Good nutrition can contribute to a better treatment outcome for childhood cancer and is an important focus at the Máxima. In fact, the motto is to eat as healthy and as normal as possible, according to a ‘food pyramid’ with a balanced intake from basic food groups, says Tissing. But good and healthy eating is by no means self-evident for a child with cancer. Problems with eating can come from the tension and emotion that come with a cancer diagnosis. Side effects of treatment such as nausea or a sore mouth or throat, or simply a loss of appetite, can also make it difficult to eat well and enough.
Dietitians Nina van der Linden and Rianne Ruitenburg gave tips that can help to obtain and maintain a good nutritional status. It can be frustrating for a child if they fail to eat normally, they said. Forcing them can be counterproductive, so a calm attitude around eating times is very important. When there is a loss of appetite, the dietitians advise eating small amounts spread over the day, and for example offering full-fat instead of semi-skimmed dairy products or double sandwich fillings: this way you get as many calories and proteins as possible from the same eating moment. Many of these kinds of small adjustments together can make a difference at the end of the day.
The underlying reasons for a reduced or changed appetite is a question that occupies PhD student Mirjam van den Brink. She talked about her research on changes in smell and taste in children with cancer. Because smell and taste cells divide quickly, just like cancer cells, they may also be killed by chemotherapy. By means of questionnaires and smell and taste tests, she is mapping out the problem of unpleasant taste changes.
Finally, two employees of Hutten, the caterer at the Máxima, took the floor to answer questions from parents. Janiek Koolen said that at the opening the philosophy was still to entice children to eat (healthily) with interesting and colorful dishes. But gradually, and based on feedback from children and parents, the approach has shifted towards recognisability. When eating is difficult for a child, it helps to be able to choose from familiar options. These are now on the menu at the ‘Kanjerkar’, the food cart that visits the care department several times a day. There are two menus, one of which is especially energy-rich for children who have or are at risk of malnutrition.