Paediatric Dietetics referrals

Oxford University Hospitals

Inclusion criteria

Children 0-18 years with any of the following:

Cow's milk protein allergy in under-1s with faltering growth (not for general CMPA online group session)
Allergy - multiple non-IgE allergy - Two or more of common allergens like milk / egg / wheat / soya / fish or other allergens impacting on nutritional intake (all suspected IgE mediated allergies to be referred to paediatric allergy clinic where they can access specialist dietetic input)
ARFID or suspected ARFID (dietitian-only appointment)
Children with complex needs / comorbidities (e.g. cardiac, respiratory, neurology, ex-preterm neonates, surgical)
Faltering growth (identified as per NICE Guidelines) - under-1s
Faltering growth - over-1s - Children with complex needs / comorbidities (e.g. cardiac, respiratory, neurology, ex-preterm neonates, surgical)
Rapid weight loss / unexplained weight loss: 0 -18 years - medical reasons excluded
Coeliac diagnosis - new and review

Exclusion criteria

IBD concerns - refer to Gastroenterologists
IBS not under a Gastroenterologist - note if under a Gastroenterologist can access dietetics via Dietetic Gastro Clinic

Oxford Health (community services)

Inclusion criteria

Children over 1 year of age with any of the following:
Cow's milk protein allergy in under-1s (non-IgE with no growth concerns).
CMPA online group session (iMAP guidance) - follow-up clinics for those requiring further support
Single allergy / intolerance - (mild to moderate non-IgE): milk and soya only
Fussy / selective/behavioural feeding problems - webinar sent to parents as first line advice.
No improvement and ongoing nutritional concerns in three months: 1:1 review available. Also relevant for autism (sensory webinar resources)
Nutritional inadequacy (moderate to severe) e.g. iron deficiency anaemia, calcium deficiency, Vitamin B12
Underweight / faltering growth: over-1s, (unless rapid unexplained weight loss), where weight is more than two centiles lower than height centile and where weight has gradually dropped two centiles
Obesity - only if it is a side effect / symptom of another underlying health condition

Exclusion criteria

New coeliac diagnosis

Mental health - CAMHS patients

Active / current / suspected eating disorder (anorexia nervosa, bulimia nervosa, binge eating disorder, EDNOS / OSFED)
At-risk patients who could be triggered by non-specialist dietetic intervention without benefit of MDT and specialist psychiatric support. (Ref BDA recommendations re MH dietetic expertise)

Allergy

IgE mediated or suspected allergy - refer to OUH Allergy Clinic

Weight management

Signpost to other weight management services:

Oxfordshire Healthy Weight Toolkit - Oxfordshire Healthier Together - please see here for most up to date information regarding services and resources which includes:

Here for Health - Oxford University Hospitals
Beezee Families - Free Healthy Lifestyle Services | Oxfordshire
Slimming World - Free2Go eating plan, activity booklet and app - free membership to slimming world if parent or guardian is a member

How to refer

Oxford Health Dietetic Service (Community)

Please send referrals to: Community.Dietitians@oxfordhealth.nhs.uk

Clinic letters will be accepted as a referral. Please provide as much supporting information either within the clinic letter or within the email - this can include anything relevant from a social or demographic perspective, safeguarding, blood test results etc.