Home

In this podcast Timira Naicker walks us through her journey as a dietitian and how she made the transition into the field of regulatory. Timira gives us great insights about her regulatory dietitian role, what are her interests, what does a typical day looks like and how you can think about a career in regulatory. Disclaimer: BDA endorsement applies only to the educational content of the learning activity.

Information for Healthcare Professional Use Only

Information for Healthcare Professional Use Only

In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel interviews Marie Watson, a paediatric specialist dietitian, about her experience managing enteral nutrition patients in the community. Marie shares her journey into dietetics and her passion for working with children.

Marie shares her knowledge about peptide feeds compared to whole protein enteral feeds and the clinical benefits of these types of feeds.  Peptide feeds are commenced in response to poor tolerance to whole protein enteral feeds.

Marie outlines the process of transitioning patients to peptide feeds, emphasising a slow, gradual approach to monitor for adverse effects such as worsening tolerance/gastrointestinal symptoms. She notes that while most patients experience improved symptoms, it is crucial to be prepared to revert to whole protein feeds if necessary.

The discussion explores the use of low-calorie peptide feeds for patients prone to excessive weight gain, highlighting the importance of achieving adequate protein and micronutrient intake while managing calorie levels, helping to overcome the challenges of balancing feed volume and tolerance with meeting nutritional needs. Examples of the use of peptide feeds in clinical practice are also discussed.

Marie stresses the significance of a multidisciplinary team approach, involving gastroenterology consultants and tube feeding nurses, to provide comprehensive care for enteral nutrition patients.

Information for healthcare professional use only

In this episode of the Inside Medical Nutrition Podcast, Dr. Linia Patel discusses the tolerance of blended diets with experts Lucy Jackman, a paediatric dietitian, and Dr. Graham O'Connor, a research lead for dietetics, both from Great Ormond Children's Hospital.

The conversation begins with the experts sharing their backgrounds and their journey into dietetics. The discussion then shifts to the increasing use of blended diets, which are household foods blended into a liquid form for tube feeding. Parents are increasingly drawn to blended diets due to a desire for natural food and the feeling of fulfilling their role as caregivers.

The experts address concerns about blended diets, including tube blockages, nutritional adequacy, and food hygiene. Research suggests that in practice, these concerns are not significantly different compared to commercial formulas. Key considerations for blended diets include using appropriate tube sizes, avoiding nasogastric (NG) tubes, ensuring proper consistency, and maintaining food safety standards.

The podcast explores the role of food-derived ingredient formulas as a middle ground between blended diets and commercial formulas. The speakers share their experience of using these formulas and how they can be particularly useful in hospital settings where providing fresh blenderised food is challenging. They also offer a way to control electrolytes and provide fibre, which is beneficial for gut health, both of which is particularly important in intensive care patients.

Once the decision has been made to start a child on a blended diet, it’s never the dietitian alone who is responsible for supporting this. The entire multi-disciplinary team needs to be aligned and working closely together to help support this patient. Harriet Farr talks us through the role of the MDT in supporting blended diets and how this is best structured, communicated and monitored.

Information for Healthcare Professional Use Only

Information for Healthcare Professional Use Only

In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel interviews Ibrahim Amin, a lead practice pharmacist, about his experience managing cow’s milk protein allergy (CMPA). Ibrahim shares his journey into pharmacy, driven by a love for chemistry and a desire for patient contact.

The conversation explores the pharmacist's role in cow’s milk protein allergy (CMA) management, emphasising that it extends beyond dispensing prescriptions. Ibrahim discusses supporting patients and healthcare professionals, conducting audits, and ensuring adherence to guidelines. He highlights the importance of recognising that pharmacists are medicine experts and can provide valuable advice.

Ibrahim notes a concerning trend of delayed diagnoses and inappropriate management of CMA, often stemming from initial visits to A&E. He stresses the need for accurate diagnoses, appropriate formula prescriptions, and ongoing monitoring of patients. He discusses some of the common symptoms of cow’s milk allergy such as rashes and gastrointestinal symptoms.

The discussion delves into the importance of communication and collaboration within a multidisciplinary team. Ibrahim emphasises the value of virtual MDT meetings, which improve efficiency and accessibility.

Ibrahim shares practical tips for managing CMA, including reminding parents that "breast is best" and providing guidance on dairy-free diets for mothers who are breastfeeding. 

Information for Healthcare Professional Use Only

In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel interviews Harriet Farr, a paediatric home enteral feeding dietitian, about navigating blended diets on a budget amidst the current cost of living crisis. Harriet shares her journey into dietetics and her passion for supporting children requiring tube feeding.

The conversation begins with a definition of what is a blended diet, emphasising the use of real food ingredients blended to a suitable consistency for administration via gastrostomy tubes. Harriet also mentions commercially made feeds with food-derived ingredients. She then delves into the practical aspects of supporting families on blended diets, including liaising with medical teams, providing information on benefits and potential problems, and ensuring safe preparation and administration.

A significant portion of the discussion focuses on the impact of the cost-of-living crisis on families using blended diets. Harriet acknowledges the financial strain and the reluctance of parents to discontinue blended diets due to the positive impact on their children's gastrointestinal symptoms. She emphasises the importance of dietitians being aware of these challenges and offering practical solutions.

