Childhood Cancer
How Treatment Affects Eating
For children with cancer, it is extremely important to eat balanced, nutritious, and nourishing meals. A child’s body needs extra energy to metabolize medications and repair the healthy cells damaged during treatment, the same treatments that can destroy the child’s appetite and taste sensations. Eating is tremendously affected by chemotherapy, radiation, and other cancer treatments, resulting in irregular eating habits. Many side effects may prevent eating, including nausea, vomiting, constipation, diarrhea, and throat and mouth sores. Radiation to the head or neck can change the way food tastes, so previously enjoyed food can become bland or undesirable.
Loss of Appetite
One of the most common issues associated with cancer treatment is the loss of appetite. While suffering from unpleasant side effects from nausea and vomiting to an altered sense of taste and smell, children reasonably do not tend to feel hungry. Loss of appetite is most prominent during the intensive periods of treatment, and it is vital for children to remain at a healthy weight. If a child loses more than 10-15% of their bodyweight, they may need to be fed intravenously or by nasogastric tube. Families of children with cancer should be aware of potential problems that may arise with poor nutrition and weight loss including fatigue, weakness, and pressure injuries. If a child develops nutrient imbalances, it may lead to mood or behavior changes, confusion, or issues with heart, liver, or kidney function. Poor nutrition over time can result in a lack of vitamins and minerals which can put a patient at higher risk for complications from chemotherapy. Children may also experience a side effect of chemotherapy called early filling, in which the child feels full after only a few bites of food. A child who is suffering from early filling may begin losing weight and become malnourished if they only eat when they feel hungry. Good nutrition and increasing calories in small amounts of food are important to help prevent these medical problems and encourage normal growth.
Click to learn more about options for increasing calories, nutritional value, and managing weight loss
Lactose Intolerance
Lactose intolerance is when the body is unable to fully digest the sugar (lactose) in milk and other dairy products. Our bodies use an enzyme produced in the small intestine called lactase to break down the sugar so that our bodies can absorb it. However, those with a lactose intolerance do not have enough of lactase, so the sugar is not broken down and can cause symptoms such as gas, bloating, abdominal cramps, and diarrhea. Lactose intolerance in some children can be caused by antibiotics or chemotherapy.If a child develops a lactose intolerance, it is important to learn about low-lactose diets and alternate sources of protein.
Suggestions for Parents of Children with a Lactose Intolerance:
Children with Lactose Intolerance may be able to manage milk alternatives such as soy milk, almond milk, rice milk, oat milk, goat’s milk, or lactose-free milk. Often these are easier to digest and allow the child to gain more nutrients and calories.
Remember that milk is a common ingredient in many foods, such as bread, sauces, desserts, candy, salad dressings, processed meats, etc. Make sure to read ingredient lists carefully.
Add special enzyme tablets to dairy products to make them more digestible. Discuss these with the oncologist or primary physician before giving them to your child.
If your child cannot tolerate any dairy products, add calcium to their diet with spinach and other leafy greens, canned salmon or sardines, chia seeds, beans and lentils, almonds, or calcium-fortified fruit juices.
Altered Taste and Smell
Another common reason that children undergoing cancer treatment do not want to eat is because food can become bland or taste bad. If food tastes bland to your child, try serving foods with more spices, such as Italian or Mexican cuisine.
Chemotherapy can also cause foods, specifically red meats, to taste metallic and bitter. If this issue occurs, try to avoid using metal utensils, pots, and pans which can enhance the metallic taste. Serving your child’s meals with plastic forks and spoons is an easy alternative to metal. Additionally, red meats can be eliminated from your child’s diet and replaced with chicken, turkey, tofu, pork, eggs, and dairy products to ensure they are receiving enough protein.
Info adapted from alexslemonade.org and Childhood Cancer, A Parent’s Guide to Solid Tumor Cancers, 3rd ed. By Anne Spurgeon & Nancy Keene.
“Childhood Cancer.” Alex's Lemonade Stand Foundation for Childhood Cancer, 1 Nov. 2019, www.alexslemonade.org/childhood-cancer/guides/childhood-cancer.