About PNAC
About Us
Childhood is a tremendously important period for healthy nutrition. Nearly every aspect of child health and development is impacted by a nutritious diet and as healthcare providers, we are committed to ensuring our patients are supported in this throughout their healthcare journey.
The Pediatric Nutrition Advisory Committee (PNAC) at McMaster Children’s Hospital (MCH) 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, family health team dietitians, community care dietitians and members of the MCH Family Advisory Council. Common to this diverse group is a shared commitment to establish, support, and advocate for strong pediatric nutrition practices within MCH and beyond.
The work of PNAC reflects our committee’s approach to focusing on child-health nutrition more broadly – from home to the hospital, and back again. While PNAC was founded at MCH, we recognize that pediatric nutrition is not just unique to a child’s hospital visits. The conditions we manage as hospital and community healthcare providers require a broader approach.
PNAC addresses challenges that affect childhood nutrition within MCH and its broader catchment area. We work closely with our community partners to identify creative approaches to existing, and emerging challenges affecting food supply, clinical expertise resource allocation, food insecurity, standardizing nutritional care, building connections (locally, provincially and nationally), and sharing resources. We work with diverse stakeholders including non-profit organizations, media, regulatory bodies like Health Canada, and industry.
We are always looking for engagement from motivated families, community healthcare providers, and inspired hospital staff and physicians. More information about what we do, and how to contact us, may be found in the tabs above.
Membership
Nikhil Pai, BSc, MD, CNSC, NASPGHAN-F, FAAP, 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
Jaclyn Adler, HBHSc, RD, MAN, CDE,
Professional Practice Lead, Nutrition,
Hamilton Family Health Team
Michele MacDonald Werstuck, RD, MSc, CDE
Nutrition Groups Coordinator,
Hamilton Family Health Team
Lindsay Zalot, MHSc, RD
Registered Dietitian and Public Health Nutritionist
Krista D’Aoust
Director, Community Food & Family Services
Hamilton Community Food Centre
Rose-Frances Clause, RN, NP
Nurse Practitioner, Pediatrician Gastroenterology, Hepatology, and Nutrition
Community Information
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.
Information coming soon.
Newborn, Infant, and Toddler Nutrition
Feeding Your Baby and Children – Learn about nutrition for babies and young children. Attend a free session about feeding your baby or young child at a local EarlyON Child and Family Centre, led by a Registered Dietitian.
Welcome Baby Prenatal Nutrition Program – Are you pregnant and looking for support? Join a weekly free Welcome Baby prenatal nutrition group to learn about having a healthy pregnancy and taking care of your baby. You must join during your pregnancy and then you can continue until your baby is 6 months old. Grocery gift cards and bus tickets are included.
Please see the sidebar (Helpful Links) for additional resources
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
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)
In collaboration with our community partners, PNAC has been working to develop a hospital- and community-wide resource list that helps support patients being discharged from McMaster Children’s Hospital inpatient wards, and ambulatory clinics who need nutrition support. This information may also be used by our community providers to identify hospital-based resources where patients may be referred.
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.
Information coming soon.