Food and nutrition for children and teens

Nutrition basics 

Food gives your child’s body the fuel it needs for healthy body function, growth and development, and the energy to go about daily life. Providing your child with healthy foods and teaching your child healthy eating patterns can help them develop a good relationship with food that will serve them well throughout their lifetime.

Infants and children younger than age 2 have nutritional needs different from those of older children and adults. Discuss this with your child’s pediatrician. If your child is an infant or toddler, visit the United States Department of Agriculture’s (USDA’s) website, which has additional information for caregivers. 

Get a free, one-on-one nutrition consultation with a registered dietitian  

Patients and caregivers of all cancer types may receive a free one-on-one phone consultation with a registered dietitian who has expertise in oncology nutrition. Healthcare professionals may also refer their patients to this free service.  

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Build a healthy plate  

The USDA MyPlate website is a useful resource to help you learn healthy eating patterns and how to build a “healthy plate” (meal) for your child and for you, along with games and activities for the family.

Teaching healthy habits 

Teaching your child to recognize and respect hunger and fullness cues helps them develop a good relationship with food and learn healthy eating patterns. Infants and toddlers are naturally good at showing hunger and fullness cues. They will cry or reach for food when hungry. When full, they will turn their heads.  

Respect your child’s hunger cues. As your child grows, don’t pressure them to “clean their plate” and don’t restrict their intake of nutritious foods. You can teach moderation, but if your child says or shows they are hungry, offer a snack such as apple slices and peanut butter, carrots and hummus, or whole-grain crackers and cheese. Check in before and after meals to ask if your child is hungry or full to help them recognize how they feel. 

Plant-based eating 

The American Institute for Cancer Research (AICR) recommends that at least two-thirds of the food on your plate should be plant foods, such as vegetables, fruits, whole grains, and beans. Plant-based eating decreases your risk of disease by adding vitamins, minerals, fibers, and phytochemicals (compounds that protect cells from damage which could lead to cancer). These may be difficult to get in adequate amounts if your meals are centered on animal protein.  

Use the following tips to encourage your child toward plant-based eating:   

• Plan your child’s meals around plant foods such as vegetables, fruits, beans, and whole grains, instead of meat and other animal products 

• Provide a colorful variety of vegetables and fruits to get the most nutrients 

• When including animal proteins (meat, poultry, seafood, eggs, and dairy), opt for seafood, poultry, and low-fat dairy. Limit red meat to no more than three portions or less per week. For example, a 3-year-old needs about two ounces of protein foods per day, so three portions of red meat equals about six ounces per week. When serving meat, avoid processed meats such as hot dogs, bacon, and sausage. 

• Provide more plant proteins, such as beans, peas, lentils (legumes), and nuts and seeds. Try serving plant proteins instead of animal proteins for one or two meals a day. 

Nutrients 

Nutrients are the substances in food that provide nourishment and support growth and healthy bodily functions. They can be divided into macronutrients and micronutrients. Macronutrients are nutrients that the body needs in large amounts and that provide the body with energy (calories), such as protein, carbohydrates, and fat. Micronutrients are nutrients the body needs in smaller amounts to support growth and healthy bodily functions, such as vitamins and minerals. The best way for your child to get all of the nutrients their body needs is by eating a variety of fruits, vegetables, lean proteins, whole grains, and healthy fats. 

Portions and servings  

A serving size is a standardized measured amount of food, such as the amount used for Nutrition Facts labels. A portion size is the amount of food your child chooses to eat. It may be more or less than the posted “serving size.” 

Keep in mind that a toddler may only need a single serving of a food group per day. However, the serving can be split into several portions over multiple meals or snacks. For example, for a 3-year-old child, the daily recommendation may be 1 cup of vegetables per day. The child may eat 1/3 cup of cooked carrots at lunch, 1/3 cup of broccoli florets for a snack, and 1/3 cup of cooked spinach at dinner to meet the daily recommendation.  

