Clinical Paediatric Dietetics Clinical Paediatric Dietetics Second Edition Edited by Vanessa Shaw and Margaret Lawson © 1994, 2001 by Blackwell Science Ltd Editorial Offices: Marston Book Services Ltd Osney Mead, Oxford OX2 0EL PO Box 269 25 John Street, London WC1N 2BS Abingdon 23 Ainslie Place, Edinburgh EH3 6AJ Oxon OX14 4YN 350 Main Street, Malden (Orders: Tel: 01235 465500 MA 02148 5018, USA Fax: 01235 465555) 54 University Street, Carlton Victoria 3053, Australia USA and Canada 10, rue Casimir Delavigne Iowa State University Press 75006 Paris, France A Blackwell Science Company 2121 S. 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No part ofthis publication may be reproduced, Clinical paediatric dietetics / edited by Vanessa Shaw and Margaret stored in a retrieval system, or transmitted, in any form or by any Lawson. – 2nd ed. means, electronic, mechanical, photocopying, recording or otherwise, p.; cm. except as permitted by the UK Copyright, Designs and Patents Act 1988, Includes bibliographical references and index. without the prior permission ofthe publisher. ISBN 0-632-05241-4 (hb) 1. Diet therapy for children. I. Shaw, Vanessa. II. Lawson, First edition published 1994 Margaret, MSc. Reprinted 1995 [DNLM: 1. Diet Therapy – Child. WS 366 C6405 2001] Second edition published 2001 RJ53.D53 C58 2001 615.8(cid:2)54(cid:2)083 – dc21 00-052960 Set in 10 on 11 pt Ehrhardt MT by Best-set Typesetters Ltd., Hong Kong For further information on Printed and bound in Great Britain by Antony Rowe Ltd, Chippenham Blackwell Science, visit our website: www.blackwell-science.com The Blackwell Science logo is a trade mark ofBlackwell Science Ltd, registered at the United Kingdom Trade Marks Registry Contents Contributors vii 11 The Kidney 158 Foreword ix Janet Coleman Preface xi 12 The Cardiothoracic System 182 Acknowledgements xii Marion Noble 13 The Immune System 193 SECTION 1 – Food Allergy and Intolerance 193 Introduction 1 Christine Carter 1 Principles of Paediatric Dietetics 3 – Immunodeficiency Syndromes 214 Vanessa Shaw and Margaret Lawson Dona Hileti-Telfer 2 Provision of Nutrition in a Hospital – HIV and AIDS 218 Setting 19 Jayne Butler Ruth Watling 14 Ketogenic Diet for Epilepsy 222 Margaret Lawson SECTION 2 Enteral and Parenteral Nutrition 29 SECTION 5 3 Enteral Feeding 31 Inborn Errors of Metabolism 233 Tracey Johnson 15 Disorders of Amino Acid Metabolism, 4 Parenteral Nutrition 43 Organic Acidaemias and Urea Cycle Janice Glynn Defects 235 Marjorie Dixon SECTION 3 – Phenylketonuria 235 Preterm and Low Birthweight Nutrition 53 Anita MacDonald 5 Preterm Infants 55 – Homocystinuria 267 Caroline King Fiona White 16 Disorders of Carbohydrate Metabolism 295 SECTION 4 Marjorie Dixon Diseases of Organ Systems 67 17 Disorders of Fatty Acid Oxidation 316 6 The Gastrointestinal Tract 69 Marjorie Dixon Sarah Macdonald 7 Anatomical Abnormalities of the SECTION 6 Gastrointestinal Tract 97 Lipids 327 Vanessa Shaw 18 Lipid Disorders 329 8 The Liver and Pancreas 110 Patricia Rutherford Stephanie France (Jackson) 9 Diabetes Mellitus 126 SECTION 7 Alison Johnston Peroxisomal Disorders 337 10 Cystic Fibrosis 137 19 Refsum’s Disease 339 Anita MacDonald June Brown vi Contents 20 X-linked Adrenoleukodystrophy 345 Lesley Haynes Anita MacDonald 25 Burns 396 Helen McCarthy and Dearbhla Hunt SECTION 8 26 Nutrition for Children with Feeding Childhood Cancers 349 Difficulties 403 21 Nutritional Support: Leukaemias, Karen Jeffereys Lymphomas and Solid Tumours 351 27 Failure to Thrive 423 Evelyn Ward Zofia Smith 28 Children from Ethnic Minorities and SECTION 9 those following Cultural Diets 431 Eating Disorders and Obesity 361 Sue Wolfe 22 Eating Disorders 363 Dasha Nicholls APPENDICES 447 23 Obesity 371 Appendix I Manufacturers of Dietetic Mary Deane Products 449 Appendix II Dietetic Products 451 SECTION 10 Other Conditions Requiring Nutritional Support and Advice 381 Index 455 24 Epidermylosis Bullosa 383 Contributors June Brown Dona Hileti-Telfer Former Senior Dietitian Senior Dietitian Chelsea and Westminster Hospital, London SW10 Great Ormond Street Hospital for Children NHS 9NH Trust, London WC1N 3JH Jayne Butler Dearbhla Hunt Senior Paediatric Dietitian