Pediatric Nutrition in Practice

1 Specific Aspects of Childhood Nutrition

Key Words

Assessment of an individual child · Barriers to

intake · Barriers to absorption · Detailed diet

history · Tailored advice · Monitoring

Key Messages

• Assessment of dietary intake is essential in under-
  standing the nutritional status of an individual child


• Assessment of the barriers to intake and absorption
  is integral to this process


• Assess food and drink intake in the individual child
  by taking a detailed dietary history, usually from the
  parent and child together


• Use information gained to tailor treatment and ad-
  vice


• This is a skilled job requiring training to perform
  and expertise to interpret; use a dietician or experi-
  enced clinician, if possible © 2015 S. Karger AG, Basel

Introduction

This chapter will deal with methods to use for the
assessment of an individual child who has pre-
sented with a problem that may have a dietary
origin. The fact that we are dealing with an indi-
vidual child in need of diagnosis and treatment

or advice dictates the methods to be used. In as-

sessing the nutritional status of a child, it is im-

portant to ascertain whether their likely needs are

being covered by their dietary intake. This will

include the assessment of any barriers to intake

or absorption of nutrients from the foods con-

sumed.

For children below the age of 8–10 years (de-

pending on the individual child’s maturity), par-

ents or caregivers will be the main source of reli-

able information. Children below this age do not

have the cognitive skills necessary to answer

questions about foods eaten accurately enough for

assessment [1]. Even with older children, it is best

to obtain corroboration and expansion of child-

supplied information from parents, although this

process needs careful handling. Interviewing the

child and parent together in a collaborative way is

probably the way to start. If conf lict arises at this

stage, this may be an important indicator of the

source of any dietary problems found.

To carry out this process is a skilled job re-

quiring a high level of expertise to achieve the

desired result of discovering the presence of like-

ly dietary problems and to formulate recommen-

dations for improvement. If available, a dietician

will have the training and expertise to carry out

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 14–18
DOI: 10.1159/000367877

1.2 Nutritional Assessment

1.2.2 Diet History and Dietary Intake Assessment

Pauline Emmett