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Pediatric Nutrition Advisory Committee (PNAC)

About PNAC

About Us

The Pediatric Nutrition Advisory Committee (PNAC) at McMaster Children’s Hospital was established in 2018. This multidisciplinary team of hospital dietitians, physicians,social workers, research scientists and nurses are joined by community public health practitioners,primary care providers, community care dietitians and members of the hospital Family Advisory Council. Common to this diverse group is a shared commitment to establish, support, and advocate for strong pediatric nutrition practices within McMaster Children’s Hospital and beyond.

Childhood is unique in the tremendous, overarching impacts of nutrition across everyaspect of health and disease. Every aspect of child health and development is madeworse in the setting of poor nutrition.The work of PNAC reflects our committee’s approach to focusing on child-health nutrition across our patients ’home and hospital environments.Pediatric malnutrition is not just a condition unique to a child’s short hospital stay. The conditions we manage in hospital are made worse if our patients’ nutrition is compromised inside, and outside hospital.

We are always looking for engagement from families, community practitioners, and inspired hospital staff and physicians. Contact information and more about what we do may be found in the tabs above.

Membership

Nikhil Pai, MD, CNSC, FRCPC Co-Chair-Pediatric Nutrition Advisory Committee (PNAC) Staff Physician-Division of Pediatric Gastroenterology & Nutrition (McMaster Children’s Hospital)Medical Lead-Complex Nutrition Service, Intestinal Rehabilitation Program Associate Professor-Department of Pediatrics, McMaster University

Jennifer Fabe, RD, BSc, MSc, Co-Chair-Pediatric Nutrition Advisory Committee (PNAC) Clinical Specialist, Ketogenic Diet Program, Hamilton Health Sciences Registered Dietitian, Division of Pediatric Neurology, McMaster Children’s Hospital

Community Information

Patient Education Library

These links provide patient education resources that have been developed by McMaster Children’s Hospital child health specialists. You may obtain more specific information by refining your search on the accompanying page.

Where do I refer my patient?

The following resource provides a“road map”for where providers may refer children with a range of feeding needs. This resource will be continually updated and may serve as a tool for our community to get children at nutritional risk to the right places most efficiently.

Current Projects

Food Insecurity Program

The PNAC/McMaster Children’s Hospital Food Insecurity Program was established in 2023 thanks to the generous support of the HHS Foundation. This multidisciplinary group seeks to support the development of programs and resources for patients experiencing food insecurity to have options for meals, community resources and information. For more information, please contact: Sandra Alexander, Program Assistant.

Further information on the PNAC/McMaster Children’s Hospital Food Insecurity Program and its available resources may be found here.

Canadian Infant Formula Shortages

Since early 2022, supply of Canadian infant formulas have been impacted by national formula shortages. While these supply shortages have affected multiple regions across North America and beyond, Canada has faced particular pressures with procurement and mobilizing alternatives. Members of PNAC have been invited by Health Canada to provide expert guidance on the acceptability of alternatives, responsible usage of existing formulas, and advocacy to introduce new products to Canadian children.

Malnutrition Awareness Week

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Recent Projects

Pediatric Nutrition Laboratory Testing Parameters

Part of a long-term strategy, PNAC has been instrumental in updating pediatric reference ranges for critical nutritional bloodwork. Revised values, that are age- and sex-specific will help clinicians better identify nutritional impairment in patients earlier.

Outpatient discharge planning (in collaboration with our community partners organizations)

Information coming soon.

Indirect Calorimeter

Thanks to generous funding from the HHS Foundation, PNAC, in partnership with McMaster Children’s Hospital’s Division of Neurology and Pediatric Intensive Care Unit recently purchased an important tool for the measurement of pediatric nutritional needs. The QNRG+ is one of the most versatile pediatric indirect calorimeters available today, and will be widely used across McMaster Children’s Hospital to support optimal nutrition support in pediatric inpatients and outpatients.

PINPAC

Pediatric malnutrition is a serious concern in hospitals that is often not diagnosed or treated.  1 in 3 Canadian children admitted to 5 tertiary pediatric hospitals for more than two days were found to be in a malnourished state on admission and children are reported to be at risk for worsening of nutritional status during hospitalization as well.

The Canadian Malnutrition Task Force (CMTF) established a Pediatric Working Group in spring of 2018 to address malnutrition in pediatric populations, with a focus initially on inpatient populations.  Two PNAC members, Dr. Nikhil Pai (Physician, PNAC Co-Chair) and Jillian Owens (Dietitian, PNAC Member) are current CMTF members.

In Fall, 2023 members of McMaster Children’s Hospital (Sarah Tiessen, RD; Jillian Owens, RD; Fariha Chowdhury, Research Coordinator; Romy Shenderey, Research Assistant; Nikhil Pai, MD), in partnership with the University of Montreal and SickKids Hospital, launched a pilot study assessing the role of the Pediatric Inpatient Nutrition Pathway for Acute Care (PINPAC) in pediatric inpatient settings. This study, funded by the Canadian Nutrition Society, will study this important malnutrition screening tool that has been developed by the CMTF Pediatric Working Group. For more information, visit: https://nutritioncareincanada.ca/resources-and-tools/pediatrics/p-inpac/pathway.

Nutrition Research

PNAC is closely aligned with our nutritional researchers across Hamilton Health Sciences and McMaster University. The following links include some of the pediatric nutrition-focused research that is occurring across our community.