After a blood and marrow transplant, your child’s immune system will be weak. Children with weak immune systems are more likely to get sick from harmful bacteria in food. Because of this, your child will need to avoid foods that may contain harmful bacteria. The diet that they follow is called a low-bacteria diet.
How long must my child be on a low-bacteria diet?
A low-bacteria diet starts on day 0, the day your child receives the blood or bone marrow transplant.
- After an allogeneic transplant, your child should stay on the diet for six months.
- After an autologous transplant, your child should stay on the diet for three months.
While your child is on a low-bacteria diet, it is important that you follow safe food handling and preparation guidelines.
Safe food handling and storage
- Always wash your hands before and after handling food.
- If you use well water, make sure to have it tested regularly, even if you only use it for bathing and cooking.
- Bacteria grow best in the “temperature danger zone”. This ranges from 4°C (40°F) to 60°C (140°F). Keep the following foods hot or cold enough to keep their temperature outside the danger zone. Never give these foods to your child after their best before dates:
- potato and other salads
- eggs, milk and milk products, puddings, custards, cream-filled baked goods
- meat, meat products, poultry, fish and shellfish, gravy
- soups and sauces.
- Do not use any fruits or vegetables that look old, slimy, or mouldy.
- Never thaw meat at room temperature, for example on your kitchen counter. Thaw all meat in the refrigerator or in a bowl of cool water in the refrigerator.
- Keep raw and cooked meat, poultry, and fish separate and on different plates, dishes or trays. Do not place any food, raw or cooked, on a tray or plate that has held raw meat, poultry or fish.
- Do not eat food that is meant to be eaten hot or cold if it has been left at room temperature for longer than two hours.
- Put leftovers in the refrigerator or freezer as soon as possible. Do not cool them on the stove first.
- Refrigerate only as many leftovers as you can eat in one to two days. Put the rest in the freezer or throw them away.
Preparing formulas and tube feeds
- Whenever possible, avoid powdered formula. Instead, use liquid concentrate or ready-to-feed versions of your child’s formula.
- Some specialty formulas only come in powder form. If your child needs one of these formulas, keep the container closed, store it in a cool, dry place and use it within one month of opening.
- Once you open a box or can of liquid concentrate or ready-to-feed infant formula, keep it covered in the fridge and use it within 48 hours.
- Once you open a box or can of your child’s enteral (tube) feeding formula, it may be kept, covered, in the fridge for 24 hours.
- Use boiled, cooled water when making your child’s formula.
- Wash all feeding equipment in hot, soapy water. Sterilize all bottles, nipples, caps, rings and feeding tube equipment before and after using.
- Discard any formula remaining in the bottle or tube after a feeding.
Recommended food storage times
Your refrigerator temperature should be 4°C (40°F) or lower. Your freezer temperature should be -18°C (0°F) or lower.
The table below is a guide to safely storing food in the refrigerator. Always follow best before dates and other food safety guidelines on this page.
| Food | Safe storage time |
|---|---|
| Uncooked meats (beef, lamb, pork, veal) | 2-4 days |
| Uncooked poultry (chicken and turkey) | 2-3 days |
| Ground meat | 1-2 days |
| Fresh fish | 3-4 days |
| Shellfish (cooked or uncooked) | 1-2 days |
| Cured and smoked meats (frankfurters, hot dogs, hams) | 1 week |
| Luncheon meat (heated) | 2-4 days |
| Eggs (in carton) | 3-4 weeks or best before date |
| Opened milk, cream, yogurt or cottage cheese | 4 days (unopened – until best before date) |
| Butter, opened | 3 weeks |
| Hard cheese | until best before date |
| Processed cheese | 5 weeks |
| Raw fruits and vegetables | 7 days |
Safe shopping
- Choose unbruised, fresh-looking fruit and vegetables.
- Check the best before date on packages and avoid buying items on or near this date.
- Do not buy cracked or non-refrigerated eggs.
- Check that food packages and boxes are properly sealed.
- Avoid buying food in damaged containers or dented cans.
- Visit the fridge and freezer sections of the store at the end of your shopping trip so food stays cold or frozen longer.
- Make sure frozen foods feel solid and refrigerated foods feel cold.
- Do not buy foods from bulk bins.
- Take groceries home and store them right away. Never leave food in a hot car.
- Avoid letting groceries sit outside the fridge or freezer for longer than one hour.
Keeping your home safe and clean
- Clean countertops with hot, soapy water, an antibacterial spray, or an antibacterial wipe after each use.
- Wash pots, pans, dishes and utensils in hot soapy water or the dishwasher.
- Do not use cracked plates or cutting boards. Choose plastic or glass cutting boards instead of wood.
- Wash can openers and the outside of cans with soap and hot water before using.
- Do not use home-canned products.
- Towels, dishcloths and sponges can store bacteria. Change your towels and dishcloths often, and throw away dirty sponges.