• Weight Management or children with restricted dietary intake/ ‘fussy eating’ with no associated growth faltering or serious medical conditions

Faltering growth is defined by a fall in one weight centile line were birth weight less than 9th centile or fall in 2 weight centile spaces where birth weight between 9th and 91st or fall in 3 centile line where birth weight is plotted above the 91st centile line. A difference of 2 or more centile between weight and height/length. Any child under the 0.4th centile line or BMI under 2nd centile line.

Weight Management:

First line support and advice on eating problems should be sought from the health visiting services/children’s centres for children under 5 or school nursing team for children over 5 years of age.

Diet and exercise information NHS.UK

Healthy eating and portions sizes for 1-5 years Layout 1

Portion sizes 5-11 Eating well 5-11yr olds June '10_Layout 1

The Eatwell Guide - NHS (www.nhs.uk)

Children with restricted dietary intake/ ‘fussy eating’:

First line support and advice on eating problems should be sought from the health visiting services/children’s centres for children under 5 or school nursing team over 5’s.

As well as sign posting to recommended resources – Infant and toddler forum Fussy and Faddy Eating in Toddlers Archives - Infant & Toddler Forum

Suspected ARFID (Avoidant/Restrictive Food Intake Disorder)

Patients with suspected ARFID should be referred to the CAMHS service for assessment and referral to dietetic service only if in agreement with CAMHS.

Children with autism spectrum disorder

Sensory issues can affect food preferences and mealtime behaviour. Unless the child has concomitantly one of the in ‘Scope’ conditions, first line support should be to sign post to recommended reading e.g. Autism UK,

Eating - a guide for all audiences (autism.org.uk)

British Dietetic Association - Food Fact Sheet: Autism and diet

Referral Criteria

Scope

Any condition that is not ‘Out of Scope’, that will benefit from nutritional intervention and support, including but not limited to:

• Allergy – including infants with allergy to cow’s milk protein (please refer to the CMPA referral system)
• Cystic fibrosis
• Diabetes
• Enteral feeding
• Gastro e.g., IBS, Crohn’s Disease & other malabsorption related conditions
• Metabolic conditions
• Nutritional micronutrient deficiencies
• Feeding difficulties
• Weight Management with serious medical conditions

Out of Scope

18 years and over: please refer to adult dietetic services, Weight Management or children with restricted dietary intake/ ‘fussy eating’ with no associated growth faltering or serious medical conditions Suspected ARFID (Avoidant/Restrictive Food Intake Disorder)Children with autism spectrum disorder (without concomitantly having any of the conditions in ‘Scope’ above).

Referral Instructions

Please send completed referral forms to Email: plh-tr.Community-Dietetics@nhs.net

Referral Forms

Dietician Referral Form - no merge fields

Dietician Referral Form - EMIS

Dietician Referral Form - Systmone

Pathway Group

This guideline has been signed off on behalf of NHS Devon

Publication date: August 2023