Children and Young People (Paediatric) 5-18 service

Our expert Dietitian, Melissa Kaplan, draws on her extensive training and experience in paediatric dietetics and is highly skilled at engaging children and young people. Melissa recognises the challenge of engaging children, especially when food can be such an emotive subject and generate meal time anxiety.

General dietetics

The nutritional goal within paediatric dietetics is to provide adequate intake of all nutrients and promote lifelong health.

We believe that complete mental health and physical health requires a holistic approach. Food plays a role in optimising our well-being, bring feelings of comfort and community while giving our body essential nutrients to function best, across the lifespan.

Melissa works with children, young people and their families who are struggling with the following difficulties :

• Fussy/selective eating
• Intolerances
• Adhering to specialist diets
• Gastrointestinal issues
• Disordered eating – over or under eating (but please note not active restrictive eating disorder resulting in weight loss of lowered BMI as this requires an NHS approach via CAMHS).
• Helping families establish healthy eating patterns early on  

ASC and ADHD dietetic service

Melissa is attuned to the specific needs of children and young people with Neurodevelopmental Conditions (ASC, ADHD ,Sensory processing difficulties)  and their families .

Children with ASC often benefit from specialist  dietary support  because :

• Children with ASC are known to have more medical issues, including gastrointestinal (GI) symptoms such as abdominal pain, constipation and diarrhea, compared with their peers. 
• Many children with ASC eat only a few foods, prefer highly processed foods, and eat fewer fruits, vegetables and whole grains. This may often be driven by sensory processing issues.
• Making dietary changes can be difficult when a child is used to selective eating, and doesn’t tolerate change well.
• Children with ADHD may be sensitive to certain food types
• Some parents request advice on restrictive or elimination-type diets in an effort to manage symptoms or behaviours. Because restrictive diets increase the risk of nutrient deficiencies, they must be thoughtfully planned, monitored and supported. 

 What makes our approach to different at the St Andrews Practice ?

• Joined up working : Melissa can work jointly with our staff team members who offer a psychological , sensory, or communication based approach, as needed. These can impact significantly on dietetic issues .
• Detection and identification : We take a proactive stance in identifying dietary issues at the point of assessment (eg as part of standard ASC assessment)
• Whole family approach: Coaching about planning and preparing nutritious meals should involve the whole family

Treatment Plan

Typically this will include 4 sessions.

• The initial session (75 minutes) is a review of your 3 day food records (which you will complete prior to your dietician appointment.) You can then discuss pertinent past medical history, take anthropometric (physical)  measurements  to establish a baseline, and formulate nutrition related goals. 
• Three further sessions (30 minutes each). The first follow up will be one week after your initial visit , then fortnightly thereafter, depending on your needs.
• Melissa is skilled at creatively engaging children and young people
• By the end of the fourth visit, you and your child will have learned a significant amount of practical information to enable meal planning/preparation and food selection. If you are enjoying the accountability of having the dietitian check in with you then of course you can continue your appointments to ensure your progress/maintenance.

Please contact the St Andrews Practice for any questions regarding your child’s nutrition and how we could help you to improve their intake. 

Adult

We believe that complete mental health and physical health requires a holistic approach.  Our Dietitian, Melissa Kaplan, draws on extensive training and over twenty five years experience in dietetics. Melissa recognises the challenge of incorporating dietary change into a daily routine that may be  impacted bystudy/work/family commitments, and practical constraints. Melissa recognises the value of providing accountability to help clients sustain dietary change. She applies evidenced-based research to her clients…real food, no fads, just the facts!  

General dietetics

Melissa will work with you to understand better your nutritional deficits, excesses and needs and support you in incorporating foods that benefit you while reducing those that aren’t necessary. Melissa’s aim is to empower clients, to make the right food choices for individual needs and which are sustainable in the long term. Melissa works with adults struggling with the following :

• Intolerances and food allergy management : The guidance you need to help identify food allergies /sensitivites and create an eating plan including the right foods for you. 
• Sports nutrition education : No matter what your fitness goals are, or how experienced you may be, a customised eating plan will help you reach your optimum self. Get to the finish line feeling strong!
• Digestive issues : IBS, IBD, and other gastrointestinal disorders can be debilitating, and frustrating to say the least. Reduce pain and discomfort by choosing the rights foods and supplements for you.
• Diet for health conditions: diabetes, hypertension
• Diet for mental health Melissa has a unique understanding of the link between food and mental health whether diet has been impacted by mood, anxiety, trauma, or OCD.
• Women’s health: Melissa can advise on  diets to support the various challenges bodily and hormonal changes can pose to Women’s health. This may encompass fertility, pre natal, post natal and the menopause. Melissa can work with you to develop a bespoke plan to support your specific needs.
• Weight management support
• Disordered eating and unhealthy eating patterns – over or under eating (but please note not active restrictive eating disorder resulting in weight loss of lowered BMI as this requires an NHS approach ). Melissa is highly attuned to the needs of those recovering from eating disorder , both dietary and in terms of how to communicate and approach eating issues.

 ADHD and ASC dietetic service

Melissa is attuned to the specific needs of  adults with Neurodevelopmental Conditions (ASC, ADHD, Sensory processing difficulties)  . Adults with ASC and ADHD often benefit from specialist  dietary support  because

• Adults with ASC often present more frequently with digestive and gastrointestinal issues and food intolerances. Adults with ASC are at increased risk of obesity, high blood pressure (hypertension) and diabetes.
• Adults with ASC food preferences may be impacted by sensory sensitivity and a preference for sameness and routine
• There are no official dietary guidelines for adults with ADHD , however research into this is ongoing with some emerging evidence of nutrients and foods which may worsen and improve ADHD symptoms.
• Organisational abilities which may be impacted in these conditions may make the practicalities of meal planning and shopping difficult. Melissa will work with you to factor this on.
• Melissa can work with other members of the team where this is thought to be helpful

Treatment Plan

Typically this will include 4 sessions.

• The initial session (75 minutes) is a review of your 3 day food records (which you will complete prior to your dietician appointment.) You can then discuss pertinent past medical history, take anthropometric (physical)  measurements  to establish a baseline, and formulate nutrition related goals. 
• Then three further sessions (30 minutes each). The first follow up will be one week after your initial visit , then fortnightly thereafter, depending on your needs.
• By the end of the fourth visit, you will have learned a significant amount of practical information which will allow for you to make educated choices around meal planning/preparation and food selection. If you are enjoying the accountability of having the dietitian check in with you then of course you can continue your appointments to ensure your progress/maintenance.

Please contact the St Andrews Practice with any queries you may have or if you would like to make a referral via book an appointment