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Ask the expert: How often should my child with multiple food allergies be assessed by a dietitian?

Linda Kirste, RD

Linda Kirste is a Registered Dietitian. She works at HealthLinkBC where she operates the Allergy Nutrition Service ― a tele-practice-based service that provides nutrition education, as well as counselling and follow-up care for residents of British Columbia with food allergies.

This month, Linda discusses how often children with multiple food allergies should be assessed by a dietitian.


The optimal frequency for visits with a registered dietitian should be individualized based on your child’s needs. Their nutrition care needs are affected by a few factors. These include their growth, nutritional status, eating patterns, food allergies, age, and overall wellbeing.

Growth and nutrition status

Helping children reach their full growth potential is an important goal among health care professionals including dietitians. Children whose growth is faltering should have access to a dietitian until their growth has returned to (or is returning to) normal and the number and frequency of visits should be individualized.

If there are signs of growth faltering, a nutrition assessment and care plan is normally recommended. Improved nutrient intakes may result in “catch-up growth” when slowed growth has been linked to inadequate nutrient intakes. To monitor for adequate catch-up growth, young children especially, should have their height and weight measured about once a month. If their growth hasn’t returned to normal, a follow-up visit with their dietitian is usually helpful to check for new or ongoing nutrient intake concerns.

Eating patterns

Healthy eating is just as much about skills and related attitudes and behaviours, as it is about being able to eat a wide variety of healthy foods. These skills take time for children to develop. Sometimes called “eating competence”, these skills include feeling relaxed about eating, trusting oneself to choose the right foods, enjoying meals and eating together.

Sometimes, coping with food allergy can be stressful and may make it harder for parents to help their child develop these skills. Children and parents interested in strengthening their skills may find it beneficial to have a few visits with a dietitian for support. When visits are more frequent, skills may develop more quickly.

Types and number of food allergies

The impact of a food allergy on nutrient intakes can vary quite a bit, depending on the foods involved. Milk or egg allergy, for example, is more likely to have a bigger impact compared to sesame or shellfish allergy. In general, seeing a dietitian more often is beneficial for children with multiple food allergies.

Nutrient needs change with age

As children develop and reach new milestones their nutrient needs change. Critical milestones include 6 months, 1, 2, 4, 9, 14 and 19 years of age. Ideally, children with food allergy should visit a dietitian around these times, or more often depending on their needs.

Visit a dietitian if you’re concerned about your child’s dietary intakes, regardless of their age or food allergies. Ultimately, your child’s progress and the recommendations from the dietitian will help you decide on the best number and frequency of visits.

For more information about accessing a dietitian please, see “Where can I find a registered dietitian who works with people who have food allergies? Are there free resources?” click on: foodallergycanada.ca/2017/06/ask-expert-nutrition-food-allergies/

Thanks Linda for your insight.


To read Linda’s other articles with us, visit our blog section, or click here to read about:

Do you have a question you’d like to ask Linda in the months to come? If so, please send it along to us at info@foodallergycanada.ca.