Tips to Help Feed & Nourish Children in Chemo

Hello friends. Today I interrupt the regularly scheduled post of lunches to share information of a different kind. Food related, and for kids, but another sort of topic entirely.

In the past I have shared how childhood cancer has touched my life, and those messages, though not the norm for this blog, were received with such warmth and compassion. You rallied with me to help Alex and the Kallas family, you opened your wallets (and split my heart open in the process) to fund our own Another Lunch Chemo Duck drive. 

This time I am not asking you to vote for a sick child's family, or asking for any money. :)

This time I am simply sharing information. Information I hope can spread, to be found by the families who need it. Lu Sipos, the founder of the Chemo Duck program, and mother to a cancer survivor, asked me to collaborate with her on a post to share tips and helpful ideas to help kids with cancer eat. This post is a collection of ideas and strategies Lu has discovered in the process of caring for her son, and in the years since, while advocating and volunteering in the world of childhood cancer.  

This post has four sections: Adding Calories, Encourage Eating, Reducing Nausea, and Easing Sore Mouths & Mouth Sores. Each section has many suggestions for dealing with that challenge. (You will see Lu's words in orange italics. Lu is from England and has a lovely classic British accent. I suggest you summon your inner Mary Poppins when you are reading Lu's segments). :)

During cancer treatment a child’s appetite is so intermittent and unpredictable that it seems like food and eating become a minefield for parents to navigate.  It was the desire to offer options and ideas to families living with this challenge that lead me to reach out to Melissa Sharp from Another Lunch.  Her flair for nutrition, and making food fun, seemed like the perfect fit for the project. Although the collaboration was conceived to assist children living with cancer, these ideas and recipes translate to any number of situations and illnesses that affect appetite. - Lu Sipos

Adding Calories

My son, Gabe,  was only 12 months old when he was diagnosed with cancer. At that time, experience lead the surgeons to think they should implant a gastric feeding tube during his chemotherapy port surgery. The doctors assumed that since he was so young he would be unable to keep his weight stable without nutritional supplements.  Gabe’s oncologist decided that it was better to “wait and see” what happened with his weight and nourishment.  We, Gabe's mom and dad, found ways to add calories to his food whenever he felt like eating and he did manage to maintain his weight throughout treatment. These ideas can be used help supplement the diets of any child who struggles to gain weight or needs to supplement their diet. - Lu Sipos

• use full-fat dairy products: calorie-rich whole milk as a beverage and as an ingredient when making meals such as cereal, macaroni & cheese, pudding, etc.

• add dry milk powder to mashed potatoes, pancake batter, etc.

• drizzle extra virgin olive oil on pasta and noodle dishes

• add extra noodles to soups

• offer French Toast instead of plain bread or toast and add butter

• frying foods and breading before frying adds a lot of needed calories

• create kid-approved smoothies by blending fruits with whole milk, adding honey and an instant breakfast mix for added calories and sweetness. Adding frozen yogurt or ice cream punches up the calorie content even more.

• spread peanut butter on crackers and use as a dip for fruits and veggies. For a super boost of calories make Super Peanut Butter (recipe below) in lieu of regular peanut butter.

Peanut butter on crackers & full fat cheddar cheese make for a high calorie snack.

recipe || Super Peanut Butter

ingredients:

1 tablespoon of dried milk powder

1 tablespoon of honey

1 teaspoon of water

5 tablespoon of peanut butter

1 teaspoon of vanilla extract

directions:

Combine dry milk, water, vanilla in a small bowl and stir until moistened.

Add honey and peanut butter. Mix until well combined.

Mixture can be stored in the refrigerator, but will be difficult to spread when cold. 
Bring Super Peanut Butter to room temperature for easy spreading.

Spreading nutrient-dense peanut butter on to apple slices is an example
 of how you can add calories and fat to a simple snack.

Encourage Eating

We all know kids who are picky eaters! It is not unusual to hear a mother lament that meal times have become a challenge for their family.  But when your child’s health depends on maintaining a semi-healthy weight, and their appetite is non-existent, food and eating quickly becomes a challenge with very high stakes. The search for food that appeals to your child is akin to the quest to find the Holy Grail! Food choices are vital for children with no appetite, including children experiencing cancer treatment. Finding ways to make food more appealing and palpable...fun food and appealing presentation might just be the answer you're looking for. - Lu Sipos

• Offer small amounts of food more frequently. 
• A large portion of food can easily become overwhelming, a smaller portion can be more approachable. Try presenting food to your little one in small amounts, but at regular intervals. It is very possible your child will never truly feel hungry, so it may help to set a timer and offer food at set intervals. Offer food and encourage eating every time the timer dings.

• Make meals more appealing.
• Offer a variety of food choices in an appealing and fun way:
• stack bite-sized pieces on kabobs, toothpicks, or fun bento picks
• serve foods in an ice cube tray, mini muffin tin, or a Dr. Sears Nibble Tray:

Offering a wide variety of foods, in smaller portions, is one strategy to encourage eating.
Dr. Sears Nibble Tray (the pineapple), an ice cube tray, and even a mini muffin tin are a few
ways to achieve a smorgasbord of food options for your little one. 

