This post is very different from other articles on this blog. I wrote it to give parents a bit of a “backstage” view at the profession of a pediatric dietitian and also help other health professionals understand what exactly we do.

When I was just starting out as a registered dietitian (RD), it was probably less common for us to specialize in child nutrition. In fact, out of my nutrition class at Columbia University, it was just me who chose a child nutrition path from the start. Some of my ex-classmates later joined me later as dietetic interns in my private practice, and it was becoming clear that the child nutrition field was growing in popularity.

And look around now! There are so many of us, working in private practice, running blogs, offering online classes, consulting for food industry, working in hospitals, school and federal nutrition programs. 

To find out more about pediatric dietitians and what they can do for parents, I polled dietitians in a Facebook group I moderate. Below are the results of the poll, mixed in with my own experience and also an input of some dietitians I reached out to directly. 

If you are a parent, I hope this article will help you understand what exactly we do and how we can help families. 

If you are a dietitian considering this specialty, you will find plenty of resources and guidance on how to start in the US and the UK. 

If you are a health professional, e.g. a pediatrician, occupational therapist, speech-language pathologist or child psychologist, this article will help you learn more about us, dietitians, and see how we can work together to help families. 

I wish I read an article like this one in my pre-dietetic years when I was a first-time mom with a child who was struggling to eat or when I was a brand-new dietitian looking for ways to get more experience and specialist knowledge in child nutrition.

First thing first, if you are not sure what is the difference between a registered dietitian and a nutritionist, here are a couple of links to to help you find out who is who in the world of nutrition professionals in the UK and in the US.

Child nutrition experts - how they can help your family - photo of basket of apples and a girl holding a crepe.

Why do some dietitians decide to specialize in child nutrition? 

Some of us fall in love with pediatrics from the beginning like Charlene Kennedy or myself. From the moment I took the Human Nutrition and Development class at my grad school, I was hooked. I knew this was exactly what I wanted to do. It is not uncommon to dietitians to find their calling during the dietetic internship as did Amy Reed or Jill Castle.

Others, like Yaffi Llova, become interested because their own kids get health complications that can be nutritionally managed, like EoE, ASD, food allergies and intolerances, ARFID. 

My favorite answer to this question was left by an anonymous RD and I agree with every word she wrote: “In pediatrics, nutrition is so delicately intertwined with family, behavior and growth. The impact I have as a nutrition professional seems ten fold in kiddos! Everyday you make a huge difference.” 

Similar to that, Anna Lutz found her path because she believes in the prevention of eating disorders by establishing a healthy relationship with food from early on.

How to start specializing in child nutrition? 

It is clear that although there is no single clear pathway to become a pediatric dietitian, it always takes a lot of work, research and curiosity to become one. 

Ultimately, it depends on what exactly one would like to do in their career.

You may love clinical nutrition, in which case becoming board certified or enrolling in a fellowship program may be the best option.

If you enjoy being a part of a team, but not in a hospital setting, an outpatient facility like a pediatrician’s office of a food allergy clinic will be a good choice. 

Or if you love marketing, public health and product development, collaboration with food companies may be an exciting opportunity for you. 

Practical experience and self-learning

The dietitians I connected with got their experience from many different places:

  • working in a hospital with a pediatric population (the best way to get clinical experience in a variety of fields of pediatric nutrition and acquire solid assessment skills)
  • attending workshops and conferences. This year, the pediatric nutrition practice groups at the Academy of Nutrition and Dietetics runs its first ever conference
  • Reading books. Jill Castle suggests this list: Fearless Feeding (Castle and Jacobsen), Child of Mine (Satter), Pediatric Nutrition in Clinical Care (Susan Konek), AAP’s Guide to Pediatric Nutrition. I would also add Helping Your Child with Extreme Picky Eating (Rowell and McGlothin), to this list.
  • participating in various facebook groups. I run one with Adina Pearson, as does Jill Castle. Check them out and join if you are a dietitian looking to make more connections in the child nutrition field.
  • taking continuing education courses with the focus in pediatric nutrition.
  • participating in mentorship programs by Pediatric Nutrition Practice Group within AND (Academy of Nutrition and Dietetics)
  • getting clinical supervision with more experienced colleagues.

And then there are very in-depth clinical programs for pediatric RDs who plan to build their career in a hospital or out-patient settings, delivering Medical Nutritional Therapy. 

Fellowship programs

Many, like Amy Reed, choose a deeper clinical experience by enrolling in Pediatric Nutrition Fellowship programs, offered by some hospitals and food companies. 

Examples of fellowship programs: 

Children’s Hospital of Philadephia

Boston Children’s Hospital

Abbot Nutrition Health Institute

Nestle Nutrition Institute

Board certification programs: 

For those dietitians hoping to follow a clinical career, providing medical nutritional therapy, the American Academy of Nutrition and Dietetics offers an in-depth Board certification program.  

Both AND (Academy of Nutrition and Dietetics) and BDA (British Dietetic Association) have special practice groups for pediatric dietitians, and run special events for them, including continuing education webinars and workshops.

Short courses and seminars in pediatric dietetics offered by the hospitals, non-for-profit foundations and universities: 

In the US

https://www.pnpg.org/Education/Training

In the UK https://www.bda.uk.com/regionsgroups/groups/paediatric/education/msc_programme

https://www.bda.uk.com/regionsgroups/groups/paediatric/education/home

Specialist trainings:

Ellyn Satter Institute offers training on family feeding dynamics and the Division of Responsibility – a must for those who plan to work with families on a variety of feeding issues. 

