Transformation to room service food delivery in a pediatric health care facility.

Patient food service is an important component in the nutritional management of hospitalized children. The previous meal delivery system at The Hospital for Sick Children in Toronto was a cold-plating re-thermalized system. Issues related to this model included order lead time, the reheating process, menu selection, and service style. Research into other systems led us toward room service, an innovative and flexible mode of meal delivery. Transformation to room service occurred over one year, and included implementation of a new computer system, kitchen renovation, redesign of menus and a new meal delivery system called Meal Train, and changes to human resource allocations. Throughout the transformation, consultations were held with key stakeholders, including the children's council, the family advisory, the nursing council, and a multidisciplinary committee involving nursing staff, dietitians, patient service aides, infection control personnel, occupational health employees, patient representatives, and food services staff. Now, Meal Train is running smoothly, and meal days and food costs have been reduced. Others considering a project like this must know their clients' needs and be willing to think outside the box. They should familiarize themselves with current information on systems and equipment, consult with key stakeholders within their organization, and then create the system that will work for them.

Feeding patterns and weight among First Nations children.

PURPOSE: Little information is available on the growth and feeding patterns of First Nations children. Our goal was to assess the anthropometric status, feeding practices, and dietary intake of children born in 1994 or 1995 (n=102) and living in Walpole Island First Nation. METHODS: Information on demographic characteristics and infant feeding practices was obtained through parent interviews conducted between 1994 and 1999. Parents also completed a 24-hour dietary recall for their children when they were 48 months old. Head circumference was measured at three and 18 months, and weight and length/height at three, 18, 33, and 48 months. RESULTS: Most infants (75%) were breastfed at birth; however, by the time infants were three months old, 39.7% of the mothers had stopped breastfeeding. Over half (57.1%) of the infants were fed solids before age three months, 11.6% were given whole milk before age nine months, and 59.4% had low fat milk before age two years. Body mass index (kg/m2) (BMI) was above the 85th percentile for 27.8% at the 48-month interview, and was associated with a maternal BMI above 25 (OR=7.8, CI=1.1-41.9). CONCLUSIONS: Mothers need to be encouraged to follow current infant feeding recommendations. Strategies should be developed to reduce the prevalence of overweight among adults and children in First Nations communities.