Lisa Jane Waddell

University of Nottingham | Notts · School of Biomedical Sciences

Background: Food allergy in infants and young children places a significant burden on primary care. This study evaluated a dietetic-led paediatric food allergy service, which attempts to provide more rapid access to the dietitian and reduce the need for general practitioner (GP) and secondary care appointments. Methods: Two community dietetic se...

Background Parents commonly ask about food allergy tests, to find a cause for their child’s eczema, yet the value of routine testing is uncertain. Objective To determine if a clinical trial comparing test‐guided dietary advice versus usual care, for the management of eczema, is feasible. Methods Children (>3 months and <5 years) with mild to seve...

Background Early-onset eczema is associated with food allergy, and allergic reactions to foods can cause acute exacerbations of eczema. Parents often pursue dietary restrictions as a way of managing eczema and seek allergy testing for their children to guide dietary management. However, it is unclear whether test-guided dietary management improves...

Lisa Waddell provides practical advice for nurses dealing with children who suffer from food allergies

Cows' milk allergy (CMA) is one of the most common presentations of food allergy seen in early childhood (2-3% of 1 to 3-year-olds in the UK 1) and is one of the most complex, implicated in both IgE (rapid onset following ingestion) and non-IgE mediated CMA (delayed symptoms occur usually 2 hours up to days after ingestion). Non-IgE mediated CMA is...

There is much confusion between the diagnostic terms lactose intolerance and cow’s milk allergy which are often used interchangeably, resulting in the potentially incorrect clinical management of these two distinct conditions. Parents and health professionals alike frequently exclude lactose from an infant’s diet in an attempt to treat symptoms inv...

According to the new NICE gastro-oesophageal reflux disease (GORD) guidelines for children, there is not enough evidence to support the belief that non-IgE mediated cow’s milk allergy (CMA) is a cause of GORD. NICE have therefore recommended specific research to answer this question. But what do we do in the meantime? This article addresses this qu...

A large number of parents I come across tell me their baby has lactose intolerance. Unfortunately, this may not be the case as lactose intolerance in babies is usually only secondary to another condition. This article discusses the differential diagnosis of lactose intolerance and cow's milk allergy. Link to article: http://foodallergynottingham.co...

Although a healthy, varied diet should be sufficient for the majority, certain population groups are at risk of micronutrient deficiencies, particularly young women of childbearing age, whose diets are commonly micronutrient poor and whose requirements increase peri-conceptually and throughout pregnancy and lactation. Infants and young children are...

The Royal College of Paediatrics and Child Health (RCPCH) Science and Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies; food allergy is the second pathway. The pathways focus on defining the competences required to improve the equity of care received by children with alle...

Food allergy is among the most common of the allergic disorders, with a prevalence of 6-8 per cent in children up to the age of three. However, many people self-diagnose, putting their children at risk of malnutrition, possibly as a result of lack of awareness by health professionals of food allergy as a potential cause of conditions such as infant...

The nutritional management of a child on chronic peritoneal dialysis (CPD) requires considerable dietetic input as frequent adjustments are necessary to account for growth and changes in biochemical parameters. The progress is described of a 6-year-old boy with chronic renal failure (CRF) from birth due to renal dysplasia. In contrast to the relati...

The need to optimise nutrition to promote growth in infants with chronic renal insufficiency (CRI) is well recognised, but there is less enthusiasm for such an approach in older children and those with milder degrees of CRI. Energy intakes and growth outcomes were prospectively monitored over a 2-year period in children aged 2–16 years with differi...

There is a lack of evidence to support the belief that dietary measures are beneficial in slowing the progression of chronic renal insufficiency (CRI). We prospectively monitored nutrient intakes and progression of CRI over a 2-year period in children aged 2-16 years with differing levels of severity of CRI, as part of their ongoing joint medical/d...

Vitamin A is known to accumulate in patients with chronic renal failure (CRF), but it is present in many micronutrient and all complete nutritional supplements. Measurements were made of serum vitamin A concentrations in eight children (mean age 6 years, range 2–15 years) on chronic dialysis six continuous cyclic peritoneal dialysis patients (CCPD)...

Practical joint dietetic/medical guidelines are required for children with differing levels of severity of chronic renal insufficiency (CRI). This thesis describes the current dietetic/medical package of care provided within a specialised paediatric renal unit, and provides an insight into considerations for future clinical guidelines. Children w...

Practical joint medical/dietetic guidelines are required for children with chronic renal insufficiency (CRI). Nutritional status and growth were compared in 95 children (59 male) >2 years age with CRI, grouped following [51Cr]-labelled EDTA glomerular filtration rate (GFR, ml/min/1.73 m2) estimations into ’normal’ kidney function [GFR>75 (mean 104...

To estimate the provision of dietetic care necessary to manage and support children receiving chronic peritoneal dialysis (CPD) with/without nutritional support via a gastrostomy button (GB) and their families. Three-year prospective, longitudinal study documenting dietetic contacts (direct: inpatient/outpatient, telephone, home, school, and family...

Dietetic care of infants with end stage renal disease (ESRD) involving intensive nutritional support and frequent monitoring in attempts to optimise growth has not been previously quantified. We describe the progress of two male infants born with ESRD due to renal dysplasia. Child A and child B were commenced on continuous cyclic peritoneal dialysi...