Paediatric Cancer and Nutrition
Nutrition in paediatric cancer patients depends on the cancer type, stage of the cancer diagnosed and the mode treatment the child undergoes. The induced patho-physiological changes like alterations in metabolism of energy, proteins and fats, hormonal and inflammatory changes along with the tumour and treatment related issues lead to the development of malnutrition, delay the healing. These ailments are causes for growth failure, inadequate neuro-development and further complications. Thus the nutritional challenges in the case of children are more daunting.
Nutritional requirements in this case, have to focus on achieving the normal growth, provision of optimum of nutritional energy inputs, promoting weight gain, providing energy for regular activity as well as growth of the child, overcoming the treatment related side effects and to provide better quality of life.
Some nutritional therapies listed below, are advised to be implemented preferably through enteral intake and parenteral in case of severe vomiting / diarrhoea / pancreatitis, altered gastrointestinal absorption, etc.
Anorexia/Loss of appetite: Provide small frequent, calorie rich meals; nutrition supplements and appetite stimulants may also be included as per condition and response.
Nausea and Vomiting: Small frequent meals, non-spicy and non-greasy/oily foods, antiemetic support when needed.
Feeding (chewing and swallowing) difficulties: Texture modified foods; mashed/pureed foods will help; if required, tube feeding to ensure requisite ingestion of nutritional requirements.
Diarrhoea: Bland diet with adequate hydration; reduce intake of high sugary and lactose rich foods.
Constipation: High-fibre foods; inclusion of sufficient fruits and vegetables and adequate fluids; laxative as per medical advice.
Mucositis: Oral hygiene maintenance, texture modified foods – non-spicy, liquids, shakes, purees and nutritional supplements.
A few tips include that one should try to understand the child’s taste perception, avoid force feeding; in case the child has hunger cramps feed energy dense meals during those times; resort to small and frequent meals in a day (5-6) instead of 2-3 heavy meals.