They should be included in the healthcare team at an early stage to assist with children who have an LTHC and a significant risk of undernutrition.
Expertise in assessing the nature and extent of the problem, constructing appropriate diets, counselling on eating habits and reviewing progress are essential elements in the care of a child with an LTHC and undernutrition.
These problems arise from the direct effects of the LTHC and the secondary effects common to most LTHCs--often in combination.
For children with LTHCs there is a need for greater involvement with healthcare services than in the case of their peers.
Therefore, special consideration must be given to nutrition for most children with LTHCs as part of any management plan that aims to optimise a child's quality of life.
This article explores the mechanisms by which nutritional problems may occur in LTHCs.
2 is the inability to use available nutrient-derived energy, because this contributor to limitation of growth in some LTHCs (especially endocrine disorders such as hypothyroidism) is not mediated through nutrition.
These are often primary effects in LTHCs affecting the gastrointestinal tract (GIT).
While the potential contribution of malabsorption to decreased food energy availability and consequent undernutrition is obvious in GIT conditions such as coeliac disease and obstructive biliary disorders, malabsorption is a factor in many other LTHCs.
While psychiatric LTHCs such as anorexia nervosa have clear nutritional consequences, other LTHCs may be associated with enough primary or secondary psychopathology to affect energy intake.
Diversion of nutrient energy into inflammation is a potent contributor to suboptimal nutrition and growth in many LTHCs.
As with inflammation, energy diversion to other non-growth activities occurs in many LTHCs.