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There are many ways to help your child get the nutrients she
needs. The most common are:
By mouth
If at all possible, your child’s nutrient needs
should be met by eating and drinking nutrient-rich foods and fluids
that are part of a healthy, well-balanced diet. Try to stick to your
normal family mealtime habits as much as you can. Regular snacks can be
helpful, too. If needed, your child may be able to get extra nutrients
by eating high-calorie, high-protein meals supplemented with snacks,
and homemade drinks and shakes. But talk to your health care team
before making diet changes like these. Liquid nutrition products you
can buy at the grocery store or pharmacy are also options. There are
many different types on the market and it is best to discuss them with
your doctor first. Clinics often have samples your child could try
before you buy any.
Taking in enough nutrients is not just about managing weight
loss; it is also part of giving your child the chance for the best
possible treatment outcome. If it gets too hard for your child to
maintain or gain weight by eating and drinking, or if his calorie and
nutrients needs have greatly increased, a feeding tube may be needed.
By feeding tube
Tube feedings are given by threading a thin, flexible tube
through the nose and into the stomach. The tube can be passed further
along into the small intestines if your child is having trouble with
nausea or vomiting. Once the tube is in place, complete liquid
nutrition formulas can be given through it. These feedings can give
your child all of the calories, protein, vitamins, and minerals needed.
Tube feedings can be given at home, with the help of family,
friends, or caregivers. Your health care team will teach you how to do
this. Once tube feedings begin, your child will usually feel better
because his nutritional needs are being met.
Children who have feeding tubes usually can still eat by
mouth. The tubes are very small and will not keep your child from
swallowing. If your child needs a feeding tube, every effort will be
made to allow him to eat by mouth. For example, he may be tube fed at
night while sleeping to allow him to eat during the day. It is still
important to keep your child’s mouth clean through regular
rinsing and brushing while getting tube feedings.
Most young children get used to tube feedings within a few
days. But older children and teenagers may need longer. Talking with a
peer who has also had a feeding tube may help the older child who is
having a hard time adjusting to the tube. Parents also benefit from
talking with other parents who have dealt with feeding tubes. They
often have fears about using the tube, or concerns about the way it
looks. Children should be involved as much as possible in the decision
to use a feeding tube.
Although tube feedings are most often used to boost weight in
children with a poor appetite, they may also be used in youngsters who
cannot eat or drink. Again, good nutrition is needed to get the best
possible outcomes of cancer treatment. Talk to your health care team
about your child's eating habits, signs of problems you should watch
for, and things you can do to help your child get the most of what she
can eat.
A more long-term type of tube can be put through the belly
(abdomen) right into the stomach (a gastrostomy or g-tube) or the
intestines (a jejunostomy or j-tube). These surgical procedures can
usually be done in an outpatient setting.
Tube feeding does not come without problems. Talk to your
health care team to fully understand the likely benefits and possible
issues for your child.
By parenteral nutrition
Sometimes tube feedings are not able to give all the fluids
and nutrients a child needs. In these cases, nutrient solutions can be
given directly through a vein. This type of therapy is called
intravenous nutrition or parenteral nutrition (PN).
PN is most often used when the stomach and intestines are not
working properly. For example, in children who have:
- had surgery involving the digestive system
- complete blockage of the intestines
- uncontrolled nausea, vomiting, or diarrhea
- an infection that requires the digestive system to rest so
that it can heal
- problems from cancer or treatment that keep them from
eating or using a feeding tube
PN solutions can usually meet 100% of a child’s
nutritional needs. Like tube feedings, PN can be given at home.
Short-term use of PN for patients like those listed above is a safe way
to support your child until the problem is better. Once these issues go
away every effort should be made to switch to tube or mouth feedings
because PN can be hard on the liver.
Last Medical Review: 02/06/2009
Last Revised: 02/06/2009
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