Nutrition during childhood cancer

Berna Harmse informs us about nutrition during childhood cancer.

Cultivating healthy eating habits is part of the well-being of any child. Food helps build strength and strong immune systems and is also important for normal growth as well as brain development. 

Children receiving cancer treatment need sufficient amounts of nutritious foods for all the same reasons, but with caution so as to prevent weight loss and long-term effects on normal development.

The basics of good nutrition during childhood include:

• Eating regular balanced meals and snacks with a variety of nutrient-rich foods.
• Including fruit and vegetables daily (aim for at least five per day).
• Include mostly wholegrain high-fibre carbohydrates in meals and snacks.
• Loads of water to stay hydrated.

Not every child is the same

Note that not every child experiences nutritional side effects and not all who suffer from side effects have the same ones. For example, some children receive cortisone treatment and can  gain weight during active therapy.

There are no generic guidelines to follow that apply to all patients. In general, the nutritional impact of  cancer or treatment thereof depends on the size and location of the tumour (digestive tract tumours may stop the child from getting food) and the type of treatment the child is receiving (chemo and radiation can cause nausea, vomiting, diarrhoea, constipation and poor appetite). The area of radiation is also a factor (radiation of the stomach and intestines can cause either diarrhoea or constipation).

Some patients might suffer from dry mouth or changes in taste perception. An individualised nutritional approach is best when your child is suffering from any of the above.

Main priority – preventing weight loss

Our one priority, with children receiving active therapy, is preventing weight loss. Patients who eat better, feel better. Loss of appetite is a concern for ill children. When a child is in pain, or stressed, or depressed, his/her appetite tends to disappear. Also, patients hospitalised for therapy often are nil by mouth before tests and surgery as well as after surgery.

Guidelines for parents whose children have a lack of appetite:

• Avoid making mealtimes stressful. Nagging, forcing and bargaining creates stress and will make your child dread mealtimes.
• Make mealtimes fun by setting the table and making it family time. You can even include your child in the planning or preparation of meals if they’re up to it.
• Be flexible – have snack foods like trail mix, breakfast bars, crackers with peanut butter, chess dippers and muffins available.
• Sometimes smaller more frequent meals during the day works instead of three main meals.
• Have their favourite foods on hand and let them have it at any time of the day.
• Liquid nutritional supplements can be helpful. 

Most importantly, if you’re worried about your child’s nutritional intake, weight or struggling to manage side effects of treatment, contact your health professional. Problems addressed early make the management thereof much easier.

MEET OUR EXPERT – Berna Harmse

Berna Harmse is a private practicing dietitian. She holds a MSc in Dietetics, and has a special interest in oncology nutrition. She is also an external lecturer at Stellenbosch University Division of Human Nutrition.