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 treatment delays due to illness. It may be difficult for your child to keep normal eating habits during therapy so you will need to be flexible and creative. The steroids (dexamethasone) that your child will take as part of the treatment for HLH will cause an increased desire to eat. You will notice that your child wants to eat very often and wants to eat larger amounts of food than usual. Your child’s food preferences will also change; children on steroids often want to eat foods that have a lot of salt or carbo- hydrates and fat. As the parent, you will want to set some limits on when and what your child eats while taking steroids. Be sure to keep fruits and vegetables handy for snacking. Try to limit snacking on chips and sweets. Make sure that foods high in protein are included in your child’s daily diet. Often several small meals during the day are tolerated better than three large meals. It is also important to include your child in the social activity of family meals. Multivitamins, other medicines (over the counter or prescribed by other doctors), and herbs should be discussed with your healthcare team before you give them to your child. Sometimes other medicines can interact with chemotherapy and cause additional side effects or change the effectiveness of the treatment so it is important for your doctors to know about any other medicines, vitamins, or herbs that you plan to give your child. A dietician trained in children’s calorie and energy needs can offer you guidance and food suggestions. The medical staff can also intervene if your child develops a nutritional problem. n CAN MY CHILD ATTEND SCHOOL DURING TREATMENT? Your child’s ability to attend school will depend on the intensity of the therapy and his or her response to treatment. Some children tolerate chemotherapy better than others. Your child may not be able to attend school for several weeks or months because of a weakened immune system, the treatment sched- ule, and/or hospitalizations. However, it is important for your child to keep up with his or her schoolwork. Talk to the staff at his or her school about arranging for a tutor or homebound teacher until your child is able to return to school. You should also discuss school attendance with your child’s doctor. Many pediatric hospitals have programs that help children attend school while they are hospitalized.
School is important because it helps children maintain social contact with other children of the same age. Maintaining 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. It is important for your child to return to school as soon as he or she is medically able to do so.
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