Feeding the beast

Keeping a child well fed is one of the most basic functions of parenthood. Wes breastfed until after 2 and until he weened had really never eaten much besides – he never had formula or even breastmilk from a bottle, and hadn’t more than tasted anything else but water. After weening he became a typical, picky toddler eater, minus basic kid stuff like juice and yogurt. He has always been on the scrawny side, though we never had cause to be concerned about his diet or weight.

Loss of appetite and nausea and other related symptoms are well known effects of chemo, and yet it’s hard to fully grasp just what this means. When you’re a normally healthy person, days or even weeks of digestive problems while down with the flu is little more than an inconvenience, and maybe even a welcome loss of a few pounds, and you bounce back. A seriously ill person, however, depends on every little calorie they can force their feeble bodies to keep down; without being able to maintain or put on weight, it can often be difficult or impossible to recover from the underlying disease, and yet many of the drugs given as part of treatment can directly cause the loss of appetite. Food can taste different, cravings and sense of hunger can evaporate, and food may simply unsettle you after eating.

And so, two months in, food is one of the most frequent topics of conversation and activity in our house – something not entirely new, only now it’s now a source of anxiety too.

After diagnosis, Wes initially lost all interest in food except for noodles or rice, with butter or marinara, and a few starchy, salty snacks like veggie straws. During induction, the steroids brought out a ravenous appetite that was also a bit more diverse; at very least we weren’t concerned about him losing weight, and he even put on a few visible pounds.

Now, in consolidation, the appetite has vanished again, and we’re trying everything. All that really matters right now is that he gets the calories he needs each day so he doesn’t drop weight. If Wes can’t keep his weight up, he’ll end up with an NG (nasogastric) tube – a feeding tube through his nose. Some parents report that while they feared it at first, having it gave them peace of mind knowing their child was getting proper nutrition. Still, of course, we hope not to get there.

1000 calories a day, then. It’s not a perfect goal – just a nice, simple number – but it’s an achievable and sufficient target that should keep a tube out of his nose. Some days I feel like he gets half that count drinking milk alone – a pretty easy way to get tons of protein, fat and calories – but he needs more than just milk. His only other reliable craving is for popcorn, which is nutritionally deficient and rough on the digestive system if it’s all you eat.

I’ve tried fattening everything, but Wes has a sensitive and particular palette. He doesn’t like sweet stuff much, and even subtle changes to his favorite recipes are instantly noticed and rejected. I tried all kinds of doctored up popcorn – cheesy, and kettle – which earned me little more than a toddler’s sneer for the attempt to add a few more sugary calories to his day. I hoped to add chocolate or vanilla milk to his rotation, but he’s refused both with a look more familiar to the person who may have killed your dog. If he wanted nothing but ice cream and milkshakes I would excitedly serve them morning, noon and night, but he won’t touch either anymore. I recently made an evening run to the supermarket and returned with a potheads bounty – cheetos and cookies and crackers and chips – and I’d never been happier to see a toddler consume absolute garbage like cheetos, and saddened when only a day later he won’t even eat one. We also unapologetically bribe him with exchanges of screentime for bites.

The boy needs his 1000 calories, come hell or high fructose corn syrup.

PS: just now, after eating essentially nothing today, he came out of the kitchen with a huge apple that he’s absolutely devouring next to me on the couch. That’s like 100, maybe even 200, calories.

PPS: he has developed a squeak in his jaw (perhaps a side-effect of one of his drugs) and it’s especially cute right now.