Clinical Nutrition

• Our dietitians specialize in caring for your growing child. We are experts in normal growth and development and how to feed children based on their age and health needs.
• We follow evidence-based recommendations to design a nutrition plan that will get the best results for your child.
• To provide your child with complete team-based care, we work closely with pediatric health professionals in more than 25 Seattle Children’s clinics — both at our hospital campus in Seattle and at our other locations around the region.

• The children we work with have many different conditions. We believe in nurturing each child nutritionally, physically and emotionally, and supporting each family toward good nutrition.
• Your child and family are unique. We partner with you to make a nutrition plan that will work for you at home. We consider things like your schedule, the foods you like to eat and whether you have other children with different nutrition needs.
• The services we offer will depend on your situation. Services could range from a single visit about 1 aspect of nutrition to a series of visits over a longer time to set and reach nutrition goals.

• Our dietitians are part of teams throughout Seattle Children’s so you can see us in the clinics you already visit. Often we see children alongside their doctor or in back-to-back appointments in the same exam room.
• Your Seattle Children’s providers can request Clinical Nutrition services, or you can ask your child’s care team to involve us.
• If your child is not already a patient at Seattle Children’s, ask your child’s primary care provider to refer you to our Nutrition Clinic.

• Our dietitians take part in research to expand their understanding about the role of nutrition in children’s health and disease. We often partner with other types of healthcare providers on studies that look at nutrition along with other factors.
• We engage with healthcare providers around our city, state and country through conferences and other events to improve the practice of pediatric nutrition for kids everywhere.

Nutrition is an important part of keeping your child well enough to receive and recover from cancer treatment.

Our dietitians help ensure your child gets the nutrients they need, either by mouth or through another method, like a feeding tube. If cancer treatment makes it hard for your child to eat or lowers their appetite, we help you deal with these side effects. We have the specialized knowledge to provide nutrition care for all types of cancer and cancer treatments, including bone marrow transplant, for children of all ages.

Through Seattle Children’s Adolescent and Young Adult Cancer Program, we work with patients in their teens and 20s on their nutrition needs.

Read more.

Our dietitians help treat children who have problems with the bones of their skulls or faces that affect the way they eat. For example, we often see babies with cleft lip or cleft palate, which can make it hard to breastfeed or feed from a bottle.

We help care for your child before surgery, while they are in the hospital for surgery and after their hospital stay when they come back for clinic visits. Nutrition care helps your child grow and be healthy and strong enough for a successful surgery and recovery.

Read more.

Healthy eating is an important part of reversing or treating insulin resistance and lipid disorders and preventing or living with diabetes.

When your child eats, their body turns food into glucose, the main sugar in the blood. The hormone insulin helps glucose get into a child’s cells to give the cells the energy they need.

• In type 1 diabetes, your child’s immune system destroys the cells in the pancreas that make insulin.
• In type 2 diabetes, your child’s body cannot respond to insulin the way it should. In insulin resistance, your child does not have diabetes, but their insulin cannot keep their glucose levels normal after they eat. This can turn into type 2 diabetes. 

Lipid disorders are conditions that cause abnormal levels of fats — like cholesterol and triglycerides — in your child’s blood. This raises your child’s risk for diabetes, early heart attack and stroke.

If your child has any of these conditions, a dietitian works with you and your child to make a healthy eating plan that fits your life, including:

• What foods your child likes
• Your family’s schedule
• What you like to cook

Read more.

We work with other specialists at Seattle Children’s to help children and teens with eating disorders, such as anorexia nervosa, bulimia nervosa and others. For example, if your child doesn’t get enough nutrition because they limit the amount or types of foods they eat, a dietitian helps with things like these:

• Teaching your child about normal metabolism and what happens to metabolism when someone restricts eating
• Setting a healthy weight goal and making a plan to help your child reach this goal
• Knowing how many calories and how much protein, fat and carbohydrates your child needs each day to be healthy
• Tracking the nutrition your child gets

Read more.

If your child has epilepsy that is not controlled with medicine, their care team may recommend a special diet. Nutrition therapy — usually combined with medicine — lessens or stops seizures for some children.

Two options are the ketogenic diet and the modified Atkins diet. Both diets limit the types of foods your child eats.

Dietitians work with the rest of your child’s team to:

• Help you decide if nutrition therapy is the right choice for your child
• Make sure your child receives the nutrients they need to grow and keep a healthy weight

Read more.

Some babies and children have feeding problems that may stop them from getting the nutrition they need. These problems include not wanting to eat or refusing to eat or nurse (feeding aversion), trouble moving to solid foods and food allergies.

