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Malnutrition affects 40–80% of cancer patients and is strongly linked to poor clinical outcomes. In paediatric oncology, nutritional challenges arise from cancer cachexia, chemotherapy complications such as mucositis, and radiotherapy-related conditions like radiation enteritis. Weight assessment can be misleading due to steroid-related fluid retention, making lean body mass and ideal body weight important for accurate evaluation and drug dosing. Nutritional management follows the principle: “if the gut works, use it,” with enteral nutrition preferred over parenteral feeding to preserve gut integrity. The presentation also highlights complications such as constipation and NEC, while emphasizing that palliative nutrition should gradually shift toward “comfort feeding only” to improve patient comfort and quality of life.
