Paediatric dieticians

Welcome to NHS Borders Children and Young People’s Dietetics RefHelp homepage.

The children and young people’s (CYP) dietetic team provides a Borders wide service to those from birth to 18 years of age*. The majority of CYP requiring dietetic input will be appropriate for advice, education and support from the paediatric dietitians who cover general and specialist services. The paediatric dietitians offer outpatient clinics in multiple areas of the Borders and there is also the option for remote consultations via video or telephone.

*Young person remains in school and/or is under the care of medical paediatrics.

There are additional specialist CYP’s services that provide dietetic support. For dietetic advice for CYP for the following, please refer directly to the services below:

Weight Management Advice
CYP under the care of CAMHS
Eating Disorders

Further information can be found within these pages on RefHelp.

Who to refer, who not to refer, how to refer

Who to refer:

Faltering growth in infants and CYP.
Infants with nutrition related co-morbidity for example developmental delay, cleft palate, congenital heart disease.
Infants and CYP on enteral tube feeding
Food allergies: for mild-to-moderate non-IgE cow’s milk allergy, see pathway (hyperlink)
Food intolerances
Restricted diets with evidence of growth faltering or other significant medical or nutritional concern.

The paediatric dietitians also accept referrals for infants and CYP under specialist services including Diabetes, GI, Renal and Respiratory. At times CYP may be under shared care with a tertiary centre.

Who not to refer:

CYP with a BMI >91^st centile for BMI. Please refer to CHW service (please add hyperlink)
CYP currently under the care of CAMHS. Please refer to CAMHS Dietitian (please add hyperlink)
Eating disorders. Please refer to Specialist Eating Disorder Dietitian (please add hyperlink)
Infants with a non-IgE CMA (mild-moderate), with nil additional red flags. Please see cow’s milk allergy guideline for more information (please add hyperlink)
Weaning advice. Please refer to local health visitor.
Nut allergy. Please refer to medical paediatrics.
Young people aged between 16-17 years who are no longer in school. Please refer to community dietitian (hyperlink)
Selective eaters without faltering growth or other medical conditions.
- <5 years, refer to local Health Visitor.
- >5 years refer to healthy eating information in resources.

How to refer:

Referrals to the paediatric dietitians can be made by completing the referral template ‘Paediatric Dietetic Request for Assistance Form’

Please send complete forms to the generic inbox paediatricdietitian@borders.scot.nhs.uk or via post (see address details below). Please do not send referrals via Sci-Gateway.

Queries:

If you have any questions or queries, please contact paediatricdietitian@borders.scot.nhs.uk

Primary care management

Information to include on the referral:

Current weight and height with trend/history
Outline nutritional concern.
For allergy patients include allergy focused history.
Previous or current dietary interventions trialled.
Relevant medications.

Faltering Growth

Classification of Faltering Growth, one or more of the following:

In the early days of life:

> 10% weight loss from birth weight.
Birth weight not regained after 3 weeks.

After the early days of life:

Current weight < 2^nd centile (infants under 12 months)
a fall across 1 or more weight centile spaces, if birthweight was <9^th centile
a fall across 2 or more weight centile spaces, if birthweight was between 9^th and 91^st centile
a fall across 3 or more weight centile spaces, if birthweight was above 91^st centile
Length and weight greater than 2 centile spaces apart
Crossing through length / height centiles as well as weight.
BMI <2^nd centile (in children ≥ 2 years)
Weight crosses 2 centiles downward on a growth chart