gastroenterologists is that they can tell you which GI symptoms are concerning for serious conditions, and which symptoms, though unpleasant, are not a sign of something serious. In my role as a pediatric dietitian, I can help parents and children with any nutrition changes that are necessary.
Psychiatrist
Many children with nutrition concerns also have psychiatric symptoms such as depression, anxiety, or disordered eating. A psychiatrist will do a comprehensive evaluation and diagnose psychiatric conditions. They may suggest medication, and if so, they also work closely with patients, their families, and the patient's therapist to adjust the child's medications. As a pediatric dietitian, if I am concerned about a child, I will encourage parents to schedule an appointment for their child with a psychiatrist.
Therapist
Seeing a therapist is key when your child is working on any behavioral change, including nutrition-related behavioral change. When a child also has depression, anxiety, or disordered eating, a therapist is even more crucial! A therapist can teach your child skills and work to improve their psychiatric symptoms. As those symptoms improve, children often have an easier time with nutrition-related behavior changes. Because I work with patients on nutrition-related behavior change, I work closely with my patients' therapists in my role as a pediatric dietitian.
Speech Therapist
A speech therapist is very helpful for children with feeding issues. Children with feeding issues range from babies who are having trouble latching on the breast or bottle, to bigger kids who are picky eaters, and many other related issues throughout the childhood years. A speech therapist's role includes oral motor exercises, sensory stimulation, and other interventions to help a child eat better. When my patients are seeing a speech therapist, one of my roles as a pediatric dietitian is to help prioritize which foods to introduce.
Occupational Therapist
Occupational therapists are another provider who can help children with nutrition concerns. Occupational therapists help children with sensory modulation, oral motor skill development, and other practical aspects of eating and feeding. Children with picky eating and children with some neurological conditions may have nutritional benefits from working with an occupational therapist. As a pediatric dietitian, I will help children add foods to their repertoire as their eating skills improve.
Physical Therapist
Many of the children who are working on improving their nutrition also are aiming to improve their physical activity. One of the barriers many of my pediatric patients have to physical activity is decreased muscle strength. These children can see improvements in their strength and ability to participate in physical activity from working with a physical therapist. As a pediatric dietitian, I am comfortable knowing that my patients are working on improving physical fitness safely.
Pediatric Registered Dietitian
Of course, a pediatric registered dietitian is crucial for a child with nutritional needs. A pediatric dietitian can help a child with metabolic concerns like diabetes, overweight, or elevated lipids; a baby with difficulty feeding and poor growth; or a child with gastrointestinal issues. Pediatric dietitians provide education on nutrition, help define nutritional goals, and provide practical ideas for how to improve nutrition.
Your Child's Nutrition Team
When your child has nutrition needs that are more complex than the average child's, there is a team of healthcare providers who can help you and your child. Different children will need different members of their nutrition team, but some providers who can help your child are their pediatrician, an endocrinologist, a gastroenterologist, a psychiatrist, a therapist, a speech and language pathologist, an occupational therapist, a physical therapist, and a pediatric registered dietitian.