Nutrition in Children with Neurological Impairment | Part 8 Bridging Research and Practice in Pediatric Nutrition

Importance of optimal nutritional status & challenges achieving it 
This talk will outline some of the consequences of suboptimal nutrition in children with neurological impairment and highlight some of the common symptoms and conditions that hinder achieving optimal nutrition. Strategies to manage these symptoms and conditions will also be briefly reviewed.

Tejas Desai, MD, MSc, FRCPC
Children’s Hospital London Health Sciences Centre

Dr Tejas Desai joined the Department of Pediatrics and the Division of Gastroenterology, Hepatology and Nutrition in 2024. He completed a master’s degree and medical school at the University of Toronto followed by pediatrics residency training at the University of Ottawa. He subsequently completed fellowship training in pediatric gastroenterology at the University of Alberta and an additional year of training in complex nutrition at Sick Kids in Toronto.  

Dr Desai has clinical interests in complex nutrition, including enteral and parenteral nutrition, growth faltering and malnutrition, as well as Celiac disease. His research interests center around quality improvement and choosing wisely initiatives. He is a member of various national and international organizations relating to pediatric gastroenterology and nutrition and currently sits on both the NASPGHAN and CPS Nutrition Committees.

Defining malnutrition and malnutrition risk in neurologically impaired children
This presentation will explore the concepts and challenges in defining malnutrition and nutritional risk in children with neurological impairment. Key topics will include malnutrition indicators, the use of condition-specific growth charts, screening tools for nutrition risk and feeding difficulties, and methods of nutritional assessment such as the Subjective Global Nutritional Assessment. Additionally, the application of these various methods and instruments will be illustrated through a case study, which will be continued in the subsequent presentation.

Jessie M. Hulst, MD, PhD
Hospital for Sick Children

Dr. Jessie Hulst is a staff gastroenterologist at The Hospital for Sick Children (SickKids) and Associate Professor in both the Department of Pediatrics and Department of Nutritional Sciences at the University of Toronto. Previously, Dr. Hulst served as a Staff Gastroenterologist at Sophia Children's Hospital in Rotterdam, Netherlands (2011 to 2018). Her extensive academic background includes the completion of her PhD focusing on nutritional assessment in critically ill children in 2004.

Throughout her career, Dr. Hulst has been deeply involved in advancing the field of pediatric nutrition. She served as a member of the ESPGHAN committee on Nutrition (2014-2018), acted as the previous chair of the ESPGHAN Clinical Malnutrition Special Interest Group, is a current member of ASPEN malnutrition committee and NASPHAN Nutrition committee. Her research focuses on nutritional screening and assessment in children with medical conditions predisposed to malnutrition, with the goal of improving outcomes through individualized interventions. She has made significant contributions to the academic literature, with over 100 peer-reviewed manuscripts and more than 10 book chapters to her credit. 

She co-chairs the Pediatric Working Group of the Canadian Malnutrition Task Force and leads the implementation of a national pediatric Malnutrition Pathway in Canada. She serves as a Distinguished Fellow in Child Nutrition at the Joannah & Brian Lawson Centre for Child Nutrition, University of Toronto, with a mission to enhance physician competency in both clinical and public health nutrition through educational initiatives and resource development.
Clinically, Dr. Hulst specializes in complex nutrition and intestinal failure, serves as the hospital's Parenteral Nutrition medical lead and chairs the Nutritional Advisory Committee.

Nutrition in Children with Neurological Impairment
In this session, Jessica will address the unique nutritional challenges commonly seen in children with neurological impairment, as well as the specialized methods used to assess growth in this population. Topics will include feeding difficulties, gastrointestinal dysfunction, and altered energy requirements. An illustrative case study will be presented to demonstrate an individualized, evidence-based approach to support optimal growth, health, and overall quality of life.

Jessica Power, RD
IWK Health Centre

Jessica Power is a Registered Dietitian with professional training from Mount Saint Vincent University and a career dedicated to clinical pediatric dietetics at the IWK Health Centre. Her practice is centered on the nutritional care of children within the rehabilitation population, including those with developmental and neuromuscular conditions, as well as individuals with genetic and acquired causes of physical disability.
She has a keen professional interest in understanding and addressing the unique and often complex nutritional needs of this population. Her work emphasizes a compassionate, evidence-informed approach to care, with a strong commitment to reducing stigma around topics such as bowel health and gastrostomy tube feeding. Through her advocacy and clinical practice, she strives to support improved nutritional outcomes and quality of life for children and their families.