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Nutrition - resources for specific groups

This page highlights resources relevant to specific groups and practice areas. You may also find it useful to look at:

Resources are arranged under the following headings:

Some of the resources on this page are in PDF format - see how to access PDF files.

Children

Lancet (2013) Maternal and child nutrition
Maternal and child undernutrition was the subject of a series of papers in The Lancet in 2008. Five years on maternal and child undernutrition are re-evaluated, and the growing problems of overweight and obesity for women and children, and their consequences in low-income and middle-income countries are re-examined. Many of these countries are said to have the double burden of malnutrition: continued stunting of growth and deficiencies of essential nutrients along with the emerging issue of obesity. National progress in nutrition programmes and international efforts toward previous recommendations are assessed.

National Institute for Health and Clinical Excellence Public Health guidance PH11 (2008) Maternal and child nutrition. Guidance for midwives, health visitors, pharmacists and other primary care services to improve the nutrition of pregnant and breastfeeding mothers and children in low income households
This guidance aims to address disparities in the nutrition of low-income and other disadvantaged groups compared with the general population. It is relevant for all women who are pregnant (or planning to become pregnant), mothers of children aged under five and others who care for children aged under five.

National Institute for Health and Clinical Excellence (2006) Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children This guidance includes recommendations on the clinical management of overweight and obesity in the NHS, and advice on the prevention of overweight and obesity that applies in both NHS and non-NHS settings. 

NHS Quality Improvement Scotland (2007) Caring for children and young people in the community receiving enteral tube feeding: best practice statement
This statement specifically addresses issues in nasogastric, gastrostomy and jejunal feeding. The importance of communication and sharing of information between local and regional services is key to ensuring best practice for those children and young people and this is reflected throughout the statement. This statement is made available by Healthcare Improvement Scotland.

Royal College of Nursing (2010) Nutrition in children and young people with cancer (PDF 326KB)
This examines the particular problems faced by children with cancer in obtaining good nutrition and recommends ways in which hospitals can improve food provision to offset some of these problems. It looks at the management of nutrition in young cancer patients in detail. This guidance has been developed in conjunction with members of a multidisciplinary team including specialist paediatric dieticians and paediatric oncologists.

Royal College of Nursing (2007) Formula feeds. RCN guidance for nurses caring for infants and mothers (PDF 201KB)
Exclusive breastfeeding is recommended for the first six months of a baby's life. However, the 2000 Infant feeding survey (DH, 2002) shows that after six months, breastfeeding figures drop significantly. While nurses should continue to promote breastfeeding, they also need to be able to advise parents and help with formula feeding. This guidance provides basic information to help nurses caring for infants and their mothers, whether in hospital or community settings. It is set out as a question and answer leaflet, covering why some infants are given formula feeds; what the NMC and the Baby Friendly Initiative say about formula feeding; what are the differences between formulas, and how they should be prepared and stored.This publication has been supported by an unrestricted educational grant from SMA Nutrition.

Royal College of Nursing (2006) Malnutrition: What nurses working with children and young people need to know and do. An RCN position statement (PDF 1.22MB)
This position statement, which is aimed at nurses in GP practices, outpatient departments, hospitals, health centres and schools, looks at the possible causes of malnutrition in children, how to recognise major or minor problems that might be related to poor nutrition and what steps should be taken.

School Food Trust (2012) Eat better, start better: Voluntary food and drink guidelines for early years settings in England: a practical guide
This guide is for early years providers and practitioners providing meals, snacks or drinks to children aged one to five years. All regulated providers are encouraged to use this guide, regardless of the amount of time children spend in the setting. The guide has seven interrelated sections which are also available to be downloaded individually.

Scottish Government (2011) Improving maternal and infant nutrition: a framework for action
The framework is aimed at a variety of organisations with a role in improving maternal and infant nutrition. It includes indicators for short, medium and long term outcomes and provides case studies of some of the good practices already in place across Scotland.