Some dietitians who work in feeding clinics may choose to complete an in-depth training on feeding problems, such as SOS training.

Others seek very specific rotations during their internship program. I was specifically interested in learning about pediatric allergies so I completed an internship rotation at Mount Sinai Jaffe Food Allergy Institute in New York.

Dietitian-developed programs

Dietitians who have worked in child nutrition for many years generously share their expertise with others by creating online programs for dietitians.

Those who need to gain skills in establishing and running a successful pediatric nutrition practice may choose to join THRIVE Mastermind which program by Jill Castle. It touches a bit on the practice of pediatric nutrition, but is more focused on thought leadership and growing your business. Jill also has an online program for professionals called Food Parenting PRO – a 4-part workshop series digging into the research and practical application of feeding and food parenting. You can learn more about Jills’s programs for dietitians, including her mentoring services, here.

Pediatric dietitians with many years of clinical experience Julie Larocque and Charlene Kennedy recognized the need for additional education in this field and created an online course, Infant Nutrition Essentials, geared towards dietitians with limited pediatric experience who are hoping to increase their knowledge and confidence in this area.  It’s 6 months in length, self-study and accredited by the Commission on Dietetic Registration for 17.5 CPEUs.

My story

My personal experience of educating myself about child nutrition started when I was still a student. I knew I wanted to work with families in the community because I saw so many parents around me who were struggling with feeding issues and not being able to get help easily. 

I joined AND’s  pediatric nutrition practice group, participated in their mentorship program, and secured my own internship and volunteering opportunities that allowed me to understand better what exactly I wanted to do. As  result, I got a range of experiences, all related to the field, but very different from each other: 

  • Pediatric food allergy institute
  • Head Start – a federally funded program for low income population
  • Creating nutrition education curriculums and website content
  • Pediatric feeding facility at a hospital 

I also had an internship rotation at a hospital working with adults. All of these experiences helped me understand that:

  1. I did not want to work in a clinical environment
  2. I was definitely drawn towards child nutrition. 
  3. I loved helping families on feeding issues and saw a clear need for more support for those who did not qualify for feeding programs in hospitals.

After I graduated, I also worked for a few months as a consultant at a research center at TC, which helped me understand how nutrition education programs got evaluated and what was involved in program delivery and data collection. 

What do we do as pediatric dietitians?

The best thing about being a dietitian is that you get comprehensive and well rounded training to work on a variety of projects, from public health projects to consulting for food companies and from blogging to working in a clinic with a team of other health professionals. 

Here are some examples of settings where you may see a pediatric dietitian:

In private practice seeing clients 1:1 for various issues, including FTT, food allergies, weight management, GI issues, or feeding problems.

As homecare dietitians, visiting families locally, for example, to see recently discharged babies with feeding tubes and helping them transition to oral feeding.

In pediatric hospitals or pediatric floors of general hospitals covering oncology, eating disorders, ketogenic diet, general medicine, NICU/PICU, eatign and feeding dieorders.

Consulting for federal and federally funded programs for low-income families.  Dietitians not only work with families in 1:1 and group format, but also develop training and protocols for other staff members.

Consulting for food industry. As food industry consultants, we work with food companies on consumer needs analysis, product development, promotional plans, and assist them with nutritional labels and analyses recipes. For example, at the moment, I am a member of Global Expert Bench – it is a fantastic project uniting a group of senior nutritional experts in more than 20 countries who provide consulting services to multinational companies. 

In pediatrician’s offices or coordinating care with other health professionals in clinics.

Writing blogs, maintaining social media presence. More and more dietitians are making their voices heard on the internet. I believe it is a very positive trend because it helps credible nutrition information reach more people. 

Developing recipes for books, websites and magazines. 

Writing books.

Developing workshops and presentations for the community.

Research. None of the dietitians I interviewed was a researcher but a few, including myself, contributed to reviewing the research-based guidelines for child-nutrition focused PEN pathways (Practice-Based Evidence in Nutrition).

How do parents find out about pediatric dietitians?

If you would like a referral to a local pediatric dietitian or need to connect with one, search the AND (in the US) and BDA (in the UK) websites or ask you primary pediatricians, family physicians, psychologists and occupational therapists, nurses, lactation consultants or other RDs for a referral. Many specialists maintain a network of referrals to help families better. 

What are the main misconceptions about dietitians?

Often we find ourselves in a situation when we have to clear some confusion around our title. Here are the most common myths we have to dispel about ourselves, every day.  

  • “That we only work with pediatric obesity, diabetes, heart disease or food allergies.”
  • “That we are going to shame parents for everything that is wrong with their child’s eating or weight”.
  • “That we are the diet police that will take away all of their favorite food in favor of quinoa, kale and tree bark!”
  • “People still believe that dietitian = weight concern. Especially among pediatric dietitians, the obstacles we help people overcome are varied and most often do not focus on weight loss. We help build parental confidence as we provide nutrition education backed by science. We help children achieve their optimum level of health by providing nutrition education appropriate to their age and health status. We encourage a long-lasting healthy relationship with food that will take them way beyond the adolescent years and into adulthood. ”

And on this positive note, I have to wrap up this exceptionally long post. There is so much more I would like to share about amazing dietitians working with children and families!

I hope it will contribute to a bigger discussion on where and how families can get support for their children, what dietitians can do in the field of child nutrition, how to get specialist training and have a rewarding career in child nutrition.

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