Nutrition is as equally important as drugs in cancer treatment, because chemotherapy drugs differ from common medications. They create numerous side effects for patients, including nausea, vomiting, abdominal discomfort, loss of appetite, and sometimes abnormal eating due to steroids. These side effects can deter the child from further treatment. Muscle mass also plays a vital role during their treatment. Since they are already immunocompromised, malnutrition increases their risk further. Therefore, drugs, nutrition, and hygiene play crucial roles in the treatment of children with cancer.

First and foremost, chemotherapy drugs affect the child’s food intake; however, many parents or caregivers lack awareness regarding why this occurs or how to address it. Their primary trust often lies in drugs alone. Additionally, for nutrition-compromised patients, meeting their nutritional requirements solely through food can be challenging. Therefore, based on their dietary intake and nutritional needs, dietitians often recommend oral nutritional supplements. But, for those lacking awareness or caregivers who cannot afford them, conveying the importance of oral nutritional supplements and adhering to the prescribed dosage can be extremely challenging.

Parents and caregivers should consult an oncology dietitian to gain a better understanding of the treatment process and potential side effects. With the assistance of the dietitian, understanding the treatment course and drug-related symptoms becomes more manageable, facilitating the maintenance of the patient’s nutritional status. 

By regularly following up with the dietitian and assessing the child’s anthropometric measurements, caregivers and parents can effectively monitor and ensure their child’s nutritional well-being during treatment.

Even though they are immunocompromised, it is always advised to follow a neutropenic diet that includes high protein. All cancer patients undergoing treatment should be encouraged to consume well-cooked foods. Half-cooked or raw foods are not advisable due to the risk of infection.

A well-nourished child at the time of diagnosis is better equipped to withstand treatment compared to a malnourished child. Due to various symptoms that occur between treatments, the child becomes more vulnerable, both physically and nutritionally. If the child is within the normal weight range or slightly overweight, it helps prevent them from becoming undernourished. Even though a normal child experiences the same symptoms as others, their nutritional stability prevents their condition from worsening.

They can consume all foods with the prescribed preventive measures. We encourage the child to have a highly balanced meal with adequate protein. The diet plan may vary based on the side effects and symptoms, but a balanced diet is advisable for children with cancer.

• Firstly, considering that they are children, their preferences should be our primary consideration. We need to assess their food choices by conversing with the child or caregiver to identify which foods may be causing issues.
• In cases of nausea or vomiting, it’s advisable to avoid or limit problematic foods for a short period and then gradually reintroduce them. During times of fever, children tend to be more comfortable with liquids over solids; hence, we can consider calorie and protein-rich liquid options while ensuring adequate fluid intake.
• For mucositis, the approach depends on its severity. If it’s mild and solids are challenging, we can experiment with semi-solid foods. If not feasible, we may opt for liquids after consulting with a dietitian.
• In instances of low blood count, there isn’t a specific food to increase it. Instead, focus on a balanced diet with emphasis on proteins.
• To address loss of appetite, smaller and more frequent meals tend to be more effective.
• In cases of taste alteration, we can explore enriched liquid options containing calories and high-quality proteins.

This can pose a significant challenge for caregivers and dietitians alike. During such times, the initial approach could involve introducing small and frequent meals, following a pattern of six meals throughout the day. Alternatively, a regimen of three small meals supplemented with three liquid servings in between could be effective. Another strategy is to offer liquids every two hours.

These methods are particularly useful when symptoms arise due to drug side effects. Implementing these dietary adjustments can help manage the situation until the symptoms subside.

Oral nutrition supplements play a vital role in maintaining the nutritional status of patients, aiding them in tolerating treatments more effectively.

These supplements should offer a variety of flavors while being rich in both protein and calories. If the intake falls below 50% of the required amount, enteral nutrition is recommended. However, the option of parenteral nutrition should only be considered after a careful assessment of the patient’s condition.

• Hygiene, including hand hygiene, is crucial.
• Opt for small and frequent meals.
• Prioritize well-cooked foods and freshly prepared home-cooked meals.
• Maintain a diet rich in high calories and high protein.
• Ensure continuous follow-up with your dietitian.