Feeding the Chemo Kids

Feeding a child undergoing chemotherapy is a real challenge to the parents. First, there's prednisone, when your child eats all the time and will be actually waiting for you in the kitchen when you wake up all blurry-eyed and before coffee and looks at you with that puppy dog look: "feed me?". "Well, chemo kid, a nice bowl of cereal with milk?" "Uh uh." No way. He wants a steak!! And then a bowl of popcorn or maybe some soup. And don't bother with just one can, put in two cans.

Revel in it while you can, because after the first month, you won't be able to entice your chemo kid to eat. When I got to this stage I was brand new to the Ped-Onc group and I asked for suggestions. They sure made me laugh. Here's my post and the answers to my post.

All,

Any good ideas to get these kids to eat? We are in consolidation, past prednisone. Every time I offer to fix my son some food he says "Can't eat that, it would just make me puke."

We have come up with a few items that the chemo kid will ask for:

• snow cones, made with shaved ice (we got a Black and Decker ice crusher a few years back) and either thawed juice concentrate or (I don't like this) powdered Koolaid
• apples
• unsalted popcorn
• raw carrots and raw broccoli
• "Crispy Dillers" which is our name for quesadillas, made with cheese
• melted between two flour tortillas either in the microwave or *preferentially* grilled on the big, heavy old grill

I love to cook - you can imagine what the prednisone era was like for me!

Patty

Hi Patty,

My definition of an exciting food was anything she would eat (and not much qualified!). During the first consolidation, she was 4 yrs old and down to 25 lbs. I begged to see a nutritionist, and a very young woman with long blond hair and perfect makeup came in and started explaining about the basic food groups. My eyes glittered with tears and I said "I know all about the food groups, what I don't know is how to get her to eat ANYTHING!" I guess I scared her, because she handed me a few pamphlets and backed out of the room.

The next week, when we arrived for Kathy's first radiation treatment (at a different hospital), the nurse took one look at her and called the nutritionist. She was a doll. She explained that I needed to stop thinking healthy foods and start thinking calories. She gave me loads of tips on packing calories into small amounts of food. Kathy gradually put weight back on, but her aversions remained throughout treatment. To this day (5 years later) she eats a very limited range of foods. I take her to the store and she has to pick two fruits and two vegetables that I buy loads of for the week. Then I insist that she eat some each day.

While on treatment, Kathy ate grilled cheese sandwiches, french fries, anything with salt, toast, potatoes, beans, cereal. She drank no milk, no juice except apple, ate no meat of any kind, and nothing green except pesto (basil, olive oil, parmesan cheese, pine nuts, and garlic) and all the leaves off 2 dozen scented geranium leaves. I later looked basil up in a medicinal herbal and found out that it detoxifies the liver. I don't know what the geraniums had that she needed. But, she's the only kid I know on the high risk protocol whose bilirubin and other liver functions never went above normal. Coincidence? I don't know.

I just decided that anything she could eat was good food. Here are some free booklets (call 1-800-4-CANCER) that might give you some ideas:

• Diet and Nutrition: A Resource for Parents of children with Cancer.
• Managing Your Child's Eating Problems During Cancer Treatment.
• Eating Hints: Tips and Recipes for Better Nutrition During Cancer Treatment.

Good luck.

-N

Mary always wants parmesian cheese (on anything) but likes it wrapped in salami (she has had it on ice cream). She also wants macaroni & cheese all of the time; breakfast, lunch, dinner or snack. Her current crave is ranch pretzel pizzas.

Occassionally we can get other food down her. Yesterday a little spaghetti, today some cookies (but hey, it is something different).

She is not always this bad, generally when she is either on prednisone or coming home from the hospital like she did last week. Tomorrow she starts prednisone.

-R

Patty,

I call my Nick the "grain kid" -- all he eats are grains (breads, pastas -- plain, no butter or sauce -- and cereals.) We limit the sugar cereals to one bowl a day, and let him have multiple bowls of regular cheerios, wheat chex, bran, etc. He will eat any type of macaroni but it must be served steaming hot and without anything on it. I cringe everytime I see him swallow elbow macaroni that's still steaming on his fork. And he'll eat as much toast as we'll give him. Plain or with a little butter, but no jam or jelly.

He will eat Kraft Deluxe American Cheese every day - but don't dare buy him American cheese in individually wrapped slices. After Tony and I worried endlessly for months about his nourishment, we began putting Carnation instant breakfast in his nightly glass of milk. That makes us feel better.

We also give him an ample supply of vitamins.

