Dietetics — Transfer to Paediatric Dietitian for a Child with Faltering Growth
A community dietitian transfers a 3-year-old boy with faltering growth and a significantly limited food repertoire to a specialist paediatric dietitian. This beginner transfer case requires communicating the key nutritional and growth concerns clearly, along with the parent's situation, so the specialist can plan the first appointment.
Letter type
Transfer
Write to
Paediatric Dietitian
Target length
170–190 words
The case notes
Patient: Master Luca Rossi, 3 years old; referred by health visitor for faltering growth and feeding difficulties
Growth: Weight: 11.2 kg (0.4th centile for age); height: 88 cm (2nd centile); weight has not crossed a centile in 6 months — static on the 0.4th
Diet: Accepts approximately 8–10 foods; will eat: plain pasta, white bread, cheddar cheese, plain milk, yoghurt, cucumber, boiled eggs; refuses all meat, all vegetables except cucumber, all fruit except banana (occasionally); strong texture aversion — refuses lumpy or mixed textures; eats better alone than at the family dinner table
Feeding: Mealtimes are very stressful for the family; mother reports battles at every meal; child often refuses after 2–3 bites; no choking or swallowing difficulties reported; drinks milk (500 mL/day) which may reduce appetite for solid foods
Developmental: No developmental delay; speaks in short sentences; hyperactive at mealtimes; referred to community paediatrics — appointment pending
Parent view: Mother is exhausted and anxious; has tried strategies from online resources without success; is open to professional guidance
Action taken: Advised reducing milk to 300 mL/day to improve appetite; given basic food exposure strategies; mother requested specialist support
Task: Write a transfer letter to the paediatric dietitian, Ms Fiona Brady, providing the information needed to plan Luca's first specialist appointment.
Writing task
Write a transfer letter to the paediatric dietitian, Ms Fiona Brady, providing the information needed to plan Luca's first specialist appointment.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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Weight 11.2 kg (0.4th centile), static for 6 months — not crossing centiles
This is the growth data that defines the clinical urgency. A child static on the 0.4th centile for 6 months requires specialist review. The paediatric dietitian uses this to determine how urgently to book the appointment.
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The food repertoire: 8–10 foods only, texture aversion, refuses all fruit except banana and all vegetables except cucumber
The restricted list tells the paediatric dietitian what they are working with for a meal plan. They cannot build a feeding programme without knowing the current accepted foods.
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That the mother is exhausted and anxious and has tried online strategies — she is open to guidance
Family context is the starting point for paediatric feeding work. The specialist needs to know the emotional state of the primary carer to plan the family support component of the first appointment.
Leave out
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The full developmental history and paediatric referral detail
A brief mention — 'referred to community paediatrics, appointment pending' — covers it. The paediatric dietitian manages the feeding programme; the community paediatrician manages the developmental assessment.
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The online strategies the mother tried
Not relevant to the specialist. 'Has tried feeding strategies at home without sustained success' is enough.
Criterion in focus · Genre & Style
A paediatric faltering growth transfer letter must balance clinical urgency with sensitivity to the family's distress. The mother is not failing — she is exhausted and asking for help. The professional tone acknowledges the family context without being patronising: 'Luca's mother has been very engaged and is open to specialist guidance' positions her correctly as a cooperative partner in the feeding programme.
Now write the letter — and find out what is blocking your Grade B
Write a 170–190 words transfer letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.