Nutritional assessment of the child with cancer.

Children with cancer are in need of nutritional support to combat the catabolic effects of malignant tumors and debilitation from surgical or other treatment and complicating infections and to maintain their immune system and other host defenses to combat cancer and infection. Also, growth must be supported in the child. Nutritional assessment should be an integral part of the care of the hospitalized and the ambulatory child. The main components of nutritional assessment are described: medical history; psychocultural history; dietary assessment; clinical examination for signs of deficiency; anthropometry; and biochemical and hematological assessment. Parameters of cell-mediated immunity, often depressed by malnutrition, are also part of the assessment. Appropriate reference data for children are included. Assessment is the first step in nutritional support.