Nutrition Concerns during Your Child's Transplant

When your child is in the hospital for a bone marrow or cord blood transplant (also called a BMT), the health care team will closely watch your child's weight and record what your child eats and drinks. The right nutrition is important for your child to heal and grow. Your child may also have a special food plan to reduce infection risks.

Questions to ask

Before transplant, a dietitian or nutritionist will assess your child. The dietitian will check your child's weight, growth and diet and identify any nutrition concerns. Some questions you may want to ask include: 

• Will my child's eating be affected by transplant? 
• Will my child need a special diet after transplant? How long will that last?
• What kind of healthy snacks can I bring to the hospital for my child?
• What will the transplant team do if my child loses weight?

Managing eating problems

Your child needs to eat healthy foods and drink lots of fluids to heal after transplant. However, your child may not feel hungry. He or she could have a sore mouth or other side effects of the transplant preparative regimen that make it hard to eat. The health care team can give your child medicine to reduce some of these side effects. They can also help find ways to manage eating problems, such as offering foods that may be easier to eat. It is important to offer your child choices and to avoid power struggles over food.

Getting nutrients through a feeding tube or IV

If your child cannot eat and drink enough, he or she can get nutrition and fluids through a feeding tube. The tube may go through the nose into the stomach (a nasogastric or NG tube) or into the intestine (a nasojejunal or NJ tube). If your child has vomiting or diarrhea, he or she may be given nutrition into the bloodstream through an IV (total parenteral nutrition or TPN). Many children need a feeding tube or TPN for a time after transplant. Your child will still be able to eat even while he or she is given nutrition by a feeding tube or TPN.

Avoiding infection risks

Until your child's transplant engrafts (the donated cells start to grow and make new blood cells), he or she will have very few white blood cells to fight infections. This means your child can get an infection easily and infections during this time can be serious, even life-threatening. To avoid risks of infection from food, your transplant center may give your child a low-bacteria food plan. Many transplant centers have rules for whether you can bring your child food from outside the hospital.

When your child is ready to leave the hospital, ask your transplant center for guidelines on choosing, preparing and storing foods for your child's health.

Contributing editors

K. Scott Baker, M.D., Director, Blood and Marrow Transplant Outpatient Clinic, University of Minnesota BMT Program at Fairview University Medical Center, Minneapolis, Minn.
Nancy J. Bunin, M.D., Director, Blood and Marrow Transplantation, Children’s Hospital of Philadelphia, Philadelphia, Pa.
Eva C. Guinan, M.D., Associate Professor of Pediatrics, Harvard Medical School, Dana-Farber/Children’s Hospital, Boston, Mass.
Mary Jo Kupst, Ph.D., Professor of Pediatrics, Medical College of Wisconsin; Director, Program in Pediatric Psychology, Milwaukee, Wis.
Mary Knickmeyer, R.D., M.S., Senior Clinical Nutritionist, University of Wisconsin Hospital and Clinics, Madison, Wis