Eating difficulties and parental feeding strategies during and after childhood cancer treatment: The experiences of parents. : A systematic literature review.

Childhood cancer is a life-threatening disease with a profound impact on the family. Treatment side-effects and accompanied dietary difficulties are for example severe stressors, as appropriate nutrition is important for the treatment success and quality of life. In addition, (unhealthy) dietary patterns established in childhood tend to maintain in survivors. Parents are key players in feeding and establishing these pat-terns, though, systematic research on how parents experience these dietary difficulties is limited. This study aimed at exploring parental experiences of children’s dietary changes and difficulties during cancer treatment and after completion: what feelings do parents experience regarding their child’s dietary changes and difficulties, what feeding strategies to they apply to handle these difficulties, and how did they experience professional support and what are parental support needs. A systematic literature review was conducted and resulted in 21 suitable articles. The children were 0-21 years old, had various types of cancer, and received various types of therapy. Findings showed that parents reported many dietary changes (e.g. increase or decrease in food intake) and associated symptoms (e.g. nausea, changed tastes) during and after the cancer treatment course. Parents reported mainly negative feelings towards these dietary difficulties (e.g. distress and anxiety) and applied a wide range of behavioural feeding strategies, both negative (e.g. pressure to eat) and positive (e.g. provide healthy food) strategies. Parents also used complementary and alternative medicine. A high need for informational support regarding eating and feeding was expressed by parents during treatment, a need for emotional and practical support to a lower extent. These results showed how frequent and profound eating and feeding difficulties are in the childhood cancer and survivor population, and their (negative) impact on parents. Parents consequently need more support: they need oral and written information to set realistic expectations and install appropriate feeding strategies. This is important for the child’s nutritional status and general health both during and after cancer