Caitlin Jacobs, MPH, RD, CD, began her career 10 years ago as a pastry chef and head baker at various restaurants. Then in 2015, she got some news: a Celiac disease diagnosis. She tried working around it for a while by paying attention to the texture of her pastries more and asking others to sample the gluten-filled treats instead. But one day, her doctor told her she couldn’t do it anymore.

“I was still sick,” she said. “I never fully healed. Gluten was my whole life, and now it can’t be.”

Thus began her career as a dietitian. Taking an idea from her mother-in-law, who had a friend who worked as a dietitian, Jacobs went back to school to study dietetics and clinical nutrition at Mount Mary University in Milwaukee, Wisconsin, and additionally earned a Master of Public Health degree from the Medical College of Wisconsin, also in Milwaukee. Her extra education was a bit ironic considering she doesn’t consider herself a “school” or “academic” person.

Now she covers two clinics at Children’s Wisconsin, working with children with pediatric feeding disorders and cystic fibrosis. The role interested her because not only had she done her internship with the hospital, but also she had grown up going there. She was born with a congenital heart defect called Tetralogy of Fallot.

“Life just kind of happens,” Jacobs said. “I handle whatever is thrown my way, and ask myself: How am I going to pivot? I can teach people how to eat, but I also had to learn how to eat.”

In this interview, she shares insights into her role, challenges in the dietetics industry and her passion for addressing food insecurity within her community.

Q. Describe your role.

A. It all depends on what the day is like and what my role is. I work with a multi-disciplinary team made up of a speech language pathologist, a psychologist and a GI physician. Nutrition is a bit psychological and there’s a bit of counseling. Patients with pediatric feeding disorders need that psychological component. I can give recommendations, but that’s not my area of expertise. I work with a lot of kiddos on the autism spectrum and there’s a lot of things outside of my scope. It’s really nice to have a full team, right there in the room, tackling a case together.

I mostly focus on the nutrition aspect of things. I ask myself: Are we meeting all their nutritional needs? We have a lot of kids on what I call the orange food diet, consisting of Doritos, Goldfish and a lot of French fries. I check their DRI, if they are good on fluid, if they are constipated and how those impact eating. I recommend supplements to meet their needs temporarily while the other team members work on eating skills and behavioral therapy. Once they make progress in those areas, I reassess and determine the next area of their diet to target that is realistic and can meet their needs. It’s a never-ending cycle.

Working with kids has really changed my view on nutrition. Before working with them, I had these ideas of what kids should or shouldn’t eat, how they should have minimally processed foods. But I learned the biggest question has to be: Is that realistic? Our goal is to get them to eat at least two foods in each category. I need to meet people where they’re at.

Q. What’s the story behind how you came to work at Children’s Wisconsin?

A. Before I took my RD exam, I initially applied for an inpatient position at Children’s. I didn’t get it. Soon after, an outpatient position was posted. I got that role, and it was meant to be. I am an outpatient dietitian, not an inpatient. I wanted to work in pediatrics. I also initially wanted to work in public and community health, and now I’ve been in clinical for two years. It’s kind of funny how that works. What’s meant to be for you will align, and it will happen.

Q. Why did you want to work with children?

A. Over the years I’ve come to realize I wanted to work with kids; it wasn’t my immediate area of interest. It started during my undergraduate years when I was doing my volunteer hours at Hunger Task Force and their farm. I volunteered with bringing culinary plant-based cooking lessons to children in Milwaukee Public Schools with FoodRight as well.

I really like working with kids, witnessing their ability to learn and watching their confidence grow. I was like, OK, this is pretty cool. At my current job, I get to hang out with kids, we’ll color together, and I get to play at work. It’s pretty fun.

I struggled to realize until I was in my role that I’m working with parents and caregivers too, and they’re adults. Sometimes it can be difficult to manage. I have an idea, they have an idea, and they don’t always align. It’s been about finding that balance and managing things in more of a collaborative way.

Q. What has been the biggest challenge for you as a dietitian working in the industry?

A. I feel like the times are kind of changing, but overall, we’re undervalued. I don’t think people see us for our expertise. Anyone can be a nutritionist; you can just say you are one and everyone believes you.

Sometimes people have really strong nutrition beliefs and they are really emotionally attached to them. Realizing you can’t necessarily change someone’s mind, but can allow them to process your advice on their own time and move beyond restrictive and reductive thinking, is huge. Food is emotional, and it has all those connections, so it can be really hard, especially because I work with caregivers and children who pass their food beliefs, thoughts and body image onto their children. A lot of our nutrition interventions are also limited by social determinants. I can’t change my patients’ socioeconomic status, I can’t make healthy grocery stores pop up in their neighborhoods and I can’t make sure the produce available to them is fresh and not rotten. That’s really hard.

Q. What is one thing you wish you had known before starting your career in dietetics?

A. One is compensation – we are not compensated fairly for what we are capable of doing. The other is awareness. I came from a different path, but I still really didn’t know about nutrition and dietetics. There are so many factors into why – what even is healthy? What does that even mean? I don’t think it’s a great word to use. For me, gluten is very “unhealthy” as it causes an autoimmune response, but for those without Celiac disease, gluten is perfectly nutritious. Nutrition is that area where nuance is so incredibly important and often overlooked.

Q. What’s helped you move forward in your role?

A. I would say all of my coworkers. I’ve had amazing managers in my role and really great supervisors. We have super great resources. One of the dietitians retired after working with cystic fibrosis patients for 32 years, and she was amazing to work with and learn under.

My institution has so much support and resources, it was easy to succeed. That’s really what made it. When I was overwhelmed and questioning, “Is this what I want to do? Is this really for me?” I was able to work through that and my imposter syndrome with the help of a mentor. I wanted to do community nutrition, and here I am in clinical. I had this thought and this vision, and my life diverged from it, as it has so many times in the past.

Q. Is there a program or initiative that you are most proud of?

A. In 2023, we started a work group to address food insecurity and I’m leading the group. We ask ourselves what we can do and what it looks like to address food insecurity. This year we hope to better empower our fellow dietitians to address food insecurity in their practice. We are focused on where we as practitioners are lacking in skills or knowledge to help empower them to address food insecurity in their daily role.

We also think from an organizational capacity to support that. We have thought of culinary teaching kitchens, implementing food pantries and trying to figure out how to meet those needs and serve our communities. We need to be able to support nutrition interventions and meet DRIs through a varied diet. I am very excited to continue that work and see what that looks like over the next year.

Q. Have any current events impacted you from a dietetics perspective?

A. The events in Gaza and Palestine have broadened my lens to an even greater global health perspective. From my public health lens, it’s hard for me not to acknowledge the need to address food insecurity and famine across the globe. Furthermore, my mind wonders what the impact of climate change will have on our global food supply for the years to come.

Bio:

After working in the culinary industry for five years, Caitlin Jacobs, MPH, RD, CD, earned a bachelor’s degree in nutrition and dietetics from Mount Mary University in Milwaukee, Wisconsin, and completed her Master of Public Health from the Medical College of Wisconsin, also in Milwaukee. She completed internships at Children’s Wisconsin, Rogers Behavioral Health, Medical College of Wisconsin and Aramark. She began working as a clinical dietitian for Children’s Wisconsin more than two years ago. She has been a lifelong resident of the Milwaukee area and currently resides in the surrounding suburbs with her husband and dog.