Blood and Marrow Transplant Nutrition Guidelines

Using basic food safety guidelines keeps food clean and safe to eat.  People with a weakened immune system are at a greater risk for getting sick when they eat foods that are not kept safe.   Using the ideas in this guide can help keep food safe for you and your child after having a bone marrow transplant.

  • Avoid buying dented / rusted cans.
  • Avoid buying loose spices from farmer’s markets, etc.
  • Avoid fruits / vegetables with bruises and cuts.
  • Check expiration dates and plan to eat foods before they expire.
  • Dishes with meats that are not cooked all the way through (e.g., smoked meats, sushi with raw fish such as salmon, tuna, red snapper)
  • Do not buy foods from open bin containers (nuts / candy scooped into bags filled by customers).
  • Do not buy foods in packaging that is torn or leaking.
  • Foods made with raw eggs (egg nog, some homemade salad dressings)
  • Honey
  • Raw sprouts
  • Soft cheeses made from unpasteurized milk (brie, feta, etc.)
  • Unpasteurized dairy products
  • Unpasteurized juices
  • Avoid any dishes made at the grocery store (for example potato salad, egg salad, macaroni salads) or at the deli counter.
  • Avoid any sliced meats / cheeses from deli counters (packaged meats are OK).
  • Hand washing is the first defense in food safety.  Hands should be washed with warm soapy water before cooking and before and after handling raw meats.
  • Wash all kitchen surfaces and wipe up any spills right away.  Cutting boards and food surfaces that come into contact with raw meats and foods should be washed with warm soapy water. 
  • Towels and dish clothes should be changed daily.  If using a kitchen sponge it should be sanitized daily in the dishwasher or in a bleach solution and replaced weekly. 
  • Dishes should be washed in the dishwasher on the highest temperature or by hand with hot / warm soapy water. 
  • Cupboards, pantries and refrigerators should be cleaned often and food rotated so the oldest items are used first.
  • Wash all lids of cans before opening.
  • Separate raw meats when shopping at the grocery store by putting them in a separate bag to prevent juices from cross contaminating.
  • Package fruits / vegetables away from raw foods when taking them home from the market.
  • DO NOT use recyclable bags for meats, vegetables, fruits (may use these bags for dairy, grain and pre-packaged products).
  • Buy two cutting boards (one for raw meats and one for raw fruits / vegetables).
  • Do not thaw frozen foods at room temperature (foods can be thawed in the refrigerator, microwave or in cold water).
  • Cook refrigerated raw meats within 1-2 days of purchase.
  • Frozen meats must be cooked within 3-4 months.
  • Use a meat thermometer to test the temperature of the cooked foods.
  • Cook all raw meats to an internal temperature of 165 degrees.

Patient may not handle / bake with raw yeast.

  • Patient may eat foods already prepared with yeast (breads, etc.).

Patient cannot eat raw cake or cookie batter.

  • Patient may eat baked cookies and cakes.
  • Patient must eat a prepared meal within 2 hours.
  • Do not let ready to eat foods sit out at room temperature for more than 2 hours (if it is above 90ᵒ F, foods can only sit out for 1 hour).
  • Maintain a refrigerator temperature at or below 40ᵒ F. 
  • Fast food may be brought to you.
  • It is best for family to visit the restaurant at non-busy times and ask for the food to be prepared fresh.
  • Request that sandwiches be made without condiments and fresh toppings (lettuce, onion, tomato). 
  • Avoid any fresh fruits and vegetables including lemon wedges in water.   
  • Do not consume raw appetizers. 
  • Use good judgment. If the restaurant looks dirty and employees are not using clean food-handling techniques, choose another restaurant.
  • Buffet restaurants and salad bars are not allowed.
  • Soft serve ice cream and yogurt should also be avoided.
  • Wash tops of cans before opening.
  • Never place more than four hours of feeding in the bag at a time.
  • Herbal supplements and health food store nutrition supplements should be avoided.
  • Let you transplant physician know if you are taking any medications not prescribed by him or her.

There are two acceptable forms of bottled water. You may use bottled water that has been processed to remove Cryptosporidium, a type of bacteria known to cause gastrointestinal infection. There are three processes a manufacturer can use to do this including reverse osmosis, distillation, and one micron absolute filtration.

The other acceptable form is bottled water from a naturally protected source, such as a deep artesian well.

To confirm that specific bottled water has undergone one of the above processes, you may contact the International Bottled Water Association (IBWA) at 1-800-928-3711. If the IBWA does not have information on a specific brand, you may call the bottler directly. Ask if any of the above processes were used to assure the removal of Cryptosporidium.

Check with your transplant physicians before using well water or water from a cistern.

Last Updated 12/2014