Services
Welcome to Thames Nutrition Services page, where Paediatric Dietitian Gemma Ransome offers expert, personalised nutrition services tailored to your child’s unique needs. Based in Maidenhead, we specialise in a range of services designed to support healthy growth and development, including feeding therapy, allergy and intolerance management, weight management, and more.
Whether you're dealing with picky eating, food allergies, or specific dietary concerns, our evidence-based approach ensures your child receives the best care. Serving families across Buckinghamshire, Berkshire, and surrounding areas, we're here to help your child thrive with tailored nutrition guidance.
Click on one of our services links to find out more information about how we can help your child:
Picky eating therapy
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Growth
Picky eating can be extremely worrying for parents, particularly when it is impacting on a child’s health and growth. Up to a third of children of children will struggle with some type of feeding and/or growth issues at some time during the first 10 years of life. Whilst most fussy eaters grow out of it and begin to accept a wider range of foods, some children do not.
Feeding issues are usually due to something in a child’s body not working well. There will be an underlying problem that is contributing to a loss of appetite or ability to take in enough food.
Picky eaters are children who demonstrate either transient or more extended challenges (up to 2 years in duration), with feeding/eating patterns characterised by:
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Strong preferences regarding liked and disliked foods, including taste, texture and how the food is prepared.
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Eating a limited number and variety of foods (>20-30 foods)
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Avoidance of new foods but usually can tolerate new food on plate and can touch or taste.
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Often refusing to eat “healthy” foods or typical portions
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Getting more upset than peers when pressured by parents to eat unwanted foods
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Stressful mealtimes
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Typically eats with family but frequently eats different foods than family.
Only 1/3 of children with picky eaters will outgrow it. It is the child’s sensory sensitivities that will predict whether they will outgrow their picky eating. 9% of severe and persistently picky eaters are categorised as problem feeders.
Problem feeders are children who demonstrate significant and often extended challenges with feeding/eating patterns:
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Long duration of feeding difficulties (>2 years)
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A very restricted food range (<10-20 foods)
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Has very strong food likes and dislikes (not just preferences)
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Refuses to try new foods
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May have growth and/ or nutrition problems
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May have some type of feeding skill deficit
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Extended mealtime duration >25 minutes
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Parents often make a special meal and or help the child eat
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Disruptive mealtimes and reduced ability to eat with others
It is essential to find children with persistent feeding problems early to avoid the risk of faltering growth and micronutrient deficiencies.
I have extensive experience working with extremely picky/selective eaters including those with Paediatric Feeding Disorder (PFD) and suspected or diagnosed Avoidant Restrictive Food Intake Disorder (ARFID), I understand that this is more than “just a phase”.
As an SOS Trained Feeding Therapist, I use systematic desensitisation strategies such as play with a purpose, the steps to eating, sensory-based problem solving and an evidence-based approach to help children develop appropriate oral motor skills and learn to eat.
Growth concerns
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Growth
Overweight and obesity
One in three children are overweight or obesity by the time they leave primary school. This puts them at increased risk of type 2 diabetes, high cholesterol and high blood pressure when childhood obesity continues into adolescence and adulthood. Other conditions that are linked with excess weight include asthma, non-alcoholic liver disease, gall stones, problems with joints and polycystic ovary syndrome.
I am committed to helping children (aged 2-18 years) and their families who are at high risk of obesity (overweight) or those already living with obesity, to manage their weight safely. One size does not fit all when it comes to children’s nutrition. I will offer bespoke nutrition education to suit your family using age-appropriate resources to cover healthy eating, portion size guidance, label reading support, and recipe ideas.
Faltering growth, weight loss or slow weight gain
Faltering growth is a term used to describe a slower rate of weight gain in childhood than expected for age and sex (NICE, 2023). The most common cause of faltering growth is caused by inadequate calorie intake. Other causes include inadequate nutrient absorption and/or increased calorie demand or expenditure.
If you are concerned about your child’s growth, please contact me for dietary advice and support. I will assess your child’s growth using World Health Organisation growth standards and UK birth and preterm growth data alongside your child’s ‘red book’. You child will be assessed for possible risk factors and to exclude other possible diagnoses (such as gastrointestinal conditions, allergies, intolerances, and feeding problems). Treatment and advice will be tailored to you child and may include advice to improve breastfeeding, oral motor skills, mealtime, and food fortification strategies and / or high calorie supplements.
Food hypersensitivity
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Growth
Food allergies and food intolerances are different, and it is crucial from a treatment point of view that the correct diagnosis is made as they require different dietary therapy.
Food intolerance reactions do not involve the immune system, like food allergy. However, food intolerances can make your child feel extremely unwell. There are many possible symptoms that could be caused by having an intolerance to food. Symptoms commonly effect the digestive, skin and respiratory systems and the onset of reactions could be immediate or delayed.
A food allergy is a reaction involving the immune system. Proteins within foods can trigger immediate (IgE mediated, within two hours) or delayed (non-IgE mediated 2-48 hours later) symptoms. This results in the release of chemicals which trigger allergic symptoms such as skin rashes or swelling, vomiting, diarrhoea or constipation to name a few. Other symptoms can include breathing problems and in rare cases an extreme allergic reaction called anaphylaxis.
If you think your child may be having adverse reactions caused by food, it can be incredibly tricky to determine which foods are causing their symptoms. Using a detailed diet history and/or food and symptom diary and, if necessary, trial elimination and re-introduction diets I can help you diagnose your child’s food intolerance or food allergy. I can offer education about food labelling, food exclusion diets and strategies to ensure your child is meeting their nutritional requirements on a restricted diet.
Following an initial dietetic assessment, I can arrange a referral to a consultant paediatric allergist for skin prick and blood testing if an IgE mediated allergy is suspected.
Personalised nutrition guidance
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Growth
Rather than a ‘one size fits all’ approach I offer my clients personalised nutritional therapy to promote health and address individual dietary problems.
Personalised nutrition consultations are relevant for those who are looking to enhance the health and wellbeing of their child.
I am also able to offer advice and support in the following areas:
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Coeliac Disease and children requiring gluten free diets following diagnosis. I can advise on a nutritionally balanced gluten free diet individually tailored to your child’s requirements and lifestyle. In addition, I help families minimise cross contamination and maximise micronutrient intake for growth on this restricted diet.
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Gastrointestinal conditions including reflux, constipation and loose bowel motions
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Vitamin and mineral deficiencies such as iron deficiency anaemia
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Vegetarian and vegan diets
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Family meal planning
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Complementary feeding (weaning)
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Breastfeeding