Scottish Government (2006) Nutritional guidance for early years: food choices for children aged 1-5 years in early education and childcare settings
This sets out the nutritional requirements for children aged one to five, providing practical advice on how to ensure that these requirements are met.

Welsh Government (2011) Appetite for life action plan
Appetite for Life sets out the strategic direction and actions required to improve the nutritional standards of food and drink served in schools across Wales. Appetite for Life sets out the strategic direction and actions required to improve the nutritional standards of food and drink served in schools across Wales.
A series of supporting documents has been produced to support school meal providers in implementing the action plan. This includes implementation guidelines, an evidence toolkit and assessment tools.

Also available is the report from a 2 year action research project involving four local authorities which tested the guidelines for implementing the food and nutritional standards proposed in this action plan and learn lessons from this project to inform wider application across all maintained schools in Wales - see Appetite for Life action research project 2008-2010.

Learning disabilities

British Dietetic Association (2008) Home enteral tube feeding for adults with a learning disability (PDF 1001.6KB)
This Consensus Statement is intended to inform and support the practice of dietitians who are not undertaking a specialist learning disabilities (LD) role but do care for adults with a LD within their caseload. The statement may also be a useful resource for other professionals. It is based on a systematic review which looked at the evidence supporting the assessment, monitoring, complications and ethical issues specific to adults who have a learning disability and who require enteral tube feeding for nutrition and/or hydration and/or medication. 

Hampshire Safeguarding Adults Board. The Group was worried that in Hampshire 5 people with learning disability died from choking.The Group saw that people with learning disability were at greater risk of choking than other people. Reports showed that some services did not give good care to people with learning disability. The Group wanted to make sure that people were safe and not at risk of choking.  See the Learning Disability & Choking document for further detail on this project.

Improving Health and Lives: Learning Disabilities Observatory. Health Inequalities & People with Learning Disabilities in the UK: 2010. People with learning disabilities have poorer health than their non-disabled peers, differences in health status that are, to an extent, avoidable.

National Patient Safety Agency (2007) Ensuring safer practice for adults with learning disabilities who have dysphagia
This resource was developed by the National Patient Safety Agency (NPSA) because of the numbers of reports received on choking-related incidents involving adults with learning disabilities, the majority of which occurred at mealtimes. It provides guidance and other tools to ensure safe practice for adults with learning disabilities who have dysphagia (difficulty in swallowing).  The 'Problems swallowing' booklet outlines the issues facing adults with learning difficulties who have dysphagia and aims to share examples of best practice. The resources it describes are also available to download separately such as the mealtime information forms, risk assessment form, eating, drinking and swallowing care plan. A protocol got general practitioners. A version of the booklet is also available for clients and carers.

Public Health England- Improving Health and Lives. The Improving Health and Lives Learning Disabilities Observatory is here to keep watch on:

Royal College of Speech & Language Therapists. Adults with learning disabilities (ALD): Position paper (May 2010). This document identifies the role of speech and language therapists (SLTs) in adult learning disability services across the UK. This information should support SLTs, speech and language therapy managers, speech and language therapy educators and other organisations that support people with learning disabilities in their role.

RCN Publishing: Dysphagia in people with learning disabilities. Tom Howseman reviews guidance for carers and professionals on the management of service users who have difficulties swallowing

Older people

Malnutrition Task Force and British Dietetic Association (2013) Prevention and early intervention of malnutrition in later life: best practice principles and implementation guide 
These guides identify best practice principles for preventing malnutrition in later life and for early identification and intervention. They provide practical steps for implementation along with examples and shared learning for different contexts.

NHS Dumfries and Galloway (2012) Communication and Mealtimes Toolkit Helping people with dementia to eat, drink & communicate. A guide for carers (PDF 7.8MB)
The toolkit is in two sections, focussing on communication, and then on eating and drinking. Unsuccessful mealtimes often reflect a breakdown in communication and the way food is given and eaten can be a means of communication in its own right. The emphasis throughout the toolkit is on centring care around the person with dementia, which relies on knowing as much about them as possible. Advice is offered on how to prepare a person for mealtimes and how to provide the most suitable environment. A chart of foods which are most likely to cause choking is included with some suggested alternatives. Care plan check lists are provided in each section, with examples, to help carers look at how they can put the advice in to practice with each individual.

