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Nutrition and Side Effects

During cancer, many children have trouble eating and meeting nutrition goals. Problems in eating and nutrition can result in:

  • Weight loss
  • Delayed growth
  • Feeling tired or irritable
  • Getting sick more easily
  • Weakness and lack of energy for physical activity

Cancer-related problems in eating and nutrition can be due to a number of factors. Children who have tumors of the mouth, stomach, or intestines are at a higher risk of not getting enough nutrients because they have trouble eating or digesting food. Changes in routine or meal restrictions during hospital stays or medical treatments can interfere with normal eating. Children may also have decreased appetite due to pain, stress, worry, and lack of physical activity. For many children, treatment side-effects make it hard to meet nutrition goals.

lunch time in a pediatric cancer hospital cafeteria

Hospital stays or medical treatments may result in changes in routine that interfere with normal eating. Side effects from treatments add to eating and nutrition troubles. There are tips below that can help pediatric cancer patients and their families address some side effects and nutrition problems.

Help for Nutrition Challenges Due to Side Effects

Chemotherapy, radiation therapy, surgery, or other treatments may result in nausea, vomiting, diarrhea or constipation, and poor appetite. Treatments can cause painful sores to develop along the mouth and throat. The taste and smell of foods can also change, and even favorite foods may no longer be appealing. There are strategies that can help families address specific side effects and nutrition problems.

How Parents Can Support Nutrition Goals

Help children plan eating around times when they are feeling better. Photo shows a childhood cancer patient eating a grilled cheese sandwich in the hospital cafeteria.

Help children plan eating around times when they are feeling better.

During pediatric cancer, eating habits can change unexpectedly. It can be easy for meal times to become stressful for families. These reminders can help families in meeting nutrition needs.

  • Encourage children to eat well when feeling well. Many patients find that the desire to eat changes at different points during a cycle of treatment. Parents can help children plan eating around times when they are feeling better.
  • Lean on favorite foods and drinks. This is particularly important when a child is too sick to eat or drink much. 
  • Don’t be pushy. Gently remind patients when it's time to eat. Trying to force children to eat can cause children to resist more. Trying to “win” a battle over food can also cause more stress on families.
  • Be flexible. Offer choices, follow cravings, and don’t get stuck on having to follow a “normal” schedule. 
  • Maintain routine. Like flexibility, routine is also important. Eating is a bonding interaction for most families. Continue family meal traditions even if the child is eats something different or nothing at all.
Pizza oven with three pizzas cooking by a wood fire

To support nutrition goals during pediatric cancer, try to be flexible during meal times. Offer choices, follow cravings, and don't get stuck on having to follow a "normal" schedule.

Nutritional Supplements

Nutritional supplements or meal replacements may be used if the child has trouble meeting nutrition needs through foods. These are usually liquid meal replacements and are available in a variety of flavors. Talk to the child’s care team when poor eating continues for more than two or three days. Be sure to ask before using any supplements or meal replacements. You care team may suggest help from a nutrition professional. In some cases, clinical nutrition support may be needed.

Weight Gain

Although weight loss and malnutrition are a main concern for many families, children may also gain weight during cancer treatment. Increased inactivity and fewer opportunities to exercise may be a cause. Or it may be due to eating more high-calorie, high-fat foods.

Some medications, such as steroids, can cause weight gain. This is because steroids increase the appetite, cause the body to make fat instead of muscle, and cause the body to retain water.

Talk with the child’s care team to decide the best course of action about weight gain.

Tips to help with weight gain include:

  • Eat more fruits and vegetables.
  • Cut back on high fat, high calorie foods. Choose:
    • Low-fat or skim dairy products
    • "Light" and fat-free products
    • Lean meats
    • Foods that are baked, broiled, grilled, boiled, microwaved, or roasted foods, with minimal amounts of fat
  • Limit sweet drinks, including cola, juice, punch, sweet tea, lemonade, and Kool-Aid. Substitute diet or sugar-free drinks if recommended by the care team.
  • Limit portion sizes.
  • Increase physical activity level.
  • Make healthy choices as a family.
  • Eat slowly. Take time to enjoy foods.
  • Eat only when you are hungry.

Good nutrition helps pediatric cancer patients achieve normal growth and weight gain, continue taking part in daily activities, and improve overall health.

For more information on nutrition and healthy weight for families, see We Can! - Nutrition Tools and Resources.

Eating Hints from National Cancer Institute

Reviewed: June 2018