Along with your child’s other healthcare providers, our dietitians help to understand the problem, make a treatment plan that’s right for your child and support the feeding plan your child needs to be healthy.

Based on your child’s condition, we may see your child in 1 of these clinics:

• Nutrition Clinic
• Pediatric Feeding Program at Seattle Children’s Autism Center

We help children with a wide range of gastrointestinal (GI) and liver conditions that can affect feeding, growth and development, including these:

• Celiac disease, when your child needs a gluten-free diet.
• Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. IBD may be treated with the Specific Carbohydrate Diet and other options.
• Intestinal failure, which may require total parenteral nutrition (TPN), intestinal rehabilitation or intestine transplant.
• Irritable bowel syndrome (IBS), in which certain foods may trigger symptoms. A low FODMAP diet is a therapy option for IBS.
• Liver diseases that can lead to liver failure and liver transplant.
• Short bowel syndrome (SBS), which limits the nutrients your child’s bowel can absorb. Children with SBS may need TPN, intestinal rehabilitation or intestine transplant.

Dietitians play a central role in caring for children with these and many other GI and liver problems. We help you understand and track your child’s condition, follow special diets and use different feeding methods — by mouth, feeding tube or intravenous (IV) line. We work closely with the rest of your child’s team to monitor your child’s health and coordinate their care.

Read more.

Seattle Children’s dietitians, medical providers, social workers and fitness specialists work together in these clinics to help with concerns about weight:

• Child Wellness Clinic — for ages 2 to 11

We work with your family to make changes to improve your child, teen or young adult’s long-term health and quality of life. We look at the medical, nutritional, social, physical and emotional aspects of weight gain so we can care for your child and family needs.

The Child Wellness Clinic is part of Seattle Children’s Obesity Program.

• Cystic fibrosis
• Hypertension
• Inborn errors of metabolism
• Kidney disorders
• Neurodevelopmental disorders
• Pulmonary disorders
• Sleep apnea

A dietitian can meet with you and your child 1 time or in a series of visits to give you information about a specific nutrition topic. We share facts, guidance, tools and resources to help with your current concern, like a new diagnosis. We also teach new skills, like how to mix a special formula that your child needs to eat. 

If your child is working toward long-term goals — like managing their weight or living a healthy life with diabetes — a dietitian can provide counseling to support changes in your child’s behavior over time. Examples of counseling include figuring out the small steps your child can take to reach their goal and adjusting your child’s nutrition plan if their condition changes.

Some children have complex nutrition needs that need special support. Our dietitians work with you and your child’s care team on:

• Using a feeding tube, like a G tube (gastrostomy tube) or NG tube (nasogastric tube)
• Total parenteral nutrition (TPN)
• Special diets that are part of your child’s care, like a gluten-free diet for celiac disease or the Specific Carbohydrate Diet for inflammatory bowel disease

The team in the Child Wellness Clinic works with you and your family on the medical, nutritional, social, physical and emotional aspects of weight gain if your child is age 2 through 11. Read more.

If your baby is staying overnight in Seattle Children’s Hospital, our board-certified lactation consultants help you with breastfeeding or pumping your milk. Read more.

In the Nutrition Clinic, dietitians see babies, children and teens who:

• Do not have an underlying condition that is causing a nutrition problem
• Need nutrition care for normal growth and development
• Have a referral to the Nutrition Clinic from their primary care provider

These are some of the reasons a provider might refer your child to the Nutrition Clinic:

• Your child has a low weight for their age or other growth concerns and may need more calories.
• Your child has feeding concerns, like trouble chewing, swallowing or making the change from breastfeeding to drinking from a cup. Dietitians work with occupational therapists to help with these challenges.
• Your child has been diagnosed with a food allergy, and you want help learning what your child can or cannot eat and how to make sure they get the nutrients they need.
• Your child is selective (“picky”) about the foods they eat, and this might keep them from being well nourished.
• Your child’s primary care provider thinks your child may benefit from diet changes because they are low in vitamins or minerals, like iron.
• Your child takes part in sports or other intense activity, like dance, and wants to know more about how to eat to best support their activity level.
• Your child has low weight because they take medicine for attention deficit hyperactivity disorder.
• Your child will have surgery for an orthopedic condition, like scoliosis, and needs nutrition care to prepare their body for the surgery and recovery.
• Your child is younger than 2 and is gaining weight faster than normal, which might lead to health problems. (For weight concerns, children ages 2 through 11 are seen in the Child Wellness Clinic.

We offer Nutrition Clinic visits at these locations:

• Hospital campus in Seattle
• Bellevue Clinic and Surgery Center
• Seattle Children's Federal Way