Clinical Paediatric Dietetics, the third edition, is the latest edition of a well-recognised and widely used manual for professional dietitians and other health professionals involved with children requiring therapeutic diets.
New chapters have been added to this third edition, covering topical issues like healthy eating throughout childhood, prevention of food allergy and autistic spectrum disorders, in line with the recent focus on public health nutrition and promotion as a key component of the healthcare system.
This manual gives a comprehensive overview of the field of paediatric dietetics, of which there are few other comparable texts. Although each chapter is a separate presentation by different authors, there is reasonable consistency in the structure and approach of chapters. All topics are extensively referenced and the references have been updated since the second edition.
This new edition is divided into four main parts. Part 1 sets out the principles of paediatric dietetics, describing the general basics of nutritional assessment and dietary requirements in healthy infants and children. It also includes a chapter on the practical aspects of designing feed-making areas, to ensure that clean food (and when necessary, sterile meals) is provided in a hygienic hospital setting. This is an area sometimes overlooked and this chapter will be particularly useful for the catering manager (or dietitian) responsible for the management of the diet kitchen.
Part 2 provides prescriptive details on enteral and parenteral nutrition. It has an added chapter on nutrition in critically ill children, and touches on topical issues like using immune-enhancing feeds and probiotics. Part 3, titled clinical dietetics, forms the bulk of the text and contains chapters which provide very useful reviews of the various paediatric nutritional disorders, although the topics are not arranged in a logical fashion. The mix of topics describing disorders of the organ systems (e.g. gastroenterology, the liver and pancreas), disease states (e.g. diabetes mellitus, cystic fibrosis) and types of diets (e.g. ketogenic diets, food hypersensitivity) means that searching for a particular disease of interest may not be as straightforward, especially for the non-expert reader.
Part 4, titled community nutrition, is a new section, comprising chapters like healthy eating, faltering growth, obesity and prevention of food allergy. The chapter on prevention of food allergy provides an excellent review on the contentious topic of infant feeding and allergy prevention, and makes practical recommendations based on current existing evidence. Overall, this section is particularly helpful for those working with normal healthy children, especially in the non-clinical setting. The title of this section may be slightly confusing to some, as chapters describing diabetes mellitus, eating disorders and autistic spectrum disorders, disorders often dealt with in the community, are listed under the clinical dietetics section. This arbitrary distinction between clinical dietetics and nutrition in the community has been acknowledged by the editors.
Individual chapters mostly give a good balance of epidemiology and physiology as background, followed by a good dose of prescriptive and detailed nutritional management information. The authors take a holistic approach in disease management, covering the medical, social and psychological aspects of the various disorders, with emphasis on working in a multi-disciplinary team. They present a strong review of existing evidence-based scientific and medical literature, stating whenever evidence is lacking. Coupled with handy and practical tips, drawn from the experience of a large group of practising paediatric dietitians around the UK (who have contributed to the book), and the list of commercial products commonly used, this book makes an indispensable manual for those studying, practising and doing research on paediatric dietetics especially in the UK. The tabular format of presenting information and the numerous worked examples also make the text easy to read and learn from. The inclusion of current topical issues like organic foods, genetically modified foods, new recommendations and guidelines (e.g. for parenteral nutrition), and the expansion of the range of disorders and treatment described in several chapters makes this book one of the most updated in this area of speciality.
The wide range of topics, together with the handy references accompanying each chapter (including resources, addresses and support groups for patients and professionals), makes the book a very good starting point for building a strong foundation in clinical paediatrics dietetics and gaining a general understanding of diseases related to paediatric nutrition. It is highly recommended for health professionals and members in the community health team, who are working with children requiring therapeutic diets. It would be ideal if growth charts and other anthropometric charts were also included in the appendices for reference.
