Malnutrition and cachexia are frequent consequences of childhood cancer and its treatment. Providing appetising hospital food in a timely, flexible way can help ensure a child has the option to eat familiar food when they are hungry and maintain a good nutritional status. A survey by the children’s cancer charity CLIC Sargent found that hospital food for children with cancer was unappealing, poorly prepared, unsuitable for sick children, lacking in choice, unhealthy and not age-appropriate. New menus and a cook-to-order service were among innovations made in one centre following similar findings in a local survey. The hospital’s young people’s executive group contributed to the changes. A follow-up survey indicated that children and families were very satisfied with the new arrangements. The need for improved nutritional support and the reduction in waste that resulted from these changes need to be balanced against the increased costs of the improved service.