This role statement was developed by members of the Paediatric and Maternal Health Interest Group.

It lists the knowledge and skills of an Accredited Practising Dietitian (APD) working in paediatrics.

Knowledge

• Nutritional requirements and nutrient reference values of infants, children and adolescents across common nutrition related disorders (for example, but not limited to: chronic respiratory issues, metabolic disorders, type 1 diabetes, oncology treatment, gastrointestinal disorders, cystic fibrosis, cerebral palsy, developmental disabilities and Down’s syndrome).
• Aetiology of common nutrition-related conditions and diseases, that have their origins in childhood such as growth rate above or below a healthy weight, metabolic disorders, iron deficiency, feeding difficulties and adverse food reactions.
• Understanding, supporting and promoting breastfeeding as the optimal feeding method. This includes feeding cues, benefits of breastfeeding and policies which promote support of breastfeeding (eg World Health Organization International Code of Marketing of Breast-milk Substitutes).
• Infant formula indications for use, type, volume, frequency, safe preparation feeding cues, quality and manipulations to meet altered requirements. Understanding of different formulas available on the market.
• Developmentally appropriate introduction of solids, considering timing, progression and suitable textures and foods.
• Understanding of child protection policies, guidelines, services and how to submit a report.

Skills

• Ability to assess the nutritional status, growth and nutritional requirements of infants, children and adolescents, including those with acute and chronic diseases or special healthcare needs (for example, but not limited to: chronic respiratory issues, metabolic disorders, type 1 diabetes, oncology treatment, gastrointestinal disorders, cystic fibrosis, cerebral palsy, developmental disabilities and Down’s syndrome).
• Utilisation of appropriate growth charts and calculation and interpretation growth patterns for infants, children and adolescents.
• Ability to provide evidence based, specific and tailored nutrition advice for the individual and family, considering the changing physiological, psychological and social needs, treatment and life stage (infant, child and adolescent).
• Employ chronic condition management approaches to facilitate long-term management, including goal setting and motivational interviewing.
• Provide support to parents or carers to feed their infants, children and adolescents, particularly relating to fussy eating, limited food acceptance and sensory issues, and encouraging a positive mealtime environment.
• Effective advocacy and age-appropriate communication with all relevant stakeholders including patients, parents or carers, families and (as clinically relevant) the multidisciplinary team to assist in family- and patient-centred decision making in developing, implementing and evaluating nutrition interventions.

Activities entry level APDs would conduct

• Assessment, monitoring and nutritional management of various disease states growth assessment and interpretation, development and eating behaviours in childhood and adolescence.
• Planning, implementation and evaluation of nutrition interventions, including dietary manipulation and artificial nutrition support measures (eg enteral feeding, supplementary feeds).
• Act as a nutrition resource person for the training, education and development and support of others involved in paediatric care eg mentoring/supervision of students or less experienced dietitians as well as various other health professionals.

Activities APDs working at a higher level would conduct

• Nutrition management of complex cases and conditions, including but not limited to eg childhood obesity, eating disorders, type 1 diabetes, liver disease, renal disease, cancer, cystic fibrosis, developmental disabilities, neurodevelopmental disorders, depressive and/or anxiety disorders and non IgE mediated adverse food reactions.
• Implementation of therapeutic nutritional interventions, including dietary manipulations using artificial nutrition support (for example, breast milk fortification, specialised infant formula, modular feeds, parenteral feeding).
• Provide support and education for problematic feeding and mealtime behaviours. ¹

Activities APDs working in this area of practice do not usually undertake

• Provide lactation management, oral motor assessment, in-depth psychological interventions without meeting credentialing requirements to extend scope of practice.

For more, download the full role statement. The full statement includes a list of document references.