Royal College of Nursing (2011) Dementia - supporting physical health
This is a section within an online resource on dementia created as part of the RCN Dementia project. The online resource signposts resources to support people with dementia and their carers and this section includes key resources such as information from the Alzheimer's Society and the Social Care Insititute for Excellence Dementia Gateway. For further information about the RCN dementia project and the online resource see Dementia.

Nursing Standard (2009) Nutrition and older people
One of a series of booklets on nursing older people, this guide outlines the importance of nutrition and hydration, the nurse's role and highlights some examples of good practice, You can access the full text of this publication if you are a registered subscriber to Nursing Standard. Hard copies of the booklet are also available in the RCN library.

Scottish Government (2009) Older People Living in the Community - Nutritional Needs, Barriers and Interventions: a Literature Review
This report presents the findings of a literature review summarising the nutritional needs, barriers to and possible interventions to improve nutrition of older people living in the community. Further information is provided in the Research Findings.  

Palliative and end of life care 

Help the Hospices Food and Nutrition Group
Formed in 2006, in response to a call by Help the Hospices, the Food and Nutrition Group aims to include professionals from a range of different disciplines as well as service users, in raising standards and awareness of the role of food and nutrition in palliative care.

Help the Hospices (2009) Food and nutrition in palliative care - a consensus statement
The Food and Nutrition Group at Help the Hospices organised this course to highlight recent developments in nutritional care. The page includes presentations and the Group's recent Consensus Statement.

Foundation of Nursing Studies (FoNS) (2010) Improving Food and Nutrition for Patients Receiving Hospice Care
A project to enhance palliative care for patients and their carers with nutritional issues was conducted in Pilgrims Hospices in east Kent between 2008 and 2010. The conclusion of this work is a Process Map for the professionals to begin to address assessment of nutritional needs. The work itself is available for other hospices and health care organisations to have some appreciation of the task to be accomplished.

FoNS Enhancing palliative care for patients with nutritional issues and their carers (2010) (PDF 494KB)
Using the benchmarking process, current nutritional practice within hospice care has been explored and by engaging with patients and carers, a deeper understanding of nutritional issues from their perspective has been gained. These approaches have enabled the development of a Programme to inform the provision of person centred nutritional care for patients with specialist palliative care needs across the care spectrum from home to inpatient unit.

National End of Life Care Programme
The NEoLCP's website is designed to support health and social care staff across all sectors who are working with people nearing the end of life. It provides publications, tools, a care pathway and case studies. The role of nurses in end of life care is highlighted in Route to success: the key contribution of nursing to end of life care.

Nursing Standard article:

Stiles E (2013) Providing artificial nutrition and hydration in palliative care. Nursing Standard 27(20) 16 January pp.35-42.
You can access the full text through the RCN e-Library at e-journals.

Peterborough Palliative Care in Dementia Group (2010) Compromised swallowing: a practical guide to nutrition, hydration and medication in advanced dementia
This guide, which is aimed at both carers and nursing and medical staff, provides a practical approach to maintaining hydration and nutrition in people with advanced dementia and associated swallowing difficulties. It also addresses the medical management of symptoms and acts as a prescribing guide. The guide is made available on the National End of Life Care Programme website.

Royal College of Physicians (2010) Oral feeding difficulties and dilemmas: a guide to practical care, particularly towards the end of life
Provides evidence-based guidance on the mechanisms and techniques of oral and artificial nutrition in health and disease. It also sets out the ethical and legal concerns that inform decision-making with case studies illustrating some of the dilemmas and solutions, for example on deciding whether to withhold or provide artificial nutrition.