Food safety and vitamin D supplementation after a bone marrow transplant (BMT)

After a blood and marrow transplant, your child’s immune system will be weak. Children with weakened immune systems are more likely to get sick from harmful bacteria in food. This risk can be reduced by avoiding foods that may contain harmful bacteria.

How long will my child be on a food safety diet?

Following food safety restrictions starts on day 0 — the day your child receives their 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.

General guidelines to minimize bacteria

• Wash your hands with warm, soapy water for at least 20 seconds before touching food. Hand sanitizer can be used if soap and water are not available.
  
• When eating out, ask for freshly made items at fast-food restaurants and avoid buffet-style restaurants, street vendors and salad bars.
  
• Food may be brought to the hospital from home as long as it is fresh and carefully prepared. Food should be transported in a cooler and reheated upon arrival to the hospital.
• Food that is meant to be eaten hot or cold should not sit at room temperature for longer than two hours.
• Leftovers should be eaten within two to four days and should not be reheated more than once.

Foods to avoid

• Raw or undercooked meats, seafood and eggs
  • Examples: steak or hamburger with a pink centre; sushi with raw fish; refrigerated, smoked seafood; runny eggs
  • Cook hot dogs until steaming
  • Pre-packaged and sealed deli meats are allowed
• Unpasteurized fruit juice, honey or dairy products
  • Please check the label on all juices, honey and dairy products for the word "pasteurized". This means it has been heat-treated to kill harmful bacteria.
• Soft cheeses and cheese with mold
  • Examples: brie, camembert and blue-veined cheeses such as blue cheese and gorgonzola
• Any fruit or vegetable with visible mold

Helpful tips

• Check the best before date on your food, and do not feed to your child if this date has passed.
• Keep raw and cooked food separate.
• Refrigerator temperature should be at or below 4°C (40°F).
• Freezer temperature should be at or below -18°C (0°F).
• Defrost raw meat, poultry and seafood in the fridge or microwave. Do not leave them on the counter to defrost.

Please see Safe Food Handling for Immunocompromised Individuals presented by Health Canada for further information or contact your dietitian.

Vitamin D is important!

Your child may be at a higher risk for weak bones. Vitamin D is important for your child’s bones because it helps support bone growth and overall bone health. Vitamin D supplements are available in drops, liquids, pills or gummies. Ask your health-care team about a vitamin D supplement for your child before going home.