Nutrition for Children with Cancer

Good nutrition (getting enough food, fluids, and key nutrients) is important for the growth and development of any child. It’s even more important for children facing cancer.

Nutrients are the key components of food and fluids that the body needs to function. Some important nutrients are protein, energy (calories), vitamins, and minerals.

Poor nutrition (or malnutrition) can happen when the body isn’t getting enough energy and nutrients from food. Most children with cancer will have some issues with food and nutrition during treatment.

Malnutrition can lead to:

• Worse side effects
• Treatment delays
• Increased risk of infections
• Slowed or delayed growth and development
• Weak bones
• Decreased quality of life

What are the benefits of good nutrition during and after cancer treatment?

Encouraging children to eat the right foods during and after cancer treatment can help them:

• Feel better and happier
• Have more energy to move and play
• Get to and stay at a healthy weight
• Tolerate side effects of cancer treatment
• Lower their risk of infection
• Heal and recover faster

Learn more about nutrition during and after cancer treatment.

What eating and nutrition problems can happen from cancer and cancer treatment?

The same kinds of problems with eating and nutrition that adults can have during cancer treatment can also affect children. The specific problems they have will depend on the type of cancer and the treatments they get.

Some of the most common eating and nutrition problems caused by cancer and cancer treatment include:

• Loss of appetite
• Nausea and vomiting
• Dehydration and loss of fluids
• Mouth sores
• Dry mouth or thick saliva
• Changes in smell or taste
• Weight changes
• Trouble swallowing

Learn more about managing eating and drinking problems caused by cancer treatment.

What are the signs of malnutrition?

Common signs of malnutrition in children include:

• Weight loss or slow weight gain
• Not growing or getting taller
• Having no interest in eating or drinking
• Not eating because of stomach problems
• Being less active or less playful
• Sleeping more than usual

The cancer care team will regularly check your child’s weight to watch for gains or losses. They will also do lab tests, such as checking electrolyte levels and doing metabolic panels, to be sure your child is getting enough of the right nutrients.

How can I help my child with cancer get the nutrients they need?

If your child is not getting enough nutrients, the cancer care team might recommend supplements such as protein drinks or vitamins.

Other ways to help your child get more nutrients:

• Encourage small snacks and meals throughout the day instead of 3 large meals.
• Choose mostly high-protein and high-calorie foods and drinks such as peanut butter and crackers, cheese sticks, pudding, fortified cereal, and whole milk.
• Avoid low-fat foods.
• Avoid drinking fluids with meals since this can make them feel full and eat less. Focus on drinking fluids between meals instead.
• Try to feed your child their biggest meal when they are most hungry. If they have a big appetite in the morning, focus on feeding their biggest meal at breakfast.
• Let your child help plan or prepare their snacks and meals.
• Invite your child’s friends to eat together.
• Encourage physical activity and play to increase their appetite.

If your child can’t get enough nutrients

It’s common for children to eat less when they’re going through cancer treatment. Many cancer treatments can affect appetite. Not getting enough nutrients can make side effects of cancer treatment worse and make your child very weak.

Feeding tubes

If your child can’t eat or drink enough to get the nutrients they need, the cancer care team might suggest a feeding tube. A feeding tube is used to give liquid nutrition with the right amounts of nutrients for your child. It can also be used to give water and some medicines if your child is having trouble swallowing or keeping anything down. There are different types of feeding tubes:

• If feedings are needed for a short time, a tube can be put in through the nose and into the stomach (called a nasogastric tube, or NG tube) or small intestine (called a nasojejunal tube, or NJ tube). These can be placed without surgery.
• If feedings are needed for a longer time, surgery might be done to place a feeding tube through the skin of the belly and into the stomach (called a gastrostomy tube, or G tube) or the small intestine (called a jejunostomy tube, or J tube).

Tube feedings can be given in the hospital and at home. Your child’s cancer care team will teach you how to give tube feedings at home if needed.

Parenteral nutrition and IV fluids

Sometimes feeding tubes might not be a good choice if cancer or cancer treatment is causing your child’s stomach or bowels to not work properly. In this case, the cancer care team might suggest giving liquid nutrition through an IV placed in a vein. This bypasses the digestive system and is called parenteral nutrition.

If your child is dehydrated, IV fluids might be needed. Water and certain electrolytes (minerals) are given through an IV.

Working with a registered dietitian

Many pediatric (children’s) cancer centers have a registered dietitian (RD) or registered dietitian nutritionist (RDN). They are health professionals specially trained to look at your child’s nutrition status and suggest ways to improve it.

A dietitian can suggest supplements or foods that are specific to your child’s needs. If your child needs feeding through a tube or IV, they often work with the doctor to recommend specific formulas based on lab tests and progress.

Dietitians can also help with other problems that affect eating and drinking such as trouble swallowing, mouth sores and pain, or dry mouth.

Learn more about nutrition, resources, and recipes for kids, or find a nutrition expert at the Academy of Nutrition and Dietetics.

Eating well after cancer treatment

Most eating and drinking problems go away after cancer treatment ends. As your child starts to feel better, encourage good eating habits to help them stay healthy.

Eating well after treatment can help your child rebuild strength, have more energy, and get back to a more normal life. Healthy eating can also help prevent health problems in the future, such as heart disease, diabetes and other chronic conditions. Survivors of childhood cancers are at a higher risk for health problems later in life compared to other children.

Learn more about eating well after treatment, physical activity, and answers to common questions.

If you need help getting food for your child

Having cancer is expensive. Research shows that many people and their families struggle to pay for daily needs. If you are having trouble buying food for your child and family, there are resources available.

• The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides food benefits for low-income women, infants, and children up to age 5. It is offered in all 50 states and through Indian Health Service (IHS) facilities.
• The Supplemental Nutrition Assistance Program (SNAP) provides food benefits to low-income families.
• The Community Eligibility Provision (CEP) provides free breakfast and lunch at school for children in low-income families.
• The Summer Food Service Program (SFSP) provides free meals and snacks to children 18 years and younger at Summer Meals Sites.
• The USDA National Hunger Hotline from Hunger Free America helps people find food assistance resources in their communities. They can be reached Monday through Friday between 7am and 10pm ET at:
  1-866-3-HUNGRY (1-866-348-6479) (for English)
  1-877-8-HAMBRE (1-877-842-6273) (for Spanish)