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Field Talk is a monthly blog post sharing the voices of early childhood providers who serve or have served military families of young children with disabilities (birth to 5 years old).  We hope you find it to be educational, personable, and encouraging.

This month we spoke with LaDonna Aebisher, MS, RD, LDN, CSP who works as a clinical registered dietitian at Carle Foundation Hospital in Urbana, IL.  Carle Hospital serves a variety of patients in its 393-beds. It also serves as the area’s only Level I Trauma Center. Ms. Aebisher is  responsible for a Surgical ICU, Pediatric ICU, Advance Care Unit, and a Pediatric Ward.

Describe your current role.
I manage enteral and parenteral orders (feeding methods using the gastrointestinal tract or a vein), complete nutritional assessments, diagnose and treat malnutrition, provide medical nutrition therapy for all medical conditions, and collaborate with physicians and other healthcare personnel. It addition, I locate, analyze, and integrate nutrition-related research into clinical practice and complete policy and protocol development.

What’s your favorite part of your current job?
Nutrition is a field that is truly fascinating and I love working with children! They always give me hope in difficult situations. It is very rewarding to see children improve with the support of nutrition. Nutrition, growth, and development are an integral part of the daily plan of care and I have the opportunity to play an important role in a child’s health care which is extremely fulfilling.

What are some strategies or resources that are useful in supporting a family whose child has a limited repertoire of food?
There are programs in the community that provide food assistance. For example, SNAP (Supplemental Nutrition Assistance Program) offers nutrition assistance to low-income individuals and families. SNAP is the largest program in the domestic hunger safety net. WIC (Women, Infants, and Children) is another great community program. WIC provides federal grants to states for supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women, and to infants and children up to age five who are found to be at nutritional risk. Most communities also have food pantries and church ministries that provide food and resources for families in need.

How do you balance nutritional needs given a child’s food tendencies and preferences? What strategies can a provider use to help a parent ensure their child’s nutritional needs are being met in such instances (e., a child who will only eat crunchy foods, or foods at a very hot temperature)?
Food tendencies and preferences can differ from child to child. There are different approaches and there is not a specific one that is the best for every child. I have seen success when the child is encouraged to help plan meals and grocery shop. It is important to respect the child’s opinion which may help reduce power struggles. For some children, the amount of food offered at meals can prevent adequate intake. Children may become overwhelmed with the task of eating a large, full plate of food. For some children, decreasing portion sizes and increasing the frequency of feedings may help. Provide positive reinforcement for desirable mealtime behaviors and ignore disruptive behaviors. Mostly importantly, be a role model by eating and enjoying the same foods you want the child to eat.

What are some strategies that providers can use to help families introduce new foods that are outside of a child’s preference? For example, how might you help a family introduce new foods when their child will only eat a food of a particular color or texture?
From my experience, I have seen the most success when offering new and different foods, especially fruits and vegetables, alongside food items the child already enjoys. I always recommend that family members do not give up if their child will not try foods the first few times they are offered. Many children need to be offered a new food several times before they will eat it. Some children who are especially sensitive to tastes, textures, smells, or new things may need even more chances.

Are there certain vitamins or minerals you have found that improve the symptoms of autism?
At this time, research does not support the use of specialized diets or specific vitamins or minerals to improve symptoms of autism.

For parents who do choose a Gluten free, Casein free (GFCF) diet, it is much harder to get adequate nutrition for the child. What do you suggest that parents do in this case?
Many families may explore the use of special diets like GFCF and/or supplements. It is recommended to discuss the GFCF diet with your child’s pediatrician. In addition, a registered dietitian nutritionist (RDN) understands the dietary restrictions involved and how they might interact with a child’s specific health conditions and nutritional needs. A RDN evaluation can reassure the family regarding their child’s nutritional intake.