Elaine Taylor-Klaus took her daughter Bex off gluten eight and a half years ago after a nutritionist suggested the irritable and sensitive girl might have a gluten sensitivity. Within two weeks of eliminating gluten from her diet, Bex, now 18, was a different child.
Melissa Berardi's son Anthony, 5, was wasting away two years ago. He was extremely small for his age, she says, and throwing up constantly. It turned out he had coeliac disease. Berardi changed his diet and says Anthony has become a healthy child.
Whether it's for diagnosed coeliac disease or suspected gluten sensitivity, many parents are switching their children to gluten-free diets. Busy parents might feel overwhelmed by the thought of a big dietary overhaul for kids already picky about food (and change in general). But going gluten-free doesn't have to be scary.
"Parents are afraid to even try it because it sounds like it would be too hard," said Taylor-Klaus, a parenting coach.. "I was one of those parents. I'm not saying it's not hard. But [Bex] became so much easier to manage that the trade-off was far superior to what I thought it would be."
The trade-off is even more pronounced for kids with coeliac disease, an inability to digest gluten, a protein found in products that contain wheat, barley or rye. It affects about one in 100 people in Europe and North America, according to the National Institutes of Health. The Mayo Clinic estimates that the number of people affected has quadrupled in the past 50 years, though the reason is unclear.
There is no treatment for coeliac disease - which can cause bloating, diarrhoea and constipation in some patients and mood swings and neurological symptoms in others - but it can be managed by eliminating gluten from your diet.
Here are some suggestions from experts and parents of gluten-free children on how to make the change easier for you and your child.
- Consult a doctor
John Snyder, chief of the division of gastroenterology, hepatology and nutrition at Children's National Medical Center in Washington, said in an e-mail that parents should check with a doctor before changing a child's diet, to ensure he or she continues to get proper nutrition.
There are many reasons parents consider putting a child on a gluten-free diet, including mood swings, eczema and autism spectrum disorders. But if you think your child might have coeliac disease or a severe gluten intolerance, it's important to have him tested before changing his diet.
"Testing for coeliac disease is only effective if the child is on a diet which contains gluten," Snyder said.
- Be a detective
Just because a label or menu says something is gluten-free doesn't mean it's safe for coeliacs, said Jerry Malitz, president of the D.C. Metro Coeliac Organization.
In addition to reading the ingredients, parents need to see how the food is prepared and stored. French fries might be labelled as gluten-free on a menu, Malitz said, because they are made with potatoes. But if they are cooked in a fryer that has been used for onion rings or fried shrimp that are coated in flour, there can be cross-contamination.
"A food might be gluten-free, but nothing about its preparation, storage or anything else is gluten-free," Malitz said. "That's a very big issue."
The same goes for checking labels in a grocery store. Even if something is labelled as gluten-free, Malitz said, parents need to look at where and how the food was prepared to decide whether it's safe.
- Make your own food
Although gluten-free products are much more readily available now than they were a few years ago, they are more expensive than their traditional counterparts.
Parents can save by buying in bulk or buying the whole grains and processing them at home. Cindy Miller, of Boring, Ore., uses a grain mill to grind her favourite flours.
"It doesn't take a lot of time to put it through a mill," said Miller, whose son, Luke, is 17 and follows a gluten-free diet because doctors noticed he wasn't growing properly and suspected he may have coeliac disease. "You can put it in the freezer and then you have whatever you want to make corn bread, hot breakfast cereal or pancakes."
Kelly Courson, a holistic health coach in New York who has coeliac disease and writes the blog Coeliac Chicks, recommends that families who are used to eating a lot of bread invest in a bread machine.
"You can have the ingredients measured and ready to go in bags so you only have to add yeast and water," Courson said. "It really helps if you are pinching pennies."
- Stockpile treats
Keep a stash of gluten-free cupcakes or cookies in the freezer at home and in the school cafeteria or office so your child will be able to have a treat at birthday celebrations.
"Anticipate where they're going and what they might need," said Taylor-Klaus. All three of Taylor-Klaus's children and her husband are gluten-free for various issues, including eczema and difficulty focusing. "Anticipate what you can do to normalise it for them so they're not different from everyone else. It may be a different dessert, but it's still a dessert."
- Get the school on board
Talk to your child's school, especially with younger children, and enlist their help. Maria Roglieri of Sleepy Hollow, N., said her daughter's school made arrangements for her to talk to other parents of gluten-free kids, to share information.
Roglieri's daughter, Sara Friedman, 16, wrote the luten-Free Guide to Washington, DC, when she was 13, and Roglieri edited the book. Sara's coeliac disease was diagnosed when she was 6. Roglieri also suggests seeing whether the school will group two or more gluten-free kids together in the same class, so they have a buddy with similar dietary restrictions.
Stephanie Epstein said teachers have helped her son, Jeremy, 8, make the transition to gluten-free.
"They do behavioural rewards at school, and one of the rewards was pizza with the teacher for lunch. She ordered pizza for the whole table," Epstein said. "His teacher specifically ordered gluten-free pizza for [Jeremy]. . . . She even ate the pizza with him. She was showing him that it's okay to be gluten-free. Everybody's different for different reasons."
- Give unprocessed foods a chance
Children are notoriously finicky when it comes to food, and most of what passes for kid-friendly in restaurants is loaded with gluten: chicken nuggets, macaroni and cheese, burgers and hot dogs or spaghetti and meatballs.
Although there are gluten-free versions of most of these kid staples readily available, Kelly Dorfman, a nutritionist, thinks the focus of a gluten-free diet should be on whole, unprocessed foods. Load up on fruits, vegetables, seeds, nuts, meats, cheeses and other healthful foods, instead of focusing on the gluten-free versions of your favourite processed foods, Dorfman said.
Dorfman suggests making a different vegetable every night for two weeks and telling your child that she has to have at least two bites, to help her get acclimated to eating a variety of foods.
"They don't have to love it; they have to tolerate it," said Dorfman, author of What's Eating Your Child. "Eventually, if they eat it often enough, they do start to like it."
- Do it as a family
Going gluten-free with your child, at least for the first month, can ease the transition to a new diet, Dorfman said.
"You don't want the child to feel like something's wrong with him," Dorfman said. "This is just a crazy thing about modern living. Doing it together, and helping the family bond that way, is really important."
Epstein said that although her husband, Brian, was coeliac, the rest of the family didn't eat gluten-free until Jeremy was diagnosed last summer. Now they all eat gluten-free at home, and she and her daughter Lauren, 5, eat gluten only when they are out.
"We couldn't have 'This is Daddy and Jeremy's food and this is Mommy and Lauren's food,' " Epstein said. "I can't let my daughter have one thing and not let him have it, because that's not fair."