Continuing our series highlighting presentations from our Nursing in Practice 365 events, specialist paediatric gastroenterology dietitian Bonnie Samani outlines key principles in supporting optimal paediatric nutrition and explains how nurses in primary care can assess children’s growth and advise on healthy dietary intake and hydration.
Why is paediatric nutrition important?
Nutrition during childhood plays a vital role in supporting healthy growth, brain development, and long-term health outcomes. Primary care professionals are uniquely positioned to identify early nutritional concerns and provide timely interventions. Good nutrition in early life:
- Supports optimal growth and development, with key nutrients like iron, calcium, and vitamin D essential for brain function, bone strength, and immune health.
- Prevents deficiencies and associated complications, such as iron deficiency anaemia, poor concentration, weakened immunity, and increased risk of chronic diseases like type 2 diabetes and cardiovascular disease.
- Lays the foundation for lifelong healthy eating habits, helping to reduce the risk of obesity and other diet-related illnesses into adulthood.
Supporting growth monitoring in the early years
Monitoring growth is a vital part of promoting children’s health and wellbeing. In the UK, the UK-WHO Growth Charts are the standard tool used from birth to 17 years, endorsed by the Royal College of Paediatrics and Child Health (RCPCH). These charts are based on the World Health Organization Child Growth Standards, developed from data on healthy, breastfed children across diverse populations.
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Growth measurements – weight, length/height, and head circumference – should be plotted regularly to observe trends over time rather than relying on single measurements. Regular monitoring helps detect early signs of faltering growth, undernutrition, or excessive weight gain.
More information and downloads can be found on the RCPCH Growth Charts page.
Recognising red flags and when to refer
Primary care professionals should be alert to growth patterns that require further evaluation, such as:
- Crossing two or more centile lines (upward or downward).
- Discrepancy between weight and height centiles.
- Rapid centile crossing upwards, indicating possible overweight/obesity.
- Significant differences between head circumference and body growth.
Early referral to paediatric dietitians or paediatric services can ensure timely support for children showing concerning growth patterns.
Promoting healthy nutrition and hydration
Key principles for encouraging healthy dietary habits include:
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- Offering a varied diet rich in fruits, vegetables, starchy carbohydrates, dairy or fortified alternatives, and protein sources (eg, meat, fish, eggs and pulses).
- Limiting foods high in added sugar and salt to reduce the risk of obesity, hypertension, and dental caries.
- Encouraging the intake of iron-rich foods from weaning, especially in infants at increased risk of deficiency. Combining plant-based iron sources with vitamin C-rich foods can enhance absorption.
- Supporting vitamin D adequacy through fortified foods or supplements, particularly for breastfed infants and during the winter months.
Adequate hydration is essential for supporting children’s concentration, digestion, physical activity and overall health. Children are more vulnerable to dehydration than adults, particularly during hot weather or illness, and may not always recognise or respond to thirst cues. Encouraging regular drinking throughout the day is vital.
The best drink choices to recommend are:
- Water – the ideal drink throughout the day.
- Milk – a nutritious option, providing calcium, protein and other vitamins.
- Fruit juice – limited to no more than 150 mL/day, and ideally served diluted and with meals.
Advise parents and carers to avoid sugary drinks (fizzy drinks, energy drinks, and sweetened juices), which contribute to tooth decay, poor appetite regulation, and excess calorie intake.
In addition, some top tips for promoting hydration are:
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- Keep a reusable water bottle handy at school and during activities.
- Offer drinks regularly, not just when a child says they’re thirsty.
- Serve drinks with meals and snacks.
- Set a good example – children are more likely to drink water if adults do the same.
Ensuring children and teenagers stay well hydrated supports not only their physical health but also learning, mood regulation and concentration. Healthcare professionals can help reinforce these messages during health checks and routine care, particularly during growth spurts, summer months, or periods of illness.
Bonnie Samani is Specialist Paediatric Gastroenterology Dietitian at Chelsea and Westminster Hospital, London
