Abstract

Objective(s): This longitudinal study aims to determine the incidence of malnutrition and track the dynamic changes in anthropometric indicators (Weight, BMI, MUAC, and Skinfold thickness) among newly diagnosed children with cancer undergoing chemotherapy in Baghdad city in Iraq. Methods: A longitudinal descriptive study was conducted at the Hematology Center of the Child Protection Teaching Hospital in Medical City, Baghdad, from May 1st to December 31st, 2025. A purposive sample of 130 children newly diagnosed with various types of cancer (hematology and solid tumor) who were monitored across three time points: at diagnosis (Baseline), at three months, and at six months of treatment. Data were collected through direct anthropometric measurements using tools like slim guide skinfold calipers; WHO MUAC tapes. The data processed using SPSS version 26, employing descriptive statistics and repeated measures ANOVA to identify significant nutritional trends. Results: At diagnosis, a significant proportion of children exhibited sub-clinical nutritional deficits. The results of post-induction showed a significant progressive decline in Weight (p < 0.001) and BMI (p < 0.01). Significantly the most acute reduction in Mid-Upper Arm Circumference (MUAC) and triceps skinfold thickness demonstrated (p < 0.001), reflecting a rapid depletion of muscle mass and fat stores. When comparing diagnostic subgroups, children with hematological malignancies (like leukemia); children experienced more severe nutritional derailment than those with solid tumors. Conclusion: The study concludes that malnutrition with cancer is not merely a baseline condition but a dynamic and worsening complication of chemotherapy in Iraqi children. The significant decline MUAC suggests it is a more sensitive early warning indicator than traditional of child weight monitoring. There is a critical need for an integrated “Nutrition-Oncology” protocol that shifts the clinical focus from reactive feeding toward proactive, nurse-led nutritional surveillance. Recommendations: It is essential to implement standardized nutritional screening at every treatment cycle. The study advocates for the development of individualized nutritional support plans and specialized training for nursing staff to recognize early signs of wasting. Furthermore, family-centered dietary counseling should be integrated into discharge planning to reduce the risk of home-based nutritional failure and ensure continuity of care.