Fatigue: How to Help Your Child Manage Tiredness

Your child’s disease and treatments might make them feel more tired than usual. This feeling of low energy is called fatigue. Fatigue affects many patients. It does not mean that the illness is getting worse or that the treatment is not working.

Fatigue can make it hard for your child to do normal activities. This can interfere with daily life and with their physical and emotional health. For some patients, fatigue continues even after treatment ends. Read about fatigue and cancer.

Causes of fatigue

Fatigue can be caused by many things. Your child might feel tired for any of these reasons:

• Disease side effects. This includes infection and anemia (too few red blood cells). These side effects can affect your child’s energy level.
• Treatments and medications. Fatigue can be a side effect of chemotherapy, radiation, and other medicines.
• Sleep habits. These might change due to changes in schedules or from exams, tests, and treatments. Noises and people can also interrupt rest in the hospital.
• Stress. The stress of dealing with the disease and coping with feeling anxious or depressed can lead to fatigue and loss of sleep.
• Procedures and healing. Bone marrow and stem cell transplants can demand a great deal of energy both during and after a transplant.
• Nutrition. Many diseases and treatments can affect appetite or the way the body gets nutrients from food.

Signs of fatigue

Fatigue affects everyone differently. It can last for a long time or for a short time. And it can happen during or after treatment. If your child is fatigued, they might:

• Want to close their eyes often
• Avoid play and other activities
• Say they are too tired to think or do other things
• Want more sleep
• Get mad, upset, or sad more often than usual
• Not act like themself or want to be left alone

Medical treatments for fatigue

Sometimes fatigue is caused by a medical issue such as infection or anemia. Your health care team watches your child and tests for these problems. Your care team may prescribe medicine or order a blood transfusion to increase the number of red blood cells in your child’s body.

Ways to help your child save energy

Feeling tired is common during an illness or hospital stay, but there are things you can do to help your child cope and have as much energy as possible.

Watch for the signs of fatigue in your child. Keep a journal of their daily activities and how much energy they have at certain times of the day. You will start to notice a pattern in your child’s fatigue. You might also notice that some activities give your child energy.

Encourage healthy eating. Make sure your child eats healthy foods that give them energy. It may also help to eat smaller meals or snacks more often through the day to help your child maintain energy. It is normal for your child’s appetite to change during treatment. But it is important for them to eat healthy food to give their body energy. A dietitian can help you plan healthy meals and snacks to help with fatigue.

Prioritize activities. Help your child decide which activities are most important and do those first. If your child is too young to decide, you choose. Do not try to do too much in one day. Have realistic expectations and plans to help your child and your family do the things that are important for you.

Plan ahead. Notice the days and times when your child feels most tired and when they feel best. This helps you plan. Your child can do important activities during these times with most energy. Plan your day ahead of time so you do not have to rush. Or have someone else help with errands and other activities.

Take breaks. Have your child stop activities and rest before they get too tired. You can have your child sit down during activities, if possible. For example, your child can sit while brushing teeth or hair, making a snack, or getting dressed. Use a wheelchair for long trips or activities, if needed.

Change the focus. Encourage your child to think about things other than fatigue and illness. Choose activities that gradually build up strength and do not quickly drain energy. This might include spending time with family or friends, listening to music, reading, and playing.

Healthy sleep habits to improve fatigue

Sleeping better can help your child feel less tired. Tips for better sleep include:

• Create a bedtime routine that begins at the same time each night. Try to wake up at the same time each day.
• Keep lights on and blinds open during the day, even in the hospital.
• Take naps earlier in the day, if your child takes naps. The nap should be less than an hour. If it lasts longer, your child may not sleep as well at night.
• Avoid screen time in bed. The bright lights from video games or mobile devices can keep your child from falling asleep.

Certain activities can help your child get ready for bed and improve rest.

• Drink warm, decaffeinated teas. Do not drink anything with caffeine in the evening. This includes sodas, coffee, or tea. Avoid chocolate because it also has caffeine.
• Do activities that lower stress, such as yoga, quiet reading, cuddling, or talking.
• Take a warm bath before bed.
• Use the bathroom before bed.

If your child seems to sleep enough but is still tired, your care team might suggest a sleep study to see if there are other reasons your child may not be getting good rest.

Learn more about sleep disorders.

Exercise to improve fatigue

Read more about Physical activity after cancer.

When to seek help for fatigue

Patients may want to seek help from care providers to figure out what is causing tiredness.

A care provider may ask questions about:

• When the fatigue started
• How long it lasts, how it affects daily activities
• What makes the fatigue better or worse

A medical history, physical exam, and lab tests are used to find out about underlying causes. Details about a patient’s sleep, physical activity, and eating habits can also be helpful in looking at fatigue.

Assessment of cancer-related fatigue may include:

• Patient and family interview
• Review of medicines
• Medical history and physical exam
• Blood tests
• Sleep and activity diary

Questions to ask the care team

• What is the cause of my child’s fatigue?
• What are some ways I can help manage the fatigue?
• What should I track and report to my care team?
• How can we find support?

Always talk to your care team if you have questions or concerns about symptoms and side effects, including fatigue.