Not hungry? Tips and tricks to help your child to eat during treatment.

‘My child doesn’t feel hungry’

A poor appetite is a common problem for children having treatment and, for some, even before starting treatment. Many children find that they don’t know what they want to eat which can make many parents feel frustrated and stressed.

If your child’s appetite is poor then they may start to lose weight so children are encouraged to eat plenty of high-calorie, high-protein foods. Fat is a rich source of energy so eating lots of high-fat and sugary foods such as burgers, chips, ice cream, cakes and biscuits can be helpful.

This may seem strange at first as it seems to go against healthy eating advice but it is simply that increasing calories is more important at this stage – nutrients and vitamins can be given in other ways.

What can I do?

• Try offering small meals and snacks throughout the day so they have something small to eat or drink every 2-3 hours during the day. Many children find this easier than sticking to their usual three meals. Always keep snacks handy (see pages 13-14 for ideas on snack foods).
• Make the most of when your child’s appetite is at its best. For many, this is in the morning. Try some of these breakfast ideas: porridge, pancakes with syrup or jam, yoghurt and fruit, bacon and eggs, hash browns, sausages, beans or spaghetti hoops on toast, omelette, scrambled eggs, cheese on toast. Remember, there is no need to stick to traditional breakfast foods, why not try sandwiches, custard or cakes and biscuits instead?
• Avoid filling your child up with low energy, bulky foods such as clear soups, vegetables and fruit. "Power pack" the food: add extra protein and energy by mixing in extra milk, cream, oil, nut butters (for more ideas, see section How to add extra calories and protein to food ).
• Encourage drinks between meals and avoid letting your child ‘fill up’ on drinks just before a meal.
• See if your child will try nutritional supplement drinks which are available on prescription.
• Ask friends and family to help with preparing food or cooking meals.

Mealtime tips

• Sometimes mealtimes can be hard work leaving you and your child exhausted. Many children with poor appetites eat very slowly. Limit mealtimes to no longer than twenty minutes. After this time it is unlikely that they are going to eat any more. Concentrate on what they have eaten rather than what they haven’t eaten at that mealtime.
• Don’t force your child to eat, sometimes they just don’t feel hungry. Wait a while and try a snack or nutritional supplement drink later.
• Even though it can be frustrating, try not to argue or nag too much about food. If mealtimes are becoming a battle or food and diet is causing you to feel stressed, speak to your child’s dietitian, nurse or doctor for extra advice and support.
• Try to include the family at mealtimes and aim to eat at the same time as your child. This can help take the focus off eating and make mealtimes a social occasion.
• Don’t put too much food on the plate and try a small plate - an overfull plate can be off-putting. They can always come back for second helpings.
• Encourage your child to be involved in choosing and preparing their food. Limit their choice to 2-3 different foods or snacks. Having too much choice can be overwhelming.

Making food fun to keep children interested

Most children enjoy cooking and decorating biscuits and cakes. Making your own pizza or homemade milkshakes and smoothies can also be fun.
Many children enjoy eating out in cafés or restaurants. If you can’t go out, why not have a ‘pretend’ restaurant at home? Use a tablecloth and write a menu. Use straws and ice for drinks. You could even serve your own version of a children’s takeaway meal!
Invite a friend over for tea
Picnics can be fun either outdoors or on the floor in your home. Ask your child to decide on what you should all eat.
Some children, especially younger children, enjoy having food that has been arranged on their plates, for example, making a face from fish fingers, chips, tomatoes and peas or sandwiches cut into funny shapes.

How to add extra calories and protein to food

If your child is not eating enough or is finding it difficult to maintain their weight, it might help to add extra energy (calories) and protein to their diet. Here are some ideas:

• Use full cream milk to drink, with cereals and in cooking.
• Choose full-fat foods wherever possible. These may be labelled as ‘luxury’ or ‘thick and creamy’. Avoid foods labelled as ‘light’, ‘lite’, ‘diet’ or ‘low fat’.
• Add extra butter, margarine, or oil to bread, potatoes, sweet potatoes, pasta, rice, chapattis, rotis, noodles, and cooked vegetables.
• Add a generous amount of nut butter (for example, peanut butter), cream cheese, honey, chocolate spread, lemon curd, jam, or marmalade on bread, toast, crackers or biscuits.
• Add mayonnaise or salad cream to sandwiches and jacket potato fillings, and salads. Try them as a dip for crisps or chips.
• Add lentils and beans to soups and casseroles.
• Add extra cheese to pizza, sauces, soups, pasta and vegetables.
• Add extra paneer to curries.
• Add cream, sour cream, plain yoghurt, mascarpone cheese or crème fraiche to sauces, soups and meat dishes.
• Add cream to porridge, custard and other milk puddings.
• Add golden syrup, nuts, seeds, dried fruit, jam or chocolate spread to porridge and milky puddings.
• Serve cream, evaporated milk, ice cream, or custard with cakes and desserts.  Ask the dietitian about energy supplements that can be added to foods.

This article is extracted form a booklet originally written by Louise Henry MSc RD, Senior Dietitian, Royal Marsden NHS Trust, in collaboration with the CCLG Publications Committee.

La Fondation La Roche-Posay and CCI make every effort to ensure that information provided is accurate and up-to-date at time of printing. We do not accept responsibility for information provided by third parties, including those referred to or signposted to in this publication. Information in this publication should be used to supplement appropriate professional or other advice specific to your circumstances.