Remember that recommendations are guidelines. Some days your child may eat more and other days they may eat less of certain foods, but guidelines offer good goals. Nutrition is cumulative, and your child’s eating pattern over a week is more important than what they eat in a single day. 

Daily recommendations 

On the MyPlate website, you can find daily recommendations by age for how much food from each food group—fruits, vegetables, grains, protein, and dairy—to eat per day. Visit the page for each food group to view the tables under the “More About the Food Group” heading. Keep in mind this is general guidance. Talk to your child’s pediatrician and ask for a referral to a pediatric registered dietitian for personalized guidance. 

Teaching healthy eating and lifestyle habits 

Children develop eating habits early in life and carry these habits into adulthood. All children can learn how to make healthy food choices.  

You can use the following strategies to teach your children healthy eating habits:  

• Be a role model: Let your child see you eating more vegetables, fruits, whole grains, healthy fats, and lean proteins.
• Introduce foods again and again: If your child does not like a certain food the first time you serve it, try again. Children may need to try a food many times before they enjoy it. The Academy of Nutrition and Dietetics suggests that it may take up to 15 tries before a child accepts a new food. (However, do not force your child to eat specific foods. There are probably some foods that they do not like, and that’s okay! Try to find foods in each food group that your child does enjoy.)
• Encourage a colorful plate: Children often gravitate toward high-carbohydrate, starchy, or bland foods such as chicken nuggets, macaroni, french fries, and bread. Teach your child to eat a “rainbow” of foods—not just brown or tan ones. Eating a variety of differently colored fruits and vegetables is a good way to get many different healthy nutrients.
• Add extra vegetables to dishes your child already enjoys to increase their intake: For example, add chopped mushrooms, zucchini, or carrots to spaghetti. Another option is to add pureed vegetables to different dishes. If you add pureed vegetables to a dish, include your child in food preparation and offer the same vegetables prepared whole or chopped on the side in case your child decides to try them.
• Make fruits and vegetables available: Leave whole fruits like apples or bananas out on a counter in a bowl for anyone to eat any time. Keep cut-up fruits and veggies in the fridge. If healthy snacks are readily available, it is more likely your child will eat them.
• Avoid buying packaged, processed snacks such as cookies, chips, and candy: If they are available, your child will eat them and ignore other more nutritional options.
• Avoid using food as a reward: Foods used as rewards are typically candy or other desserts. These items often have little nutritional value and may take the place of other foods with more nutritional value, such as vegetables, fruits, whole grains, and proteins. Use stickers or verbal praise to reward your child instead of food or candy.
• Eat meals together as a family: It is a valuable way to teach your child healthy eating and lifestyle habits.  

Hydration 

Staying hydrated supports healthy body function and improves mood and energy. Your child’s fluid needs can change based on their health and activity level. When it’s hot outside, your child may need more water. Ask their pediatrician for a specific daily fluid goal.

 Follow these tips to keep your child hydrated:  

•  Provide fluids for your child throughout the day instead of waiting until they are thirsty.
• Keep a cup or bottle of water in your child’s sight at all times to remind them to drink.
• If your child does not like plain water, try sparkling water; flavored water; adding berries or slices of lemon, cucumbers, or lime to water; or mixing water with a splash of 100% fruit juice.
• Food contains some fluid as well, but only fluids that are liquid at room temperature, such as popsicles, count toward your hydration goal. Soups are liquid at room temperature, but many soups contain a lot of salt.
• While fruit juice can be part of a balanced diet, it is not the best source of hydration. Fruit juice is not only high in calories, but also does not have the fiber of whole fruit. 

Relationship with food and body image  

Many people have a complicated relationship with their body and with food. Often, these complicated relationships begin in childhood. Modeling healthy behaviors is a wonderful way to help your child develop a healthy relationship with food and form a positive body image. 