I guess the best advice I'd share with other parents is to "go with the flow." Though Nick's been off prednisone since July 31, '96, his food cravings change at a moment's notice. Though, thankfully, he's not waking up anymore at 4 a.m. looking for pizza (like he was on prednisone.) You gotta be flexible. And don't beat yourself up so much.

-C

Sherbet could be another option. I used to crush plain cones and mix them with lime or orange sherbet when I was on chemo, and since I was never on Prednisone and this was pre-Zofran, pre-Kytril, it was always "that-would-just-make-me-puke" time. . . . ;}

My blender has an ice crushing function -- would the B/D ice crusher work better? I *adore* that kind of thing even now.

-K

Patty,

Actually, if you're getting your son to eat all that, well I'd be pleased as punch if my daughter would do that. Even after chemo, she still complains that things taste funny, and she's on every other night TPN. But I can usually get her to eat pizza with "no sauce".

-L

Getting kids to eat when they're really not hungry is tough. And, when you're used to a teenaged eating machine, it's really hard to watch. I asked Joe what he wanted to eat when he wasn't very hungry and this is his response: cereal, chinese food, veggies with ranch dip and anything BBQ. Not exactly a well-balanced diet, but it did get calories into him. We stocked up on the things he wanted and let him munch when he felt like it. I wanted to cook for him, but he just wanted to pick all day.

Hang in there, his appetite will be back. Joe is now in maintenance and eating normally. Actually, more than normally during the 5 days a month that he's on prednisone.

-M

Mom to Joel, 15, Dx ALL 7/95

Hello,

I can relate to what you are going through with all the food issues. While Sharon was on therapy she would only eat chicken wings, pepperoni and salami!!! That is a tuff diet for a 3 year old....it lasted all 3 years of therapy also. While on prednisone she would wake up at 2:00 a.m. and "need" chicken wings....it was worse than a pregnant craving!!!

Although she is off treatment now and 6 1/2, her eating is not much better. She will only eat meats and a couple fruits...no veggies at all. She does not even like french fries. I have started making muffins that are "packed" with all kinds of stuff. Her favorite pumpkin muffins are actually 1/2 carrots, and her cinnamon muffins are actually zucchini muffins, which are very good. She will not even eat eggs, so I have to disguise everything for her. Im sure her eating habits are not helping her immune system problem either!

-D

I just had to respond to a child's "need" for something in the middle of the night.

My son just finished his induction month (all month on prednisone) and he wanted corn every day, every meal, every minute. Corn anyway he could get it. On the cob, frozen, canned, creamed, with carrots, with peas, corn with anything.

Also we have a small store near us (we live in a rural area) and they make pizzas. Every time we even got in the car, he thought we were going there for pizza. Thankfully, they sell by the slice. So, corn and pizza. Wow what a diet!

Peace and blessings,

-L

Well this just figures,

Sharon is in day three of treatment. Tons-O-AraC. Can't ever get her to eat during the day, but her appetite picks up late at night, like now. So what does the Princess desire for this evening's fare? ? ?

SHRIMP ! ! !

Yep, cold coctail shrimp and it better be the big ones. So, , , I'm off to the local grocer to find frozen shrimp that I can rinse in cold water and serve up with some coctail sauce.

Hmmmm, I remember when some Micky D's Fries were good enough to satisfy her. She better get into and stay in remission soon, or I'm gonna go broke on these late night binges.

Boy I love that little girl.

-K

Ahhhh... A girl after my own heart. Anne gets a craving for Steamed Clams when shes on Decadron. We ordered from the hospital one day, you could smell those all the way down the hall...but she loved them.......

-E

Shrimp... midnight trips to Subway.... Steamed Clams.... Boy ... all Kay ever wanted was spray cheese on crackers or sliced cheese along with a glass of chocolate milk :)

-C

Shrimp!! What a great craving to have! I guess we lucked out, Megan only craved Oodles of Noodles and that was it!

-T

Lauras favorite was Popcorn with lots of butter and salt!! Of course the nurses made lots of extra stops at our room on a popcorn night :) Then there was those pickle cravings....sheesh.....

-d

Tobi is in remission now but do I remember those months of not eating. orange push ups, ravioli, and ham and cheese hot pockets. yum yum. no chocolate here no meat (real meat). no sweets no veggie's no nothing but when her weight went to 30 lbs. the nutristist said any thing any thing at all she was on the verge of having iv feeding. she is almost 5 now. and still doesn't like much but is in remission and doing fine.

I for got about the gummy worms for about 2 weeks she lived on gummy worms had to be worms not bears and there was the 11pm chicken legs not thighs or breast, legs and only legs had to go to the chevron down the road for that I was also told don't worry about nutrition give her whatever she wants any thing no matter what.