• Keep snacks handy.
• Take an assortment of snacks to the hospital and doctor appointments so they are available at a moment's notice if hunger strikes.

• Snack ideas that are shelf-stable (can be kept in a diaper bag or vehicle indefinitely):
• cereal bars 
• granola bars
• crackers, pretzles, Teddy Grahams, Goldfish, etc.
• dry cereal
• individually packaged fruit cups, applesauce/fruit squeeze pouches
• beef jerky
• dried fruit, such as banana chips, raisins, and freeze dried apples
• yogurt covered raisins
• cookies
• small bottled waters, juice boxes, packaged milk boxes

Some samples of snacks that have a long shelf life. Stock snacks in your "go bag", 
the car, etc. so you have food to offer whenever your little one has an urge to eat.

• Snack ideas that require refrigeration (carry in an insulated lunchbox with an ice pack):
• string cheese
• yogurt
• sandwiches
• fresh fruit, such as clementines, apple slices, and grapes
• bite sized veggies, such as baby carrots and sliced cucumber
• hard boiled egg
• bottled smoothies

Reducing Nausea

A child experiencing nausea and vomiting becomes a source of stress and anxiety for any parent. Usually the symptoms pass quickly and it is not necessary to feed your child much more than a bowl of chicken noodle soup. However, when children experience prolonged bouts of nausea, common in chemo treatment, it becomes important to identify foods that will not aggravate the situation and will be agreeable to an unsettled tummy.  These tips are great for children that are feeling queasy for any number of reasons! - Lu Sipos

Bland foods, such as Cheerios and bananas, are gentle foods for an upset tummy.

• try foods with minimal odor (scent of food can trigger nausea), such as baked or boiled chicken breast, plain pasta
• dill pickles may help with the metallic taste sensation caused by chemotherapy
• offer dry cereal, crackers, toast in the morning as low blood sugar can trigger nausea
• offer snacks before bedtime or even the middle of the night to avoid an empty tummy
• find foods your child can tolerate, add one food per day for variety
• use a cold cloth over eyes when nausea strikes
• sip clear liquids: tea and Ginger Ale may decrease nausea, flat soda pop
• avoid fatty, greasy, or fried foods
• avoid icy drinks, very carbonated drinks, very hot drinks
• tepid peppermint tea
• Jell-O
• try the BRAT diet foods: bananas, rice, apples/natural applesauce, toast
• offer Queasy Pops 

Queasy Pops were developed by healthcare professionals with a unique blend
 of essential oils and aromatherapy to provide relief from a queasy stomach.

Easing Sore Mouths & Mouth Sores

Both Chemotherapy and radiation treatment can destroy the cells that line the mouth; which can lead to dry mouth and painful mouth sores. This can make feeding your child, a difficult situation already, almost unbearable.  This may be a time to consider using more liquid meals to avoid having to chew solid foods. The following ideas are foods that are easy to eat and will coat little mouths to ease discomfort. - Lu Sipos

Food ideas that help soothe a sore mouth or throat:

• cold yogurt, frozen yogurt bites, frozen yogurt tubes
• Jello-O, Jell-O Jigglers
• cold pudding
• popsicles, ice cream, soft-serve yogurt

Food ideas that are easier to eat with a sore mouth or throat:

• mashed potatoes, mashed potatoes with gravy
• bananas
• pasta
• smoothies

recipe || Sore Mouth Smoothies & Soothies

ingredients:

1 cup whole milk

1 cup vanilla yogurt

1 cup canned fruit, include syrup or juice (pears, peaches, mixed fruit)

add almond or vanilla extract to taste

directions:
combine ingredients in a blender, mix completely. 

For a Sore Mouth Smoothie: chill mixture and serve. 
Try serving in a sippy cup with a large spout opening, cup with a wide straw, bottle with the tip of the nipple cut off, or an open cup.

A smoothie can provide nourishment to a child who is resistant to chewing firm foods
due to painful mouth sores.

For a Sore Mouth Soothie: pour mixture into popsicle molds and freeze. 
Serve when frozen solid.

To make Sore Mouth Soothies, simply pour a smoothie mixture into popsicle molds and freeze.
Popsicles will last several weeks in the freezer.

An ice-cold popsicle, especially one made with mild ingredients such as those
in the above recipe, can provide numbing relief to a child with mouth sores.

If you would like more information about how to deal with the feeding challenges of children with cancer, here are some more resources:

Happily Hungry, Smart Recipes for Kids With Cancer, by Danielle Cook Navidi

Nutritional Needs for Kids with Cancer, www.KidsHealth.org

Nutrition for Children with Cancer, www.cancer.org

Lu Sipos may be found at the following:

the web: ChemoDuck.org

Facebook: Chemo Duck

Twitter: Quack Quack

email: lu@ChemoDuck.org