Harriet provides several budget-friendly tips, such as utilising more affordable protein sources like beans and lentils, which also offer added fibre. She suggests considering frozen fruits and vegetables and batch cooking to reduce costs and time. Harriet also highlights the importance of menu planning, shopping lists, and buying in bulk.

Information for Healthcare Professional Use Only

In this episode of Inside Medical Nutrition, Dr. Linia Patel interviews Jacqui Lowdon, a paediatric specialist dietitian, about managing enteral nutrition patients in the community. Jacqui shares her journey into paediatric dietetics, starting with an interest sparked during a placement at a children's hospital. She discusses her current role as a clinical specialist in cystic fibrosis (CF) and her involvement with the British Dietetic Association.

The conversation delves into current trends in enteral nutrition, noting an increase in children with respiratory issues requiring long-term ventilation and tube feeding. Jackie explains the criteria for choosing a feed, considering factors like the duration of feeding, the patient's ability to take oral diets, and potential underlying conditions. She emphasises the importance of understanding the patient's overall nutritional needs and tolerance to support enteral feeding at home for children.

Jacqui highlights the evolution of available enteral feed formulas, from basic whole protein options to more specialised choices like fibre-containing, lower calorie, higher calorie, whey-based, and peptide-based feeds. She explains the use of peptide feeds for children who don't tolerate whole protein feeds and high-calorie feeds for those with high energy needs or limited tolerance for large volumes.

The discussion emphasises the crucial role of parents and carers in decision-making. Jacqui stresses the importance of open communication, considering cultural backgrounds and religious beliefs. She shares a case study illustrating the challenges of convincing resistant parents to switch feeds, ultimately succeeding through persistence and a bit of luck.

Clare Thornton-Wood shares her experience of supporting children with blended diets and discusses why they are becoming more popular amongst parents and carers. Why are they preferred by some parents? How do they benefit the children and the family? And how can dietitians themselves ensure they are set up to support parents wishing to start a blended diet? Clare also talks through what the BDA has to say about blended diets with a look at their latest policy statement.

Information for Healthcare Professional Use Only

In this podcast Dr Michelle Harvie discuses the importance of research and setting research questions to test a hypothesis. One particular interesting area of work researched by Michelle is the very low-calorie diet and the 5:2 diet within diabetes. Disclaimer: BDA endorsement applies only to the educational content of the learning activity.

Information for Healthcare Professional Use Only

Managing the nutrition and hydration needs of dysphagia patients in the care home setting can be challenging. Sophie Murray Quality Improvement and Regulatory Partner for Signature Care Homes sits down with Linia to discuss optimal management and the positive impact this can have on patient outcomes.

Information for Healthcare Professional Use Only

Information for Healthcare Professional Use only

In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel hosts a discussion with Sandra Robinson, a speech and language therapist, and Caroline Hill, a dietitian, about the importance of a multidisciplinary team (MDT) approach in managing patients with dysphagia.

The discussion begins by defining the different types of teamwork: multidisciplinary, interdisciplinary, and transdisciplinary. The guests emphasise the value of an interdisciplinary approach (IDT), where team members actively collaborate and communicate to provide coordinated care. They contrast this with a multidisciplinary approach, where professionals work independently with less interaction.

The podcast highlights the diverse members of an MDT, including physicians, nurses, therapists, assistants, chefs, and, importantly, the patients and their families. They discuss how MDTs function in primary care and the role of specialist nurses in bridging communication gaps.

The conversation explores the impact of COVID-19 on dysphagia management, particularly the increased reliance on telehealth. While telehealth offers benefits, it also presents challenges, such as ensuring patient safety, relying on facilitators, and addressing communication barriers. Best practices for virtual consultations include being prepared with technology, supporting patients and facilitators, and setting clear expectations.

The guests stress the importance of ongoing education and awareness of dysphagia, suggesting that speech and language therapy training should begin at the undergraduate level. They also propose considering a title like "dysphagia practitioner" to better reflect the scope of practice.

Information for Healthcare Professional Use Only

In this episode of the Inside Medical Nutrition podcast, Dr. Linia Patel interviews dietitians Jamie Leung and Sam Ogundere about blended diets in transitional care. Jamie and Sam discuss their roles supporting patients needing enteral feeding, as they observe  an increasing number of adults requiring blended diets. They highlight the variety of conditions necessitating enteral feeding tubes, including stroke, MND, Parkinson's, and cancer.

The conversation explores the use of homemade blended diets, with Jamie estimating that around 5% of their paediatric caseload relies entirely on blended diets, while 30% use them partially. They share positive experiences regarding tolerance and the natural inclination of parents to blend familiar foods. Challenges include inconsistent support from schools and the resource demands of administering blended diets.

The discussion shifts to tube feeds with food-derived ingredients, which both dietitians embrace as a valuable option, particularly for parents with limited time, small kitchens, or financial constraints. They acknowledge that awareness of these options is still growing, and that initial management often focuses on medical solutions.

Jamie and Sam emphasise the importance of open-mindedness, flexibility, and parental involvement in blended diet management. They recommend the EPSGHAN guideline for children and the BDA toolkit as helpful resources. The need for risk assessment forms, information leaflets, and nutritional analysis programs is also highlighted.