THE DIETITIAN ROLELouise Bannister MSc RD - The Hospital for Sick Children, Toronto, Canada
In Canada and Australia the dietitian role is a regulated role. Dietitians hold a Bachelor’s degree in Human Nutrition and Dietetics and then must complete supervised practical training before writing an examination. Dietitians can work in a variety of community, education, industry and healthcare settings.
As dietitians it's probably not surprising that we love food and flavours and one of our favourite moments is mealtimes with family and friends. The art of cooking and the joy of sharing food is intrinsic in culture and society. In early development, feeding dynamics bond infant and mother, and set the scene for exploring tastes and textures. Then there is the nutritional aspect!
We love that every day is different and presents a new challenge. We are fortunate enough to follow children from listing through their transplant journey and beyond, working with families to address concerns and provide education at each age and stage. Although we work in different areas (Louise in cardiac and Sheridan in renal) there are similarities as well as differences in the nutrition challenges for our patients. Intrinsic to our role as a dietitian is to encourage adventure with textures and flavours and to try to influence a positive enjoyment of food. Many infants and toddlers who are unwell prior to transplant may miss out on key feeding skills in the development of feeding as they often have poor appetites, reflux or intolerance. Mealtimes become a stressful experience. Children may then be extremely fussy or have a very limited range of foods they will accept. Helping families through this is so rewarding. We love to hear more about families’ food culture and eating practices and to encourage their empowerment in feeding their child.
Our role is supported by several other allied health professionals as we often work closely with occupational therapists/speech language pathologists around oral feeding as well as child life therapists, psychologists and social workers amongst others. Furthermore, we aim to create a seamless experience for families by liaising with community partners to support transition to a “new normal”. We are leaders in the provision of enteral and parenteral nutrition and use our expertise and practice based knowledge to ensure safety and quality and appropriate utilization of resources.
A large part of the role of the dietitian is to interact with other team members to support and enhance the patient experience. We work closely with doctors, nurse practitioners and nurses to manage fluids and electrolytes and nutrition support. We work with child life specialists, speech pathologists, occupational therapists, psychologists and social workers to optimize oral feeding and provision of services when patients are discharged. Frequent multidisciplinary rounds keep us focused and allow for sharing of information, concerns and updates.When time allows, we engage in committee work, such as IPTA as well as research.
I am very proud of the team approach we provide to patients and families. Each member of the multidisciplinary team is respected for the expertise they provide to optimize patient outcomes. We all work together, focusing on the goals of the family.
I love getting to know children and their families and feel privileged to share in their journey with feeding and nutrition. Creating interactive tools of education is an area of work constantly in progress to help children and young people develop a better understanding and enjoyment of healthy eating. Participating in and generating an effective and supportive multidisciplinary team culture is very rewarding.
We recommend IPTA membership for all allied health practitioners working in pediatric transplant and would welcome your expertise and collaboration!