A good diet includes sufficient calories to ensure a normal rate of growth; fuels the body’s efforts to repair and replace healthy cells; and provides the energy the body needs to break down the various chemotherapy drugs given and excrete their by-products. Over the time that chemotherapy is being administered, maintaining weight is the priority over a balanced diet. Research shows that well-nourished children can tolerate more treatment with fewer side effects, recover faster from treatment, and maintain weight better.

When the body becomes malnourished, body fat and muscle decrease. This leads to weakness, lack of energy, weight loss, a decreased ability to digest food, and a diminished ability to fight infection and recover from injury. These health issues often require a reduction in the dose of chemotherapy drugs.

To keep your child’s body well-nourished, foods from all six basic food groups are needed. The groups are (1) meat and other proteins; (2) dairy products; (3) bread and cereal; (4) fruits; (5) vegetables; and (6) fats and sweets. Children on chemotherapy also benefit from a higher than average intake of fats, which add needed calories.

Examples of foods contained in each group are listed below, with a small child’s serving size in parentheses beside each food. Consult a nutritionist to determine the serving size that is appropriate for your child.

Meat and other proteins (two or three servings per day)

Meat (1 ounce)

Fish (1 ounce)

Poultry (1 ounce)

Cheese (1 ounce)

Eggs (1)

Peanut butter (2 tbsp.)

Dried beans, cooked (½ cup)

Dried peas, cooked (½ cup)

These foods provide protein, which helps build and maintain body tissues, supply energy, and form enzymes, hormones, and antibodies. Some typical 1-ounce servings of meat and meat substitutes are: a meatball 1 inch in diameter, a 1-inch cube of meat, one slice of bologna, a 1-inch cube of cheese, or one slice of processed cheese.

Dairy products (two or three servings per day)

Milk (½ cup)

Cheese (1 ounce)

Ice cream (½ cup)

Tofu (½ cup)

Custard (½ cup)

Yogurt (½ cup)

Dairy products provide calcium, vitamin D, and protein. Steroids can weaken bones, so calcium and vitamin D (both necessary for bone growth and strength) are very important.

Breads and cereals (six to 11 servings per day)

Bread ( ½ slice)

Oatmeal ( ½ cup)

Cream of wheat ( ½ cup)

Graham crackers (1 square)

Rice ( ½ cup)

Dry cereal ( ½ cup)

Granola ( ½ cup)

Cooked pasta ( ½ cup)

Saltines (3 squares)

Potatoes (1 baked)

Breads and cereals supply vitamins, minerals, fiber, and carbohydrates. Try to use only products made with whole wheat flour and limited sugar to get more nutrients per serving. One sandwich made with two slices of bread provides four servings of this food group.

Fruits (two to four servings per day)

Fresh fruit (1 medium piece)

Canned fruit ( ¼ cup)

Dried fruits ( ¼ cup)

Fruit juice ( ½ cup)

Fruits provide vitamins, minerals, and fiber. Fruits can be camouflaged by puréeing them with ice cream or sherbet in the blender to make a tasty milkshake or smoothie, or by adding them to cookie and muffin recipes.

Vegetables (three to five servings per day)

Raw vegetables ( ¼ cup)

Cooked vegetables ( ¼ cup)

Vegetables, like fruit, are excellent sources of vitamins, minerals, and fiber. If your child does not want vegetables, they can be grated or puréed and added to soups or spaghetti sauce. If you own a juicer, add a vegetable to fruits being juiced. There are also many brownie, cake, bread, and muffin recipes that use vegetables that cannot be tasted, such as zucchini bread, brownies with spinach, carrot cake, and veggie muffins.

Fats and sweets (several servings per day)

Butter or oil

Mayonnaise

Peanut butter

Meat fat (in gravy)

Ice cream

Nuts

Whipped cream

Avocado

Olives

Chocolate

Although the food pyramid calls for fats to be used sparingly, higher consumption of fats is needed for children being treated for cancer. Experiment to find the fats your child enjoys eating and serve them frequently.