n IS MY CHILD’S DIET IMPORTANT DURING THE TREATMENT? Yes. We know from research that well-nourished children tolerate therapy better and have fewer treat- ment delays from illness. It may be difficult for your child to resume normal eating habits while on therapy, so you will need to be flexible and creative. Often, numerous small meals will be tolerated better than three large ones. Offer foods high in protein and carbohydrates. A dietitian trained in the calorie and en- ergy needs of children can offer you guidance. Multivitamins and all medicines not specifically prescribed for your child by the team treating the retinoblastoma should be approved by your doctor before you give them to your child because there may be some interactions between them and the chemotherapy your child is receiving. Children will be more interested in eating foods that they help prepare. It is important to include your child in the social activity of family meals even if full meals are not eaten. Nobody wins food fights—it is best not to force your child to eat. The medical staff can intervene if a nutritional problem develops. n CAN MY CHILD ATTEND SCHOOL DURING TREATMENT? Because most children with retinoblastoma are infants and toddlers, they are not yet attending school. Your child may have visual problems ranging from limited sight to complete blindness that can affect his or her adjustment to normal activities and school work when he or she is old enough to attend. Your child, regardless of age, should have his or her vision checked to determine vision level and be referred for services for children with vision limitations. Many of these services are available through the public school system, beginning with “infant stimulation” programs for infants and toddlers. These services are usually accessed by calling your local school district. The earlier your child begins receiving visual and infant stimulation services, the better he or she will adjust to any vision impairments. Children older than 3 years of age who develop sight problems are able to receive special services through the local school district. Your child’s ability to attend day care, preschool, or school during treatment will depend on the intensity of the therapy and his or her response to treatment. Some children tolerate therapy better than others. Your child may not be able to attend school for extended periods because of the treatment, side effects, or hospitalization. However, it is important that your child keep up with school work. Talk to someone (teacher, principal, or counselor) at your child’s school about arranging educational services until he or she is able to return to school. You also should discuss school attendance with your child’s doctor or nurse. Many pediatric hospitals have programs that enable children to attend school while hospitalized. Your child’s school also may be able to arrange for a home tutor to provide instruction for your child. School is important in helping children maintain social contact with their peers. Therefore, it is important for your child to return to school as soon as he or she is physically and medically able to do so. Maintain- ing time with friends will be an important part of your child’s recovery and will ease the adjustment when he or she returns to school.
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