Senior Dietitian St Mary’s Hospital, Praed Street, London W2 The Children’s Hospital, Temple Street, Dublin, 1NY Eire Christine Carter Stephanie France (née Jackson) Specialist Dietitian Senior Paediatric Dietitian Great Ormond Street Hospital for Children NHS Kings College Hospital, Denmark Hill, London Trust, London WC1N 3JH SE5 9RS Janet Coleman Karen Jeffereys Chief Paediatric Renal Dietitian Chief Dietitian City Hospital, Hucknall Road, Nottingham NG5 Services for People with Learning Disabilities, P O 1PB Box 107, Southsea, Hants PO4 8NG Mary Deane Tracey Johnson Senior Dietitian Senior Dietitian Royal Hospital for Sick Children, Sciennes Road, The Birmingham Children’s Hospital NHS Trust, Edinburgh EH9 1LF Steelhouse Lane, Birmingham B4 6NH Marjorie Dixon Alison Johnston Specialist Dietitian Senior Dietitian Great Ormond Street Hospital for Children NHS Royal Hospital for Sick Children, Yorkhill, Trust, London WC1N 3JH Glasgow G3 8SJ Janice Glynn Caroline King Senior Dietitian Chief Paediatric Dietitian Royal Liverpool Children’s NHS Trust, Eaton Queen Charlotte’s Hospital, Goldhawk Road, Road, Liverpool L2 2AP London W6 0XG Lesley Haynes Margaret Lawson Specialist Dietitian Nestle Senior Research Fellow Institute of Child Health, 30 Guilford Street, Institute of Child Health, 30 Guilford Street, London WC1N 1EH London WC1N 1EH viii Contributors Helen McCarthy Vanessa Shaw Senior Dietitian Chief Dietitian Manchester Children’s Hospitals, Charlestown Great Ormond Street Hospital for Children NHS Road, Blackley, Manchester M9 7AA Trust, London WC1N 3JH Anita MacDonald Zofia Smith Head of Dietetic Services Senior Dietitian The Birmingham Children’s Hospital NHS Trust, St Mary’s Hospital, Greenhill Road, Leeds LS12 Steelhouse Lane, Birmingham B4 6NH 3QU Sarah Macdonald Evelyn Ward Specialist Dietitian Senior Paediatric Dietitian Great Ormond Street Hospital for Children NHS St James University Hospital NHS Trust, Beckett Trust, London WC1N 3JH Street, Leeds LS9 7TF Dasha Nicholls Ruth Watling Clinical Lecturer in Neurosciences and Mental Chief Dietitian Health Royal Liverpool Children’s NHS Trust, Eaton Institute of Child Health, 30 Guilford Street, Road, Liverpool L2 2AP London WC1N 1EH Marion Noble Fiona White Former Specialist Dietitian Chief Dietitian Great Ormond Street Hospital for Children NHS Manchester Children’s Hospitals, Hospital Road, Trust, London WC1N 3JH Manchester M27 4HA Patricia Rutherford Sue Wolfe Chief Dietitian Chief Paediatric Dietitian Royal Liverpool Children’s NHS Trust, Eaton St James University Hospital NHS Trust, Beckett Road, Liverpool L2 2AP Street, Leeds LS9 7TF Foreword The first edition of Clinical Paediatric Dietetics was provides lists of commercial products and the published in 1994, contributions being made by many addresses of manufacturers. senior dietitians. It is now a great pleasure to write a Once again, Vanessa Shaw and Margaret Lawson Foreword to this second edition to which no fewer have undertaken a huge task; they have contributed than 28 experienced colleagues have contributed. chapters themselves and undertaken the editing. Over the years the role of dietetics in the treatment Obtaining high standard material from so many col- of sick infants and children has become both increas- leagues is certainly not easy, and I congratulate ingly important and in many instances far more com- Vanessa and Margaret most warmly. This multi- plex. The Paediatric Group of the British Dietetic author book will, I am sure, go through numerous Association is to be congratulated for the way it has editions as the years pass and each edition will help moved dietetics forwards, with great benefit to their so many sick infants and children. Looking back to young patients. 