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Welcome to Sheffield Children’s Hospital medical ward where your young person has been admitted for support with their eating, medical intervention, monitoring and medication. The purpose of this admission is to address serious medical health concerns which have resulted from disordered eating.
At times it can be a difficult and emotional journey and so our multidisciplinary team – Sheffield Eating Disorder Assessment and Treatment Team (SEDATT) and our eating disorders liaison nurses are here to provide assessment and consultation support to young people, families and ward staff as required. Young people with restrictive eating disorders usually require a minimum of 2 to 3 weeks in hospital and sometimes significantly longer before they are medically safe enough for discharge.
It is likely that you have been referred to the ward by the Emergency Department, your GP, paediatric specialist or Children and Adolescent Mental Health Services (CAMHS). This can feel like a worrying time and you may feel a loss of control, relieved, or both.
On admission your child will have a set of blood tests followed by daily blood tests for 5 to 7 days and weekly thereafter.
An electrocardiogram (ECG) will be performed on admission. We will continue to monitor heart rate as well as lying and standing blood pressure (BP) throughout the admission. Continuous heart rate monitoring overnight may be necessary.
Daily re-feeding supplements including Phosphate Sandoz and thiamine will be prescribed on admission and stopped when medically safe to do so. A multivitamin, mineral and trace element supplement (Forceval) will also be commenced and this will be continued at discharge until your young person has restored to a healthy weight.
Weight and height are checked on admission and then every Monday and Thursday in our Growth and Measurement department during your stay. Weight is checked in underwear only to ensure the measurement is accurate. We also sometimes check mid upper arm circumference.
Weight measurements will not be disclosed to your young person at the time of weighing as experience shows that this can significantly worsen anxiety for the young person.
For medical reasons, your young person will initially be required to be placed on strict bed rest until the consultant paediatrician advises that your young person is safe to start moving around slowly. This will include being taken in a wheelchair to the bathroom, school room or off the ward as needed.
We will ask your young person to go to the toilet if they need to just before a meal or snack as we require them to stay on their bed for a minimum of 30 minutes after a meal or snack.
We have a standardised meal plan system (meal plans 1 to 8). Each meal plan consists of 3 meals and 3 snacks.
The meal plan level will be reviewed twice a week by the dietitian and consultant paediatrician and will be increased until your young person has reached a level which is sufficient for their nutritional needs and is achieving weight restoration. Commonly, nutritional requirements are very high during this early phase of treatment.
We are aware that mealtimes can be very anxious times and sometimes distressing for young people with eating disorders especially when the meal plan level has recently increased. The medical nurses are here to offer support at mealtimes and SEDATT can provide advice around mealtime strategies to staff and family.
On admission your young person is asked about up to 3 food ‘dislikes’ which should be individual foods rather than whole food groups. These 3 food dislikes should be from before the development of an eating disorder.
We do not advise you to bring whole meals from home but are happy for you to provide cereal bars or ‘favourite brands’ which will need to be approved by the dietitian before they can be included on the meal plan.
Nutrition is vital to restore medical safety. Therefore, nutrition is non-negotiable.
If a young person is struggling and not able to complete 100% of a meal or snack we ask them to drink a prescribed volume (on their meal plan) of a complete nutritional supplement or have this through a nasogastric tube.
We encourage a young person to complete a meal in 30 minutes and a snack in 15 minutes. All meals are supervised by the ward staff. The family or carers are important members of the care team and therefore we welcome parent and carer involvement in mealtime support where possible.
Food is the medicine to help your young person get better.
Family and carers play a critical role in providing structure and support during meal times. Most staff and families have found that the approach they take has a big impact on the ability of a young person to follow their meal plan. The following strategies may help:
We appreciate that it is often a long time to stay in hospital and so we would advise activities to keep your young person occupied. We have a school room which is open during term time. By accessing the school room, this provides them with an attendance mark for school. We also have a play team that will chat, provide art and craft activities, board games, DVDs and games consoles at the bedside or in our teenage room.
The community eating disorder service for children and young people’s in Sheffield is SEDATT. They are a small specialized group of clinicians (consultant paediatrician, psychiatrists, family psychotherapists, mental health nurses and dietitian).
This team may already be involved in your child’s care. If not, they will be alerted that a young person with a possible eating disorder has been admitted to the ward and will arrange a formal assessment. The team will work to understand whether your child’s needs are best treated within SEDATT or within generic CAMHS.
Treatment for an eating disorder often involves medical ward admission to establish medical safety followed by discharge planning and ongoing support from SEDATT to help the young person get back to a healthy weight back at home. SEDATT will aim to start building therapeutic relationships with the family and help with psychoeducation.
We also have eating disorders liaison nurses who can assist with communication between the medical in-patient team and SEDATT and also with discharge planning.
You will already know the things you enjoy or use to enjoy doing. Staying in contact with your interests, religious beliefs, family, friends, clubs are some of that can help to distract you during your stay in hospital.
Beat is the UK’s leading charity supporting those affected by eating disorders and campaigning on their behalf. Founded in 1989 as the Eating Disorders Association, it celebrated its 30th anniversary in 2019.
Eva Musby provides free help sheets, books, videos, audio, and coaching or counselling.
Read the free ‘Set-Up For Success’ resource at anorexiafamily.com.
This website is good for signposting to other helpful, apps, videos, resources, websites and downloads.
This is a UK charity dedicated to young people’s mental health.
Not everyone wants to get mental health support in school, but if you do need support there are trained mental health leads in each school in Sheffield that can help support you.
Specialist children’s psychologists have produced resources to help your mental health and emotional wellbeing during the pandemic.
This is an online service offering counselling support for 11 to 24 year-olds.
They offer some drop in support sessions, but also have counsellors available for those over 13 years old.
They offer individual and group support for young people aged 11 to 18.
This website was developed to help young people support their friends who are struggling with their emotions or mental health.
Have a chat with a counsellor online about whatever’s worrying you.
This is a free, confidential 24/7 text support service. Text SHOUT to 85258.
This is an online crisis messenger.
Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.
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