It is devastating for a parent to know their kid has an autoimmune disease like Celiac Disease in kids. It becomes more challenging when the condition forces the child to restrict something that is a family staple food ~ Wheat. When we discover Celiac Disease in Children, Gluten-Free Nutrition Guide is highly important. Celiac disease is an autoimmune disease that damages the intestine when gluten-rich foods are consumed. Some children can develop gluten-intolerance as a secondary condition. For example, if a child has Intestinal bowel disease, a gluten intolerance can show up, and the consumption will be restricted. Parents can start seeing symptoms as early as 6-9 months when weaning food is introduced to the baby and gluten rich foods cause digestive problems. The most challenging part is that Indians feel that if they do not give wheat to the child, the child will not get enough food. How will the child grow? How will we fill his stomach? The Bad News Yes, the food restriction seems massive. Wheat is a staple food in the north and central India. Kids often wish to eat what their family eats, hence we find it difficult to avoid it too. Also, Wheat is not exactly the restriction; gluten is. The other grains that have gluten are as follows: Common Ingredients we should check while buying foods are: Malt flavoring, malt syrup, malt extract, malt vinegar, and brewer’s yeast. We have to be careful not only while preparing food at home, but also while buying ready-made food. Awareness has been created, hence most food companies issue label warnings on their product which may contain gluten. Some products are not made of the raw material that has gluten, but are prepared in the same production line, hence, can be contaminated. That’s why checking labels should become a law. The Good news India being rich in variety, your kid still has a lot of options even to prepare roti. Nutrition, growth, and satisfying hunger are all challenges that can be easily overcome with minor planning. Nutrition Challenges The parents might continue to give gluten-containing foods if the child has celiac disease, but hasn’t been diagnosed yet. This will impose a serious challenge as the child will have digestive issues like chronic diarrhoea (often foul-smelling), abdominal pain/distension, bloating, vomiting, constipation, nausea, and gas. These challenges will lead to excessive weight loss. Hence, if you can understand the pattern, as to when the baby shows symptoms, based on that, you must visit the paediatrician and explain everything to them. Once the diagnosis is established, we can take precautionary measures. If unrestricted food is continued, the baby might face failure to thrive (poor weight gain), short stature, delayed puberty, irritability, anaemia (from iron deficiency), enamel damage on teeth, weight loss, and even neurological issues like ADHD or headaches due to malabsorption of food. Infants, toddlers, older children and teens can all show slightly different symptoms. Family Elders, Neighbours, Google and Chat GPT For some reason, elders in your family or neighbours might say, “Doctor to aise hi kehte hai, roti nahi khayega bacha to kaise chalega, khila do kuch nahi hoga”. Astonishingly, many people will believe that and continue to feed the child wheat-based products. Self-diagnosis with internet searches is another major challenge. We have to understand that some kids might have mild indigestion, and the parents might self-diagnose and create unnecessary restrictions. Mostly because gluten-free is a trend, and people say anything for likes and views. Building a Balanced Gluten-free plate To manage nutrition, our only concern is providing optimum nutrition so that the kids’ growth and development reach maximum potential. We have already discussed various cereals and grains that can be safely given to the child. That is the only replacement happening in the child’s diet. Rest remain the same. 25% cereal based foods, ~ Gluten-free as mentioned above 25% protein rich foods, ~Dairy, pulses and legumes, nuts and seeds 40% vegetables, Seasonal 10% fruits, Seasonal Healthy fats from nuts and seeds, Less visible fats from Ghee, butter, Oil Adequate water. Other important factors will include adequate physical activities, sleep and rest, playtime and education for overall development of the child. Sharing is not caring for Celiac Kids We have to educate the child now and then and make sure there is no scope for errors. Maybe the child was diagnosed with celiac at the age of 9 months and now he is 12 years old. They wish to explore recipes and talk to friends, share tiffin. They will be inclined to processed foods, a lot of which are seemingly safe, but might have traces of gluten. Your kid knows potato is allowed, but as mentioned earlier, the potato chips might have been made on a production line used for other products containing gluten. Such warnings are mentioned on food labels, but the friend might be carrying a few potato chips in their tiffin box that do not have the label. Junk food is, anyway, not good for kids, better to avoid. The teachers and caretakers also must be educated and warned. Keep in touch The most challenging time is the initial time when diagnosis is made. Regular touch with the clinical team, including the doctor and dietitian, is essential till all doubts are clear. After that, at least 6 monthly follow-ups with both doctor and dietitian will help manage symptoms and avoid trouble in the long term. Regular professional interaction will also motivate the child to follow the restrictions well. Parents can also discuss how to keep meals interesting for the children alongwith maintaining a gluten-free pattern. Stay Safe.