Nutrition for children with cancer
All children need good nutrition to grow and develop normally. Good nutrition is especially important for children living with cancer and getting cancer treatments. Their bodies need nutrients to repair and heal damage caused by cancer and its treatments. Making sure a child with cancer gets proper nutrition can help:
- maintain and improve their strength and energy
- prevent delays in treatments
- manage side effects of treatments and speed recovery
- lower the risk of infection
- improve prognosis or outcome
- improve quality of life
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Children need the following nutrients for their bodies to grow, develop and work normally.
Protein is found in meats, poultry, fish, eggs, milk, cheese, yogurt, dried beans and peas, lentils and nuts. The body needs protein to grow and develop muscles. Protein also helps build a healthy immune system.
Carbohydrates are found in foods like grains, vegetables and fruit. Carbohydrates give the body energy. The body needs energy to keep it active and working properly. Getting enough energy helps the body grow, heal and stay at a healthy weight.
Fat is in foods like oils, butter, margarine, meats, poultry, fish, eggs, milk, cheese and nuts. It gives the body energy. Fat is also very important for body growth and development, including the brain’s development.
Vitamins and minerals are found in a variety of foods. The body needs them to grow, develop and work properly. For example, vitamin D and calcium form bones and teeth and keep them strong. Children who eat a variety of foods usually get enough vitamins and minerals.
Water is a very important part of health and good nutrition. Drinking water and other fluids keeps the body working normally.
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Problems with nutrition can lead to malnutrition, which is not getting enough nutrients. Malnutrition can cause weight loss, tiredness and slow growth. It can also make it easier for infections to develop.
Children with cancer can have problems with nutrition for different reasons. Certain cancers can make it hard to eat or can make a child lose their appetite. This may be because the cancer causes pain or discomfort, or it affects the digestive system so it doesn’t use nutrients as it normally would. Having cancer and being in a hospital can be very stressful or depressing for children, which can also affect their appetite and the foods they eat.
Certain symptoms of cancer or side effects of treatment can affect a child’s nutrition. Report the following problems to your child’s healthcare team so they can suggest ways to manage them:
- loss of appetite
- nausea and vomiting
- sore mouth and throat
- dry mouth
- difficulty swallowing
- taste changes
- symptoms of bone marrow suppression like irritability, fever and bruising
- weight gain
Find out more about managing symptoms and side effects.
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Nutritional status is a measure of how well the nutrients you get are meeting your body’s needs. The healthcare team will regularly check your child’s nutritional status throughout their cancer journey.
When a child is diagnosed with cancer, the healthcare team does a detailed nutrition assessment. This assessment can identify children who have problems with nutrition, or who have a high risk of developing problems because of the type of cancer they have or the treatment plan. Nutrition assessment is also used throughout treatment to identify malnutrition as soon as possible so it can be treated.
Your child’s healthcare team may use the following to check your child’s nutritional status:
body mass index (BMI)
- head circumference, which is used to check brain growth and development in young children
- arm circumference
- food and fluid intake
- blood tests to check protein and vitamin levels and how well organs are working
Find out more about tests and procedures used to check nutritional status.
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Each child with cancer has different nutrition needs. The healthcare team can help children and families maintain good nutrition and prevent malnutrition during the cancer journey.
A registered dietitian is a key member of the healthcare team. Dietitians can give advice about good nutrition and create a personal nutrition care plan for your child. Ask the doctor for a referral to a registered dietitian if you have questions or concerns about nutrition.
The whole family can support a child in eating well throughout their cancer journey. Encourage your child to eat well by serving small meals and snacks regularly throughout the day. Praising children when they eat well shows them that good nutrition is important. Try not to force children to eat or punish them for not eating. Try to wait until the next meal or snack time, and then give the child food and drinks again.
Find out more about nutrition for people with cancer, including how to eat more protein. See Canada’s Food Guide for ideas on healthy eating.
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Children with cancer may not be able to eat, or they may only be able eat small amounts each day. The following can help children with cancer get the nutrition they need.
