It's hard enough getting any three year old to eat, but parents of children with cancer face a special challenge ensuring their child is getting adequate calories each day. In addition to natural childhood stubbornness about food, treatment side effects like poor appetite, mouth sores, dry mouth, taste changes, and nausea can all affect a child's willingness and ability to eat. But rather than turning the kitchen into a battlefield, there are a handful of things a parent can try to help their child get proper nourishment.
First and foremost-don't force your child to eat. The resulting stress and bad feelings can actually make their appetite worse. Make meal time a fun time-which could include a game that leads to everyone taking a bite of food, or a special toy they can only have at meal times. It may also help to serve a small snack with meals-something you know they like-to get them to start taking bites. Then once they get going, encourage them to try a couple of bites of their meat or cheese. Use a cookie cutter to make their food into fun shapes-stars, triangles, or even a snowman-or you can use small fruits to make a happy face on their plate. You may even try picnics outside or in different areas of the house to make a meal more exciting. The pleasant environment created by a few small touches can help a child get in the right mood to cooperate and eat. And remember that it's ok if they don't eat much at a meal. Your child may prefer more frequent small snacks throughout the day.
Another way to get your child excited about mealtime is allowing them to participate in choosing their food. Let them help you pick foods at the grocery store, or even let them use a miniature cart and pick some of their favorite foods. You can also try some easy, home-made creations that your child can help you prepare. Kids often like rolling dough or sprinkling cheese on a home-made pizza. If they tend to only destroy your creations, give them a piece of dough to play with, or a plate and a cup of cheese so they can practice making their own mini-version of the meal. Allowing your child some control in the matter may improve their feelings about food and their willingness to take at least a few bites at a meal.
If they are only taking a few bites, you'll have to consider making every bite count. Spreading peanut butter on fruit or melting cheese on meat will enhance the calorie count of a smaller serving. High calorie snacks like cheese sticks, pudding, or cinnamon-flavored applesauce can also help a child achieve their calorie requirement of the day. If you're having more trouble, or your child is feeling ill, try high calorie drinks like a milkshake or a yogurt smoothie.
When your child is feeling well you can try to serve drinks after meals. While it's important for children with cancer to get adequate hydration throughout the day, getting a large amount of calories from beverages can suppress their appetite for food. Avoid sugary drinks, and even sugar-free drinks, which can displace the more nutritious calories of foods like chicken or fruit. Stick to fortified drinks like milk or 100% juice. If you have trouble getting your child to drink milk, add a teaspoon of chocolate or strawberry-flavored powder to it. With a small amount of flavoring you can make milk more appealing without turning it into a 200-calorie syrup drink, like the kind would buy at a restaurant or in a pre-mixed container. Offering straws may also encourage your child to drink a healthy beverage.
No matter which style you choose, try to establish a routine. Young children like to know what to expect, and if eating the food is just one step in the routine they may be more willing to cooperate. The general recommendation for a child's daily calorie intake is about 1300 calories per day for children ages 1-3, and 1800 calories per day for children ages 4-6 years. But remember, your child's daily calorie requirements will vary by their height, weight, activity level, and stage of disease, so you should discuss their nutrition goals with your child's oncologist or dietitian.