Nutritional Care of Hospitalized Children in Belgium: A Follow-Up Survey

Background: A 2014 survey showed nutritional management could be improved in Belgian paediatric departments. This follow-up survey aimed to: 1) List paramedic resources/staffing in Belgian paediatric departments; 2) Survey nutritional screening and follow-up; 3) Identify barriers. Methods: A nationwide survey (February-April 2021) via national and regional paediatric associations. Results: 61/90 (67.8%) of Belgian paediatric departments responded (80.1% of all Belgian paediatric hospital beds); 60.7% of the respondents were from larger centers (LC, ≥20 beds). A dietician was present in 80.3% of all responding units (LC vs smaller centers (SC): p= 0.133), compared to 46.5% in the 2014 survey. Most dieticians seldom or never participate in ward rounds (86.9%) and participate only ad hoc to case discussions (72.1%). Systematic nutritional screening is done in 32.8% of paediatric departments. The most common barriers to conducting nutritional screening were lack of time (59.0%), lack of knowledge (47.5%), and lack of staff (42.6%). In French-speaking centres (FrC), a positive screening result most often led to referral to a dietitian (86.7%), whereas in Dutch-speaking centers (DuC) it more frequently resulted in a discussion with the paediatrician about nutritional management (54.3%) than referral to a dietician (34.8%). Nutritional follow-up after discharge is most often conducted by a physician, with or without the involvement of a dietician (95.1%), rather than a dietician alone (3.3%). Malnutrition treatment barriers included “no barriers” (50.8%), lack of knowledge (34.4%), lack of reimbursement (24.6%) and lack of time (24.6%). Conclusions: Increasing paramedic resources and systematic screening might reflect improved nutritional awareness in Belgian paediatric departments. Barriers remain however unchanged compared to 2014.