In some homes, mealtimes turn into battlegrounds, with worried parents resorting to threats or bribery to get their child to eat. Parents rarely win these battles—eventually they give in, exhausted and frustrated, and serve the sick child whatever she will eat (often to the dismay of the siblings who still have to eat their vegetables). The next several sections are full of ways parents made mealtimes both fun and nutritious.

How to make eating more appealing

Many children are finicky eaters at the best of times. Cancer and its treatment can make eating especially difficult. Here are some general tips for making eating more appealing for your child:

• Give your child small portions throughout the day rather than three large meals. Feed your child whenever she is hungry.
• Make mealtimes pleasant and leisurely.
• Rearrange eating schedules to serve the main meal at the time of day when your child feels best. If she wakes up feeling well most days, make a high-protein, high-calorie breakfast.
• Do not punish your child for not eating.

In the beginning of treatment, we decided that my son had to eat what the rest of the family was having. If he didn’t eat that, he got no more food. He usually just didn’t eat. Some mornings, I had trouble waking him up. He was limp and would have his eyes rolled back in his head. He was tested and diagnosed with hypoglycemia (low blood sugar). The doctor told us to give him whatever foods he was willing to eat and to make sure he ate something right before bed, even if it was ice cream or cookies and milk.

• Set a good example by eating a large variety of nutritious foods.
• Have nutritious snacks available at all times. Carry them in the car, to all appointments, and in backpacks for school.
• Serve fluids between meals, rather than with meals, to keep your child from feeling full after only a few bites of food.
• Limit the amount of less nutritious foods in the house. Potato chips, corn chips, soda, and sweets will fill your child up with empty calories.
• If your child is interested, include her in making a grocery list, shopping for favorite foods, and making meals.

How to make mealtimes fun

Here are some suggestions for making mealtime more fun:

• Try to take the emphasis off the need to eat food “because it’s good for you.” Focus instead on enjoying each other’s company while sharing a meal. Encourage good conversation, tell stories and jokes, and perhaps light some candles.
• Make one night a week “restaurant night.” Use a nice tablecloth and candles, allow the children to order from a menu, and pretend the family is out for a night on the town.
• Because any change in setting can encourage eating, consider having a picnic on the floor sometimes. Order pizza or other takeout, spread a tablecloth on the floor, and have an in-home picnic. One parent even sent lunch out to the treehouse.

My son enjoyed eating in different places around the house and seemed to eat more when he was having fun. I sometimes fed the kids on their own picnic table outdoors in good weather, and at the same picnic table in the garage during the winter. They were thrilled to wear their coats and hats to eat. Occasionally I would let them eat off TV trays while watching a favorite program or tape.

• Some children seem to eat more if food is attractively arranged on the plate or is decorated in humorous ways. Preschoolers enjoy putting a smiley face on a casserole using strips of cheese, nuts, or raisins. Sandwiches can be cut into funny shapes using knives or cookie cutters.

My daughter liked to have food decorated. For example, we would make pancakes look like a clown face by using blueberries for eyes, a strawberry for a nose, orange slices for ears, etc. She also enjoyed eating brightly colored food, so we would add a drop of food coloring to applesauce, yogurt, or whatever appealed to her.

How to serve more protein

Because many children cannot tolerate eating meat while on chemotherapy, below are ideas for increasing protein consumption:

• Add 1 cup of dried milk powder to a quart of whole milk, then blend and chill. Use this extra-strength milk for drinking and cooking.
• Use extra-strength milk (above), whole milk, evaporated milk, or cream instead of water to make hot cereal, cocoa, soup, gravy, custards, or puddings.
• Add powdered milk to casseroles, meat loaf, cream soups, custards, and puddings.
• Add chopped meat to scrambled eggs, soups, and vegetables.
• Add chopped, hard-boiled eggs to soups, salads, sauces, and casseroles.
• Add grated cheese to pizza, vegetables, salads, sauces, omelets, mashed potatoes, meat loaf, and casseroles.
• Serve bagels, English muffins, hamburgers, or hot dogs with a slice of cheese melted on top.
• Spread peanut butter on toast, crackers, and sandwiches. Dip fruit or raw vegetables into peanut butter for a quick snack.
• Spread peanut butter or cream cheese onto celery sticks.
• Serve nuts for snacks, and mix nuts into salads and soups.
• Put ice cream or whipped cream on top of pie, pudding, or fruit.
• Use dried beans and peas to make soups, dips, and casseroles.
• Use tofu (bean curd) in stir-fried vegetable dishes.
• Add wheat germ to hamburgers, meat loaf, breads, muffins, pancakes, waffles, and vegetables, and use it as a topping for casseroles.

Ways to boost calories

Many parents have ingrained habits about serving only low-fat meals and snacks. While your child is on chemotherapy, your mission is to find ways to add as many calories as possible to your child’s food. Here are some suggestions:

• Add butter to hot cereal, eggs, pasta, rice, cooked vegetables, mashed potatoes, and soups.
• Use melted butter as a dip for raw vegetables and cooked seafood such as shrimp, crab, and lobster.
• Use sour cream to top meats, baked potatoes, and soups.
• Add mayonnaise or sour cream when making hamburgers or meat loaf.
• Make milkshakes, puddings, and custards with cream instead of milk.
• Serve your child whole milk (not 2% or skim milk).
• Make dips with cheese, avocado, butter, beans, or sour cream.
• Sauté vegetables in butter.
• Serve bread hot so it will absorb more butter.
• Add mayonnaise or butter to sandwiches.
• Spread bagels, muffins, or crackers with cream cheese and jelly or honey.
• Make hot chocolate with cream and add marshmallows.
• Add granola to cookie, bread, and muffin batters. Sprinkle granola on ice cream, pudding, and yogurt.
• Serve meat and vegetables with sauces made with cream and pan drippings.
• Add dried fruits to recipes for cookies, breads, and muffins.
• Serve ice cream or milkshakes made with real cream.

Nutritious snacks

Try to always bring a bag of nutritious snacks whenever you leave home with your child. This allows you to feed him whenever he is hungry and avoid stopping for non-nutritious junk food. Examples of healthful snacks include:

• Apples or applesauce
• Baby food
• Granola bars with no added sugar
• Celery sticks filled with cream cheese or peanut butter
• Cookies made with wheat germ, oatmeal, granola, fruits, or nuts
• Crackers with cheese, peanut butter, or tuna salad
• Dried fruit such as apples, raisins, apricots, or prunes
• Fresh fruit
• Granola mixed with dried fruit and nuts
• Muffins
• Nuts
• Peanut butter on crackers or whole wheat bread
• Protein bars
• Vegetables such as carrot sticks or broccoli florets

Snacks that you can carry in a small cooler with ice packs include:

• Yogurt, regular or frozen
• Cheese
• Chocolate milk
• Cottage cheese
• Hard-boiled and deviled eggs
• Pudding made with whole milk or cream
• Juice made from 100% fruit
• Fruit smoothies made with frozen fruit, sherbet, or ice cream