How long will the visit last? Will it start on time?
It will take approximately one or two hours, however, the length of your child's visit will depend on the diagnosis and what he or she is being treated for. Regardless of the type of visit, please prepare for waiting time in the clinic and the possibility of staying longer in case further tests and/or procedures are necessary.
What does the visit consist of? Will there be testing?
The format of your child's visit depends on his or her diagnosis and reason for being at the hospital. The dietitian most often discusses eating and food with you and your child and decides from that what the best way to move forward would be. If necessary, yes, there may be tests and procedures that day, depending on the diagnosis.
What kinds of tests will your child need?
Depending on your child's diagnosis and reason for the visit, there are many possible tests that may be performed. Some tests may be measured at every visit and other tests are usually periodically measured. Possible tests include:
Weight, height, head circumference: growth measurements taken on a scale, stadiometer and using a tape measure.
Recording of dietary intake: may be just a 24-hour recall or you may be requested to fill out a form for a 3-day food record.
Skinfold Measurements: assesses body fat and muscle stores using calipers.
Labs: check blood levels for electrolytes, liver function test, vitamin and mineral levels and others as needed.
Urine samples: assessing for electrolyte, glucose and/or protein losses.
Stool collections: could be a one-time test or a 72-hour collection to check for fat malabsorption. If necessary, may need to analyze it for other nutrient losses.
Indirect calorimetry: assesses energy expenditure using computerized system where the patient lies under a clear hood so the expired CO2 is collected and analyzed.
Will any of these tests hurt?
No. None of the tests or exams that we do for nutrition are invasive or painful.
Do I have to bring my child with me?
Yes. It is very important for the dietitian to see the patient for a proper assessment to be made. In addition, there may be a need to perform tests, such as arm anthropometrics, and to take an accurate weight and height measurement, so there is a proper and consistent way to compare these variables at follow-up visits.
Is it better to see the registered dietitian (RD) first, or the specialist that I'm seeing the same day and then see the RD?
Because we work as a team at Boston Children's Hospital, unless otherwise instructed prior to your visit, it does not matter what order your child sees the dietitian and the specialist in the same visit.
Does Boston Children's have any RDs at the satellite where I see my gastroenterology doctor?
Yes, there are nutritionists available at Lexington, Peabody and Waltham.
My child has not seen an RD yet, but we have a quick nutrition question. What should we do?
Because there are so many questions we need to have the answers to and, before we can give you a legitimate answer to any questions you and your child may have prior to the initial visit, we often recommend waiting for your child's RD visit.
How Should You Prepare Before Coming To The Hospital?
As a parent, the best way to prepare for your child's visit to the Nutrition Center is to:
- Bring a growth chart or recent growth measurements.
- Bring food records, if requested by your child's physician. The requested food records are 72 hour food recalls of your child's food intake.
- Bring a list of medications that your child takes.
- Call a week or two ahead to let staff know of special formula, foods and/or feedings that your child needs before he or she is admitted to the hospital.
- If you do not call ahead and your child requires special feedings or food or special formula, please make sure to bring more than enough for any type of visit. In the event of a late admit or if your child's visit gets extended, we prefer you to be prepared, as we may not have the necessary special nutrition readily available.
- Expect the possibility of tests and/or procedures to be done at your child's visit, although primarily the nutritionist talks about what your child eats.
Plan at least 30 to 60 minutes time before your child's appointment for traffic, parking and clinic check in.
- Expect a co-pay for the Registered Dietitian (nutritionist) at the time of your child's clinic check in.
- Unless specifically instructed to fast prior to visit, your child does not have to fast.
How long will you need to be at the hospital?
If your child is an in-patient, staying overnight in the hospital, the amount of time he or she will need to be in the hospital depends on the medical condition being treated. If your child is at the hospital for ambulatory (outpatient) care and will only be there for a day-time appointment, then you and your child should plan to be here for one to two hours.
What can you expect after a visit with a Registered Dietician (RD)?
As a parent, you should expect follow-up recommendations dependent on the diagnosis and outcome of the visit. If needed, the doctor will order special dietary/formula changes.
What can you do if you have questions after the visit?
Please feel free to contact the Nutrition Center staff with any questions at 617-355-6177.
Questions that involve re-evaluation, new education or significant time lapse since your child's initial appointment will require a scheduled follow-up clinic visit.