Your child is now ready to go home after having a bone marrow transplant. They still need special care at home to prevent infection and help with recovery. Here is some information to help you.

Follow the transplant care team's recommendations about:

• when to come in for a follow-up visit
• what medicines to give your child
• any medicines your child should avoid, such as ibuprofen (Advil^®, Motrin^®, or a store brand)
• any foods your child should avoid or any special nutrition they may need
• whether your child needs a medical alert bracelet
• whether your child can be around your pets
• any special precautions about plants in your home
• any special cleaning to be done at home
• when your child should start getting their routine childhood vaccines again. This is usually around 1 year after the transplant.
• how to care for a catheter (central line), if your child has one
• any special mouth care

To help prevent infections:

• Your child should:
  • bathe every day with a mild shampoo and soap.
  • stay away from people who are sick.
  • avoid crowds.
  • wear a mask when around other people, if your transplant team tells them to.
  • not get a tattoo or piercing.
  • not smoke tobacco or marijuana, vape, or be around secondhand smoke. These make lung infections more likely.
  • stay away from construction sites and out of musty areas, like basements, where mold might grow.
  • avoid using a room humidifier or other devices that have standing water where bacteria might grow.
  • avoid wood-burning fireplaces, because the wood can contain fungus.
• Your child and all members of the household should:
  • wash their hands (or use hand sanitizer) well and often.
  • get seasonal vaccines like the flu vaccine or COVID-19 vaccine.

To help build their strength, your child should:

• get plenty of sleep.
• eat nutritious food. Eating smaller meals more often might work better as your child's appetite returns. If the transplant team suggests it, take your child to a nutritionist or dietitian.
• slowly increase their physical activity. They can start by walking around the house and then slowly build up to longer walks. If your transplant team suggests it, take your child to physical therapy or occupational therapy.

When the care team says it's OK for your child to go back to school, talk to the school nurse, teachers, and principal before the first day about what your child will need. Your child may need shorter days and a lighter workload at first. Often, your child's social worker and/or psychologist can help you figure out your child's needs and how to talk with school staff.

Your child has:

• a fever
  • a one-time temperature of 101°F (38.3°C) or higher 
    OR
  • a temperature of 100.4°F (38.0°C) up to 101°F (38.3°C) on 2 separate readings at least 1 hour apart
• chills/shivering or doesn't look well
• new or worse pain
• nausea, vomiting, or diarrhea that lasts longer than a day or two or is very severe
• a new or worsening rash
• extreme weakness or tiredness
• new bruises or bleeds easily
• new or worse headache or changes in vision
• a new cough or runny nose
• black bowel movements (poop)
• any new or concerning symptoms

Also call your health care provider if your child:

• is short of breath or breathing fast
• isn't eating or drinking
• needs to pee a lot, has blood in the pee, or has pain when peeing
• was around someone with chickenpox or shingles

You know your child best. If they have symptoms that worry you, call your health care provider or transplant team. They can help you decide if your child can be treated at home, can be seen in the office, or needs to go to the emergency room (ER).

How can I support my child? A bone marrow transplant can be stressful for your child and the whole family. The doctors, nurses, social workers, and other members of the transplant team are there to help your child and the rest of the family too. Talk to any of them about resources that can help.

Take care of yourself too. Parents who get the support they need are better able to support their children.

You also can find more information and support online at BMTinfonet.org: 

https://www.bmtinfonet.org/transplant-article/returning-home-after-transplant