My Child Won’t Eat!
“My child just started treatment and she never feels like eating anything. I know nutrition is really important now and I feel frustrated and helpless when I can’t get her to eat.”
It can be challenging to get your child to eat well when they are dealing with a new diagnosis, medication changes, treatments, testing and stress. Treatments, medications and sometimes the illness itself can change how foods taste and smell, and how they are digested and tolerated. Your child was probably feeling ill and not eating normally before her disease was diagnosed and probably feels really yucky now that the treatment has started. Feeling lousy combined with worrying about the diagnosis can have a negative effect on your child’s appetite.
It takes quite a toll on a child, no matter the age, when something totally disrupts their world. Their minds and hearts are heavy with concerns for themselves and their future. They don’t know what to expect. In particular, young children do not have the language to describe these deep emotions, so they get frustrated and angry and cannot explain what they are angry about. In addition, children pick up on our frustration. They have an incredible ability to read how we are feeling and if something is going on, they sense it. The stress and effort it takes to go to and from the clinic, hospital and multiple appointments is exhausting. Combine all of this with the physical toll the disease is taking, and it is no wonder they don’t want to eat.
Because maintaining weight and nutrition can contribute to a better response to the treatments, good eating habits are an important part of aggressively fighting and treating disease. Ask your child’s doctor to recommend a diet that will work in tandem with the treatment and which foods to avoid. Post the recommendations on your refrigerator and highlight any of the foods from the list that your child normally likes and focus on those.
Don’t put too much pressure on yourself or your child. This is not a time to try to get your child to eat foods they normally don’t like. Sometimes, you’ll be lucky if they eat even one bite of their favorite snack. This is normal, but make sure you let your child’s doctor knows what she is eating and what your concerns are. Your medical team may want to order supplements, vitamins or even IV fluids or medication if there is a more dramatic eating problem to ensure your child is getting what they need.
Here are some suggestions that have helped some of us when our child refused to eat during treatment:
• Try offering smaller, more frequent meals.
• Keep a small cooler or lunchbox with you. Fill it with water, juice packages, nutritional snacks and microwavable foods your child likes to eat. You don’t want to miss an opportunity when she might just decide, after three days of eating almost nothing, that she wants to eat—NOW!)
• Prepare or buy “lunches to go” for clinic days, long treatments and lots of traveling days. Don’t forget about yourself! It is important for you to make time for meals and good snacks too!
• Talk to the hospital nutritionist. At this phase there may be dietary or nutrition consultation available to guide you in adding or deleting foods and providing ideas for meeting the nutritional needs your child’s condition and activities demand. Ask if any of your child’s medication might be impacting appetite, causing nausea or changing the taste of certain foods. Sometimes even the disease process or treatments and therapies can change how things taste.
• Ask your doctor about medications that might help. Sometimes a physician might suggest an anti nausea or similar medication to help reduce the symptoms and bring relief. It is important to try something new more than once to see if it might help.
• When your friends and family ask how they can help, ask them to prepare simple meals and snacks that your child likes. This is one way they can help to sustain you and your family while you focus on the treatment needs of your child. Ask them to bring a favorite food to the hospital as a surprise for your child.
When more is needed
If your child continues to refuse food for a prolonged period, your child’s doctor may recommend intervention. They may ask you to consider a feeding tube, which may seem scary and invasive. However, you will breathe a sigh of relief knowing that your child is getting the nutrition she needs. There are three types of intervention.
• NG Tube (nasogastric tube) is used on a temporary basis to give liquids and medication. It goes into the nostril, down the throat into the stomach. Once it is passed, it is not so bothersome, but does require some care of the nose and skin from the tape that is used.
• G Tube (gastrostomy tube) is surgically placed directly through the abdomen into the stomach. It requires daily care and attention to the skin but is a more long term way of maintaining control over nutritional intake, ensuring many kinds of medication can be given.
• TPN (total parenteral nutrition) is a combination of minerals, vitamins and nutritional ingredients that is given through an IV. It is complete nutrition when there are more intense needs to maintain proper balance of all aspects of nutrition and blood levels.
Beyond loss or change in appetite, your child may experience nausea or vomiting. There are medications and other ways to bring relief and comfort to your child. Discuss with your care team what foods and drinks are routine now and what suggestions they might have given how your child is feeling. Some changes will be easy; some may be difficult. For example, your child may not be able to tolerate one or more of their favorite foods for a time.
Eating is a natural, nurturing part of our existence. It is natural for a parent to feed their child and cuts to the core of our fears when our child is not eating. We hope these suggestions help you remain calm, get the support you need and know that you are not alone in this struggle.
If you have a suggestion or story to share which might help some of us going through this, please share it here.
Article contributed by Liz Sumner RN, BSN
Palliative Care Coordinator, The Elizabeth Hospice