On 5 May 2016, the British Nutrition Foundation (BNF) invited leading infant feeding experts to discuss and debate the strength of the evidence base on a 'vegetables first' approach to complementary feeding. Consensus was reached on the translation of the science into practical messages for parents/carers. In particular, it is known that familiarising infants with a variety of vegetables from the start of complementary feeding increases the likelihood that vegetables will be accepted throughout childhood, though currently in the UK vegetables tend not to be prioritised as first foods. Infant feeding guidance could include recommendations to offer tastes of a variety of vegetables when complementary feeding begins, as a first step in the transition from milk to solid foods, so that liking and acceptance are established during this early window of opportunity. This report describes the main themes emerging from the discussions and the specific messaging recommendations which could be included within infant feeding guidance.

Ideally, more research is needed to compare tube feeding with oral supplements and with normal diet. New trials should also look at when tube feeding should be started for the best results. These trials may be di icult to run as it may be wrong not to provide people with the extra calories they need, and when they need them, in this way. Enteral tube feeding for cystic fibrosis (Review)

No abstract

Twenty one children with cystic fibrosis were advised to decrease their pancreatic enzyme supplement (PES) dose to less than 10 000 units lipase/kg/day. Mean PES dosage was significantly decreased in 15 patients from 18 380 to 8647 units lipase/ kg/day. There were no significant changes in energy or fat intake, but there were significant increases in weight SD score, height SD score, and weight/height ratio.

It seems obvious to healthcare professionals that patients with coeliac disease should receive regular follow-up. Surprisingly, there is little evidence that patients benefit in terms of reduced morbidity or mortality. However, several authoritative bodies have published guidelines on the management of coeliac disease that recommend regular follow-up. There is good evidence that compliance with a gluten-free diet reduces the risk of complications such as osteoporosis or small bowel lymphoma. Compliance is enhanced particularly by education about the disease and the gluten-free diet and by support from peers or professionals. Such input can be provided by regular follow-up, which thereby should improve compliance and hence long-term health. The consensus of the recommendations for follow-up suggests an annual review by a physician and dietitian. At annual follow-up the disease status can be checked and nutritional advice can be given, including checking the adequacy of, and the compliance with, the gluten-free diet. Complications and associated medical conditions can be sought, genetic risks explained and support and reassurance given. Specialist dietitians have particular expertise in relation to diet and nutritional management; specialist clinicians have a broader range of expertise in many aspects of management of the disease. A team approach for providing follow-up is the ideal, with a clinician and dietitian, both with expertise in coeliac disease, being involved. No one particular group of healthcare professionals is necessarily better than the other at providing follow-up.