As parents and caregivers, we want to do everything we can to support our children’s health and development. This is increasingly challenging when a child is going through cancer treatment. At the Nutrition Education Services Center, we often hear from folks that are looking for resources to support the children in their lives nutritionally through cancer treatment. Today we are going to explore a common nutrition challenge that is frequently expressed: picky eating.
What is picky eating?
While there is no standard definition for picky eating, society often applies the term picky eating to describe those who are selective about the foods that they are willing to or not willing to consume. However, through cancer treatment, children who previously were willing to try and consume a variety of health supporting foods can suddenly become picky about what foods they will accept. For example, the child who was previously willing to consume most foods served to them but, since starting chemotherapy, may only eat a certain brand of chicken tenders.
Why may picky eating begin during cancer treatment?
There are several possible side effects from cancer treatments that can make eating challenging such as taste change, decreased appetite, fatigue, or nausea. Any one or combination of these or other side effects can make some foods undesirable and may be observed as picky eating. It is very normal through treatment for people of all ages to find that some tastes, textures, temperatures and aromas of foods become unappealing or intolerable.
In infants, toddlers, and younger school aged children, identifying the cause of eating challenges can be extra tricky. They may not be able to tell you what they are experiencing, identify what they are feeling, or explain why certain foods are suddenly unappealing. But they can communicate by refusing to eat certain foods.
How can I support my child who is a picky eater during cancer treatment?
- Have realistic expectations. Perfect nutrition does not exist, especially with the added challenges of cancer treatment. And that is okay! Do the best you can. Maybe your child won’t eat any vegetables during treatment but will eat fruit. Or your child may not want to eat meat through treatment but will eat peanut butter or yogurt. As Voltaire wrote, “Don’t let perfection be the enemy of the good.”
- Consult professionals. There are many professionals on your team that can play a role in optimizing the nourishment, growth and development of your child. Registered dietitians are nutrition experts and can help develop ongoing individualized nutrition plans for your child. If you don’t have a registered dietitian on your health care team, consider asking your doctor for a referral to a registered dietitian who specializes in cancer care. The Leukemia & Lymphoma Society offers free consultations with a registered dietitian. Additionally, oncologists, social workers, occupational therapists, speech-language pathologists, and pharmacists may all play essential roles on your child’s nutrition team.
- Manage side effects. Do address side effects with the medical team to limit their impact on your child’s food and fluid intake. If the current plan is not working, continue to communicate with members of your child’s healthcare team to adjust.
- Be a sleuth. Take notice of the types of foods that your child is eating and try to apply those clues to other foods. For example, if your child will only eat the specific brand of macaroni and cheese they serve in the hospital, it could be a sign that your child may be experiencing taste change. They may require more seasoning (such as salt) to make food taste palatable. This can be a clue that your child may also prefer other foods with more seasons.
- Engage your child. As age-appropriate, do involve your child in helping find solutions for tolerating new foods. It may be helpful to do a taste test with your child of different foods or one food that is seasoned in different ways to see what type or level of seasoning tastes best to your child. Involving your child in selecting and preparing foods may also encourage them to try certain foods.
- Be creative. Explore new ways to incorporate different food groups into foods your child will eat. You could blend fruits or vegetables into a smoothie or blend some vegetables into spaghetti sauce. Make a face with fruit on pancakes or try new dips to add new flavors. If your child likes cheese, adding cheese to other foods may also help.
- Keep mealtime calm. Set a relaxed tone and atmosphere at mealtimes. Children can feel your emotions and pick up on your stress. Staying calm and positive helps to keep mealtimes an enjoyable and pleasant experience for everyone. This can encourage healthy relationships with food and reduce negative associations with food.
- Remove the pressure. Feeding expert Ellyn Satter defines responsibilities of nutrition between the caregiver and children from infancy through adolescents. In short, the child is responsible for how much and whether they will eat, and the caregiver is responsible for what, when, and where the food will be served. Dividing responsibilities in this manner is helpful in raising confident, trusting eaters and supporting a healthy life-long relationship with food. Through cancer treatment, this outlook can take the pressure off both the caregiver and the child at meals and hopefully limit any power struggles over food.
Picky eating is challenging, and it may feel heightened through cancer treatment. Fortunately, picky eating is typically temporary, and there are resources for you to support your child to have the best nutrition they can through this time. Studies show focusing on managing side effects and reducing stress around feeding children is helpful. Do what you can to make positive changes, acknowledge the things that are going well with your child’s nutrition, and don’t forget to nourish yourself as well!
If you have concerns about prolonged or severe picky eating, your child’s nutrition, or growth and development, please talk with your child’s doctor and dietitian.
Through LLS’s Nutrition Education Services Center patients and caregivers of all cancer types can receive a free nutrition consultation with a registered dietitian who has expertise in oncology nutrition.
LLS Resources:
Nutrition and Childhood Cancer
Nutrition Handbook for Parents: Feeding your children and building healthy habits
Managing 4 Side Effects of Childhood Cancer Treatment
