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Staying at a healthy weight can be difficult for some children during and after cancer treatment. Side effects of treatment, taste changes, fatigue, depression or anxiety can all decrease a child’s appetite and make eating difficult. And even if a child is eating enough calories, they may not be getting all the nutrients they need to tolerate and recover from treatment.
Ways to help your child get more protein and calories:
Don’t force your child to eat but work with them to come up with an eating plan that works for both of you. Don’t make eating a power struggle. Talk to the cancer care team if you don’t think your child is eating enough.
Some children gain too much weight during or after cancer treatment. Studies show that many children getting treatment for cancer eat enough calories, but don’t follow a healthy diet. In fact, the average child with cancer does not eat enough fruits, vegetables, whole grains or dairy foods and eats too many sugary and salty foods. Without the healthy foods, children with cancer may not get all the nutrients they need to tolerate treatment and stay on track with normal growth and development. In addition, these types of diets tend to lead to weight gain which can have negative health effects later in life.
Your cancer care team can also give you tips on planning meals and snacks that are satisfying, but not high in calories. Ask to meet with the dietitian on your team if weight gain is a concern. Offer your child fresh, nutritious, filling foods, such as fruits and vegetables, homemade soups, non-processed meats, dairy products, whole grain breads, and whole grain pastas. Your child does not have to feel deprived of their favorite foods, but some changes in the recipe might be wise. Consider thin crust pizza with low sodium cheese for the pizza lover, and baked chicken tenderloin strips and potato fries for the chicken nugget and french fry lover. No food is especially bad, but how it is prepared or the portion size can be unhealthy. Another option is to have some favorite foods less often, but on a regular schedule (for example once a week).
If your child has been gaining weight during or after treatment, your focus should be on helping them make healthy food choices and increase their physical activity level. This will help them not only lose the extra weight but will help them learn healthy habits that they can use for the rest of their lives. Cancer treatment may have interfered with their sports activities or school activities and getting them back out there as soon as you can will help.
Here are some suggestions to increase healthy food choices and increase physical activity.
For more ideas about how to help your child include more healthy options in their diet, ask to talk with a dietitian.
Some children with cancer take steroids, such as prednisone or dexamethasone, as part of their treatment. The steroids may cause them to gain weight and retain fluid in the face and belly. And children taking steroids usually feel hungry and need to eat often.
You can help your child by making some diet changes to help reduce fluid retention and weight gain. Your doctor, nurses, or dietitian can help you know what to do. They may recommend foods lower in sugar because prednisone can increase the chances of elevated blood glucose levels. They may also suggest foods low in salt (sodium).High-sodium foods, such as most snack chips and pretzels, processed foods, or frozen meals should be avoided. (Those labeled “reduced sodium” are usually OK.) Instead, have your child try foods seasoned with spices instead of salt.
The appetite changes and fluid retention caused by steroids will go away when treatment ends. When steroid treatment ends many children will lose their appetite for a short time. The weight loss that may come with this is expected and will be closely watched. But some children, especially teens, may have a hard time losing the weight gained during treatment. Encouraging them to make healthier food choices while on prednisone (especially lower sugar foods and drinks) and being as active as possible may help.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Brinksma A, Sulkers E, IJpma I, Burgerhof JGM, Tissing WJE. Eating and feeding problems in children with cancer: Prevalence, related factors, and consequences. Clin Nutr. 2020;39(10):3072-3079.
Cohen J, Goddard E, Brierley ME, Bramley L, Beck E. Poor diet quality in children with cancer during treatment. J Pediatr Oncol Nurs. 2021;38(5):313-321.
Children’s Oncology Group. The Children’s Oncology Group Family Handbook (2nd ed.) childrensoncologygroup.org. Accessed at https://childrensoncologygroup.org/family-handbook-268 on March 30, 2022.
Fullmer M. Nutritional Needs for Kids with Cancer. kidshealth.org. Accessed at https://kidshealth.org/en/parents/cancer-nutrition.html. on April 6, 2022.
Goddard E, Cohen J, Bramley L, Wakefield CE, Beck EJ. Dietary intake and diet quality in children receiving treatment for cancer. Nutr Rev. 2019;77(5):267-277.
United States Department of Agriculture. MyPlate. Accessed at https://www.myplate.gov/ on April 1, 2022.
Last Revised: June 22, 2022
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