1965 when the first edition of Diets for Sick Children As before, the chapters cover a wide variety of sub- appeared, one is conscious of the huge developments jects ranging from the principles of paediatric dietet- which have taken place in dietetics and the ever ics to the treatment of diabetes mellitus, allergic increasing importance of the dietitians. disorders, inherited metabolic disorders, burns and eating disorders to name but a few. As previously, Dame Barbara Clayton DBE, MD, PhD, HonDSc, the needs of sick children from ethnic minorities FRCP, FRCPE, HonFRCPI, HonFRCPCH, have been included. The practical aspects of dietary FMedSci, HonFIBiol, FRCPath management are given a high profile, excellent tables and clear diagrams provide essential information and Honorary Research Professor in Metabolism, University each chapter has a suitable list of references. All the of Southampton chapters are full of commonsense and the volume Honorary President, British Dietetic Association Preface The aim of this manual is to provide a very practical There has been an expansion of the range of dis- approach to the nutritional management of a wide orders and treatments described: additional informa- range of paediatric nutritional disorders that may tion has been included on nutritional assessment, benefit from nutritional support or be ameliorated or inborn errors of metabolism, food allergy and intol- resolved by dietary manipulation. The text will be of erance, immunodeficiency syndromes and gastroen- particular relevance to professional dietitians, dietetic terology. Arranged under headings of disorders of students and their tutors, paediatricians, paediatric organ systems rather than type of diet, and with nurses and members of the community health team much information presented in tabular form, the involved with children requiring therapeutic diets. manual is easy to use. Dietary restrictions due either The growing importance of nutritional support in to customs, religious beliefs or environmental condi- many paediatric conditions is recognised and reflected tions which may affect the nutritional adequacy ofthe in new text for this edition. diet of the growing child are also discussed. The authors are largely drawn from experienced Appendices list the many and varied special prod- paediatric dietitians around the United Kingdom, ucts described in the text, together with details of with additional contributions from other specialist their manufacturers. The appendices are not exhaus- dietitians and a psychiatrist. The text does not tive, but include the products most commonly used attempt to discuss normal nutrition in healthy in the UK. The information has been updated for this children (though references for this topic are addres- edition and the most recent data has been used in the sed), but concentrates on the nutritional require- preparation of the manual, but no guarantee can be ments of sick infants and children in a clinical setting. given ofthe validity or availability at the time ofgoing Normal dietary constituents are used alongside to press. special dietetic products to provide a prescription that will control progression and symptoms of Vanessa Shaw disease whilst maintaining the growth potential of the Margaret Lawson child. January 2001 Acknowledgements We would like to thank a number of the contributors to the first edition, who were unable to contribute to this second edition, but whose work has formed the basis for the following chapters: Chapter 2, Provision of Nutrition in a Hospital Chapter 14, Ketogenic Diet for Epilepsy: Jane Eaton, Setting: Christine Clothier, Former Chief Dietitian, Former Chief Community Dietitian, Dorset Health Royal Liverpool Children’s NHS Trust Care NHS Trust Chapter 3, Enteral Feeding: Debra Woodward, Chapter 18, Lipid Disorders: Anne Maclean, Former Former Senior Dietitian, The Children’s Hospital, Senior Paediatric Dietitian, St George’s Hospital, Birmingham London Chapter 4, Parenteral Nutrition: Alison Macleod, Chapter 22, Eating Disorders: Bernadette Wren, Former Senior Dietitian, Royal Liverpool Children’s Former Principal Clinical Psychologist, and Bryan Hospital NHS Trust Lask, Former Consultant Psychiatrist, Great Ormond Street Hospital for Children NHS Trust Chapter 6, The Gastrointestinal Tract: Sheena Laing, Chief Dietitian, Royal Hospital for Sick Children, Chapter 25, Burns: Judith Martin, Former Chief Edinburgh Dietitian, Whittington Hospital, London. Chapter 8, The Liver and Pancreas: Jane Ely, Former Senior Paediatric Dietitian, King’s College Hospital, London
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