Keep these things in mind when talking about your body, other people’s bodies, food, and food choices:  

• Be conscious of how you talk about your own body in front of your child. Do not criticize your own body or others’ bodies in front of your child. Do not criticize your child’s body. Body size or appearance is not reflective of a person’s character or worth. If you hear your child criticize someone else’s body, correct the behavior. If you hear your child say something negative about their own body, ask, “Would you say or think something like that about a friend?” Help your child learn to treat and think about themselves in the same way they would talk to or about someone they love.
• Monitor the media your child consumes. Encourage your child to avoid looking at images online and in magazines that make them feel bad about their own body or appearance.
• Be aware of the way you talk about food around your children. Eating broccoli doesn’t make someone a good person. Eating candy doesn’t make someone a bad person. This may seem obvious, but people often describe foods using words such as “good,” “bad,” “clean,” or “sinful.” There are no good or bad foods. Some foods may do a better job of fueling the body or providing the body with more nutrients than other foods. However, food choices do not reflect a person’s character.
• Think about your own relationship with your body and food. If you struggle with your body image, you may find it helpful to speak to a therapist to work through your feelings. Ask your primary care doctor or health insurance provider for a referral to a therapist.  

Eating disorders: When children reach their preteen or teenage years, they often become more aware of their bodies. They may feel pressured to look a certain way or be a certain size. To achieve this, they may even try trendy diets, pills or supplements, excessive exercising, or other dangerous techniques to change their body. Visit the National Eating Disorders Association to learn the warning signs and symptoms for an eating disorder. Remember that people of all body sizes can struggle with eating disorders. If you suspect your child is struggling with an eating disorder, talk to their  pediatrician. Ask for a referral to a registered dietitian and/or therapist who specializes in eating disorders. 

Diet guidelines for immunosuppressed patients  

Food safety is important during and after cancer treatments. The immune system is often weakened by cancer treatments, making the body more susceptible to foodborne illnesses.  

Neutropenia is a condition where you have lower-than-normal levels of “neutrophils” (a type of white cell). If your child has neutropenia, their doctor may suggest they follow special guidelines, which can help protect them from bacteria and other harmful organisms found in some food and drinks.  

If your child has had a stem cell transplant, their diet may be stricter than that of a patient who had chemotherapy or radiation therapy and no transplant. 

Diet guidelines published by institutions or doctors about handling food safely may also recommend avoiding foods that are more often associated with illness. 

Learn more about food and nutrition during cancer treatment.  

Basic guidelines to follow 

• Avoid raw or rare meat and fish and uncooked or undercooked eggs. Cook meat until it's well done.
• Thoroughly cook eggs (no runny yolks) and avoid foods containing raw eggs, such as raw cookie dough or homemade mayonnaise.
• Avoid unpasteurized beverages, such as fruit juice, milk, and raw milk yogurt.
• Avoid salad bars and buffets.
• Refrigerate pâté, cold hot dogs, deli meat (including dry-cured salami and deli-prepared salads containing these items), eggs, and seafood.
• Consume only pasteurized milk, yogurt, cheese, and other dairy products.
• Avoid soft mold-ripened and blue-veined cheeses such as Brie, Camembert, Roquefort, Stilton, Gorgonzola, and Bleu, or other soft, unpasteurized cheeses.
• Avoid raw sprouts such as alfalfa sprouts.
• Wash fresh fruits and vegetables before peeling.
• Avoid well water unless it has been tested, filtered, or boiled for one minute before drinking. At home, it's okay to drink tap water or bottled water. 

Neutropenic diet 

Your child’s healthcare team may refer to these guidelines as a “neutropenic diet” or you may have encountered the term on your own. This diet was supposed to help individuals with neutropenia learn how to decrease exposure to bacteria and other harmful organisms found in some foods. However, a universally accepted definition of what foods should be included was never developed. 

In a review of studies, the neutropenic diet was never proven to decrease exposure to bacteria in foods. This diet does not seem to benefit patients in any way. Safe preparation and handling of foods is more important than restricting intake of specific food groups, as balanced diet and nutrition is important for coping with chemotherapy and other treatments. 

Food guidelines for immunosuppressed patients vary among cancer centers. Ask your child’s doctor for any special instructions.