Historical and contemporary perspectives on children's diets: is choice always in the patients' best interest?

• Published in: Medical humanities 2010-06, Vol.36 (1), p.14-18
• Main Authors: Denny, G, Sundvall, P, Thornton, S J, Reinarz, J, Williams, A N
• Format: Article
• Language: English
• Subjects: 18th century; 21st century; Adolescent; Adults; Age; Carers; Child; child health; Children & youth; Choice Behavior; Diet; Diet - history; Female; Food Service, Hospital - history; History of medical; History, 18th Century; History, 21st Century; Hospitalization; Hospitals; Hospitals, Voluntary - history; Humans; Malnutrition; Medical libraries; Milk; modern medicine; National Health Programs - history; nutrition and metabolism; Nutrition Policy - history; Nutritional Requirements; Patient safety; Patients; Pediatrics - history; Prescribed; Recipes; social history; United Kingdom
• ISSN: 1468-215X; 1473-4265
• DOI: 10.1136/jmh.2009.003368

On 29 March 1744, Thomasin Grace, a 13-year-old girl, was the first inpatient admitted to the Northampton General Infirmary (later the Northampton General Hospital). Inpatient hospital diets, then and now, are mainstays of effective patient treatment. In the mid-18th century there were four prescribed diets at Northampton: ‘full’, ‘milk’, ‘dry’ and ‘low’. Previous opinions concerning these four diets were unfavourable, but had not been based upon an individual dietetic assessment. Thomasin would most likely have been given the milk diet, but use of the full diet cannot be excluded.‘Grace Everyman’ is Thomasin's modern equivalent. Under current NHS guidelines Thomasin would be considered a paediatric patient, but in 1744 she would have been considered as an adult. This study undertakes a full dietetic analysis of all the prescribed diets available for Thomasin in 1744 and compares this against random choices for Grace from the 2009 inpatient menu from the paediatric (Paddington) ward, and the adult ward inpatient menu at the Northampton General Hospital. The results show that, for Thomasin, the 1744 milk and full diets met the current advised nutritional requirements for adequate dietary intake. However, for Grace, the present 2009 Paddington and adult ward menu, although generally meeting nutritional requirements, could, if Grace or her carer consistently chose poorly during a prolonged inpatient stay, lead to inadequate nutrition. This challenges assumptions that hospital diets were historically inadequate, and that choice in present day equates with satisfactory nutritional intake.