Nutrition screening, assessment and intervention practices for children with cancer in Aotearoa, New Zealand

Objective: The purpose of this study was to investigate dietetic resource and current nutrition screening, assessment and intervention practices in paediatric oncology centres in Aotearoa, New Zealand. Methods: : A national survey of the two specialist treatment centres and 14 Shared Care Centres (SCC’s) that provide care to childhood cancer patients in Aotearoa, New Zealand (NZ) was conducted. Results: : The two specialist treatment centres in Aotearoa, NZ were the only centres with dedicated dietetic oncology FTE; this FTE was devoted to inpatient care. Only 5 SCC’s (44%) had access to general paediatric dietetic support. Dietetic cover for outpatients/day-stay, and use of standardised nutrition screening and assessment tools was limited. Weight and height were commonly measured but there was inconsistency in the frequency and recording of measurements. Nutrition interventions including nutrition education, oral nutrition support (ONS), enteral nutrition (EN) and intravenous nutrition (IVN) were available within all centres but criteria for initiating support varied. Common barriers to providing nutrition interventions included staff resourcing and ad-hoc referral pathways. Awareness of the relevance and clinical benefit of nutrition in paediatric oncology was low; suggestions to improve nutrition screening, assessment and intervention within Aotearoa, New Zealand included the creation of standardised screening and referral criteria. Conclusion: Resource limitations and lack of nutritional screening and assessment prevent adequate nutritional intervention for children with cancer in Aotearoa, NZ. Akin to other high-income countries there is a need to harmonise the management of nutritional challenges among children with cancer. This study provides a first step in establishing an evidence base to help support efforts to address this need in Aotearoa, NZ.