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Commercial nutrition products give you many nutrients. They are sold in most pharmacies and grocery stores. They come in different flavours and forms, including drinks, powders, puddings and bars. Some commercial nutrition products are made specifically for children.
A registered dietitian can help you pick the products that are best for your child’s needs. Check with your provincial and private healthcare insurance plans. They may cover the cost of commercial nutrition products under certain conditions.
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The best way to get vitamins, minerals and other nutrients is by eating healthy foods. Cancer and its treatments may make it difficult for the child to eat healthy. Talk to the healthcare team to see if your child needs vitamin and mineral supplements. It may not be safe to take supplements if the child is receiving chemotherapy or radiation therapy.
Some people may also consider using natural health products, such as herbal supplements. It’s important to remember that even if a product is natural, it isn’t always safe. These products may cause side effects and interact with your child’s treatments. Proper doses for children may not be shown on the product label. Always talk to your child’s healthcare team about natural health products before using them.
Tube feeding and parenteral nutrition @(Model.HeadingTag)>
Problems like poor appetite, difficulty swallowing or sore mouth and throat can make it hard for children with cancer to eat and drink. The healthcare team may suggest tube feeding or parenteral nutrition if your child can’t get proper nutrition.
Tube feeding is also called enteral nutrition. The doctor places a tube directly into the stomach or small intestine. A special liquid mixture of nutrients is given through this tube. Depending on your child’s needs, tube feeding may be used to supplement what they take in by mouth. It can also be used to give your child all the nutrients they need. Tube feeding may be used to improve the child’s nutritional status before treatment starts or to prevent malnutrition during treatment.
Parenteral nutrition is a special liquid mixture of nutrients given by intravenous (IV) directly into the bloodstream. It is used when cancer or its treatments affect the stomach and intestines so they don’t work normally. Parenteral nutrition is usually used for a short period of time until the child can go back to eating or tube feeding.
Find out more about tube feeding and parenteral nutrition.
The healthcare team may prescribe medicines to help manage symptoms or side effects that affect a child’s nutrition. They can be used to improve appetite, prevent or manage nausea and vomiting, and manage pain. These medicines make it easier for a child with cancer to manage good nutrition.
Find out more about pain medicines.
Expert review and references
American Cancer Society. Nutrition for Children With Cancer. Atlanta, GA: American Cancer Society; 2012.
Ballal SA, Bechard LJ, Jaksic T, et al . Nutritional Supportive Care. Pizzo, P. A. & Poplack, D. G. (Eds.). Principles and Practice of Pediatric Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2011: 41:1243-1255.
Bauer J, Jurgens H, Fruhwald MC . Important Aspects of Nutrition in Children with Cancer. Advances in Nutrition. American Society of Nutrition; 2011.
Blinova E, Zelunka E . Natural Health Products and Cancer Treatment. Hospital for Sick Children. AboutKidsHealth. Toronto, ON: Hospital for Sick Children; 2013.
Brain Tumour Foundation of Canada. Pediatric Brain Tumour Handbook. 6th ed. 2012.
Co-Reyes E, Li R, Huh W et al . Malnutrition and obesity in pediatric oncology patients: Causes, consequences, and interventions. Pediatric Blood & Cancer. Wiley; 2012.
Sala A, Pencharz P, Barr RD . Children, Cancer, and Nutrition – A Dynamic Triangle in Review. Cancer. Hoboken, NJ: Wiley; 2004.
St. Jude Children's Research Hospital. Tube feeding. Memphis, TN: St. Jude Children's Research Hospital; 2004.
St. Jude Children's Research Hospital. Nutrition in Children with Cancer. Memphis, TN: St. Jude Children's Research Hospital; ND: http://www.stjude.org/.
St. Jude Children's Research Hospital. Tips for Handling Set-Backs to Good Nutrition During Therapy. Memphis, TN: St. Jude Children's Research Hospital; ND: http://www.stjude.org/.