Celiac disease (CD) is a genetic autoimmune digestive disorder that affects 1 in 100 people. Those with celiac disease are unable to digest gluten, a protein found in wheat, rye, barley, and derivatives of those grains. When the disease is left undetected or untreated, gluten damages the cells of the small intestine.
A child with celiac disease may experience gastrointestinal problems, slowed gross motor development and learning problems.
What is gluten sensitivity?
Gluten sensitivity (GS) can present with the same symptoms as celiac disease. GS is still poorly understood and defined, and is not an autoimmune disease. Gluten is not thought to damage intestinal cells in children with GS, but it can still cause adverse health effects.
With strict adherence to a gluten-free diet, a child with celiac disease or gluten sensitivity is able to live a normal and happy life.
What should I watch for?
While on a gluten-free diet, it is unlikely that a student with celiac disease will exhibit any noticeable symptoms of disease. But regardless of lack of symptoms, a strict gluten-free diet is a medical requirement for the child’s health. Gluten, even in small amounts, damages the intestine. Although gluten is not thought to cause intestinal damage in children with gluten sensitivity, even very small amounts of gluten can be problematic for them as well.
If a child ingests gluten, he or she may exhibit one or more of the following:
- Bloating, cramps, or foul-smelling gas
- Irritability or short-term memory problems, which may interfere with school performance
The severity of these symptoms will vary, but are not likely to escalate to a state of emergency requiring medical intervention. Parents should be notified if gluten is ingested.
What are the restrictions?
A student with celiac disease or gluten sensitivity who complies with the gluten-free diet will be able to actively participate in all academic and social activities with few exceptions. Most activities involving food products would be off limits, unless the food is gluten-free.
Common products with gluten*
- Bread products, cereals, crackers and pasta
- Pastries, donuts, cookies, cakes, and other desserts
- Many snack foods
- Some candies and chewing gum
- Finger paints
- Play Dough and some crayons
- Some paste/glue
*gluten-free versions of most food products are now widely available
Arts and crafts
Some materials used for arts and crafts projects may contain gluten. Paste-type glues and Play Dough are potential hazards and should be investigated. Crayons may also be a problem for small children. Work with the child’s family to provide safe materials or an alternative project.
Limited selections available in school cafeterias mean gluten-free choices may not be available. It is the responsibility of the child’s parent(s) or guardian(s) to work with the school dietitian to provide the student’s lunch, work with the cafeteria staff to have alternative gluten-free items available, or send their child to school with a packed gluten-free lunch.
Keep parents or guardians informed of classroom activities involving food. Working as part of a team with parents or guardians to have the appropriate gluten-free substitutes available will allow the child to participate in activities, rather than feeling left out or forgotten. An emergency supply of snacks and treats at school may be helpful.
All products containing any of the gluten-containing grains or flours (wheat, rye, and barley) must be completely avoided. Be aware that the following are types or forms of wheat and therefore must also be avoided: spelt, durum, graham, semolina, couscous and bulgur. In addition, oats and oat products are safest when they have been certified gluten-free. While products labeled gluten-free should comply with the FDA definition of containing no more than 20 ppm of gluten, this is not third-party verified. GFCO’s standard for gluten-free is 10 ppm of gluten or less. Consult with your physician or dietitian before adding oats to your gluten-free diet. Safe grains and starches include rice, corn, potato, tapioca, bean, sorghum, soy, arrowroot and nut flours.
How Can I Help?
The importance of communication between the parent(s) or guardian(s) and the teacher cannot be over-emphasized. As with all medical conditions, it is imperative that the teacher respect the wishes of the family. Children frequently share food. It is important that the classroom teacher be aware of food sharing when it involves the child who must avoid gluten. Maintaining a gluten-free diet in a “gluten-filled” society can be difficult. You may also be in a position to let parents and families know about GIG’s programs and resources just for kids: https://gluten.org/kids/. The family and your student with celiac disease or gluten sensitivity will certainly appreciate all of your support.
This article has been assessed and approved by a Registered Dietitian Nutritionist