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Nutrition and Cancer for Children: High-Protein/High-Calorie Diet

Nutrition tip

Children younger than 3 years of age should avoid chunky peanut butter and cut-up hotdogs due to the risk of choking. Children under two years of age should not have peanut butter at all because of the risk of choking; however, if they really want it, the peanut butter can be mixed with applesauce. The color will not be too attractive, but the risk of choking will be reduced. If more than one serving is mixed at a time, the mixture must be refrigerated; otherwise, it will quickly mold due to the high moisture content of the applesauce.

The importance of good nutrition

Receiving adequate nutrition is important for all children to help them grow and stay healthy. However, consuming sufficient calories and protein is even more important for children with cancer since the disease typically increases their nutritional needs. But since every child is unique and tolerates treatment differently, the child's health care team will individualize the nutrition plan. A dietitian can determine your child’s specific calorie and protein needs.
Children with cancer need proper nutrition to:

  • Continue to grow and heal
  • Better tolerate chemotherapy or radiation and experience fewer side effects
  • Maximize quality of life
  • Gain, maintain, or lose only a minimal amount of weight

Following a high-protein and high-calorie diet

The treatment of cancer can be difficult for individuals of any age. It is important that children with cancer receive supportive care from the entire health care team, such as doctors, dietitians, and child life therapists, to make the nutritional aspects of treatment less difficult. Suggestions such as creating a child-centered environment, making tasty high-calorie snacks, and offering alternatives to oral nutrition are all part of supportive care. If your child is having trouble eating enough calories and protein, your child’s doctor or dietitian may suggest serving a high-calorie and high-protein diet. This will ensure that each bite has the highest nutritional value possible.

Foods high in protein include:

  • Meats, such as beef, chicken, fish, turkey, and lamb
  • Milk, cheese, eggs, including cottage cheese, yogurt, cream cheese, and ice cream
  • Peanut butter

Puddings and yogurts packed for children typically contain high amounts of protein and are often appealing to your child. Dried beans and peas are also high in protein, but because they cause gas may not be the best food choice for your child.

Listed below are foods you can use to add calories and protein to your child’s meals and snacks:

  • Add powdered milk (adds 33 calories and 3 grams protein per tablespoon) to:
    • Foods and beverages
    • Puddings, potatoes, cream soups, ground meats, vegetables, cooked cereal, milkshakes, yogurt, and pancake batter
  • Add eggs or egg substitute (adds 80 calories and 6 grams protein per egg) to:
    • Casseroles, meat loaf, mashed potatoes, cooked cereal, macaroni and cheese, and chicken or tuna salads
    • French toast and pancake batter; Add more eggs than you normally would.


Add raw eggs and egg substitutes only to dishes that will be cooked. Do not use raw eggs or egg substitutes in uncooked dishes for children, especially those whose immune systems have been compromised.

Egg Beaters add 25 calories and 5 grams protein per 1/4 cup. Do not use raw eggs or egg substitutes in uncooked items.

  • Add butter or margarine (45 calories and 0 grams protein per teaspoon) to puddings, casseroles, sandwiches, vegetables, cooked cereals, breads, and pasta.
  • Use cheese (100 calories and 7 grams protein per ounce) as tolerated:
    • As snacks, or on sandwiches; String cheese can be fun for kids to eat.
    • In casseroles, potatoes, vegetables, and soups
  • Add wheat germ (25 calories and 2 grams protein per tablespoon) to:
    • Hot cereals
    • Meat dishes, cookie batter, and casseroles

Wheat germ is fiber. It is okay as long as the child is not having stomach or bowel problems. It should only be taken orally, not in a tube feeding.

  • Add mayonnaise or salad dressing (45 calories and 0 grams protein per teaspoon) liberally to sandwiches, salads, and as a dip for raw vegetables; or add a ranch, Italian, or oil/vinaigrette dressing as a sauce on cooked vegetables.
  • Add whole milk (150 calories and 8 grams protein per cup) to desserts, baked goods, meat dishes, and cooked cereal.
  • Add sour cream (26 calories and 0 grams protein per tablespoon) to:
    • Potatoes, casseroles, and dips
    • Sauces and baked goods
  • Add sweetened condensed milk (60 calories and 1 gram protein per tablespoon) to:
    • Pies, puddings, and milkshakes
    • 1-2 tablespoons of peanut butter and spread on toast
  • Use peanut butter (95 calories and 4 gram protein per tablespoon) on toast, bagels, crackers, bananas, apples, and celery. Put it on pretzel rods for peanut butter to go, or even spread it on a tortilla for a new twist to the traditional peanut butter and jelly sandwich.
  • Add Carnation Instant Breakfast (130 calories and 7 grams protein per packet) to milkshakes or milk. Buy the vanilla flavor and add a variety of flavors from Strawberry Quick to almond extract so that your child does not become bored with the taste. You can mix it in milk as directed, and use it to cook hot cereal for a new taste treat.
  • Add gravies (40 calories and 0 grams protein per tablespoon) liberally on mashed potatoes, rice, noodles, and meats. Thickened pureed meats--canned infant or baby food meat--may be a better alternative than just gravy itself.
Nutrition tip

Three ounces of thickened baby meat is an ample meat serving. Place thickened baby meat on top of mashed potatoes and stick broccoli flowerets in the potatoes. Call it “a river on a mountain of mashed potatoes with broccoli trees.”

Calcium for children with lactose intolerance

If your child’s doctor tells you that your child has lactose intolerance, you will want to be sure your child’s calcium needs are met from products besides milk. Some other ways to include calcium in your child’s diet include:

  • Use calcium fortified orange juice that can be frozen into treats.
  • Yogurt is often well tolerated because it contains less lactose than milk.
  • Adding spinach to your child's diet
  • A multivitamin supplement with calcium or even the use of Tums antacids could also be used, but you should check with your child’s doctor first before using either.

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