Nutrition

A dietitian is an allied health professional who provides expert nutrition advice informed by science to optimise diet in both health and disease.

In Australia, all dietitians are also nutritionists, as all dietitians must study nutrition at university. One of the key differences between a dietitian and a nutritionist is that a dietitian has the qualifications and skills to provide tailored nutrition advice for medical conditions – called ‘Medical Nutrition Therapy.’

Some dietitians working with children and young people in a clinic setting also do further paediatric nutrition courses.

A dietitian can work with your family to:

• Understand how DMD impacts nutrition and diet
• To monitor and manage growth (height and weight) in children, especially around the time children are introduced to steroids and during transition periods for physical function
• Optimise your food choices for DMD

In several states in Australia, there is dietitian that works with the neuromuscular clinic.

Children and young people with neuromuscular conditions may also be able to access a dietitian through the National Disability Insurance Scheme.

Alternatively, you can find an Accredited Practising Dietitian (APD) via the Dietitians Australia website: Find a dietitian. For children, you can search for dietitian with paediatric experience.

Some key times when a dietitian may be helpful include:

• Before starting steroids – a dietitian can assist with some tips to prevent excess weight gain and manage hunger. A dietitian can also assess dietary intake and provide dietary suggestions to ensure there is enough calcium in your child’s diet for bone health.
• When your child starts to use a wheelchair more often. This can impact the amount of energy they need from food. A dietitian can help adjust energy intake to prevent weight gain.
• If your child is gaining weight too quickly. A dietitian can provide suggestions to slow weight gain or to lose weight if needed.
• If your child is losing or has lost weight after an acute illness or surgery. A dietitian can provide suggestions for food or supplement intake to help stabilise or gain weight if needed.
• If your child is experiencing problems with constipation or other digestion symptoms, a dietitian (together with your medical team) may be able to assist with some dietary suggestions.
• If your child is experiencing problems with eating or swallowing, a dietitian can work together with a speech pathologist to suggest appropriate foods.
• If your child receives some or all of their nutrition via a PEG, a dietitian can provide advice on the type of feed, amount, timing, amount of additional fluid from water and whether your child needs additional nutrition supplements. A dietitian will monitor how your child is growing on their feeding regime and can help you adjust regimes if needed.
• If your child has other health conditions that are affected by diet, such as food allergies.
• If you want help planning a healthy, balanced diet for your family.

The dietitian will ask some questions about your child's medical and growth history, as well as what they would typically eat on a weekday and a weekend day. A dietitian will also measure your child's height and weight and plot this on a growth chart. In a dietitian's assessment of your child's nutrition and growth, they may also consider other aspect of their life such as mobility, physical activity, screen time, school, family life, mental health and family medical history. A dietitian may also ask your doctor to order blood tests to see whether they are receiving adequate nutrition (e.g. by looking at iron levels) or if there are any problems in the blood that are affected by too much or too little nutrition (e.g. blood sugar levels).