Every week I have parents come to me to seek advice on how to support their child’s digestive system. The parent will often say that they tried cutting out the gluten but it didn’t work. The first thing I will ask the parent is, “have you had pathology testing to rule out Ceoliac’s disease or gluten sensitivity?”. Quite often the doctor has told them that there is nothing to suggest that the child has such a condition and offer other treatments for the child.
Gluten sensitivity is common in children. They may experience symptoms of bloating, behavioural issues, constipation, eczema or hives.
The importance of pathology in understanding whether a child or an adult for that matter needs to adhere to a gluten free diet is paramount. Without pathology we cannot measure the severity and cause of the problem. If the child does have Ceoliac’s disease, a strict lifelong avoidance of gluten is essential. However, if a child a mild sensitivity to wheat or gluten it may not require a gluten free diet?
For those that are not familiar with the condition Ceoliac’s Disease, it is an autoimmune condition that causes the immune system to attack the small intestine when gluten is consumed. In children it is vital that it be diagnosed as it can cause symptoms of failure to thrive and compromise their bone mineralisation. It doesn’t always present so aggressively so pathology is really the only clear way of diagnosing Ceoliac’s Disease.
On a personal note I have Ceoliac’s myself, and I have two children. Do I keep them on a gluten free diet? No, I don’t because at this stage, even if they carry the gene, there is no reason to. Avoiding gluten unnecessarily may actually disrupt the immune system when gluten is introduced. So please do not self-diagnose your children you could be making the problem worse.
In trying to measure if a child needs to avoid gluten there needs to be consistency. If the child is given gluten free meals at home and when they are at a party or in the care of another family member they are not gluten free. There is no way of measuring the effectiveness of the gluten free diet.
There is that misconception that a gluten free diet is healthier, as someone who has to follow one strictly I can honestly tell you it can be nutritionally inferior. As an adult I don’t need bread and cereals and therefore I avoid buying many of the commercial gluten free refined products. However, for children they often end up having more preservatives, stabilisers, soy and canola as they are common ingredients in gluten free bread, cakes and cereals.
For some children who have a mild sensitivity after undertaking the appropriate pathology and controlled elimination diets are useful in understanding how their digestion responds to gluten. It may be established that the child can of course have gluten but perhaps there is a threshold of how much they can tolerate. For example, these children may have sensitive digestive systems and the Australian patterns of having a wheat based biscuit breakfast, muffin or crackers for morning tea, sandwich for lunch and pasta for dinner will usually cause them gastro intestinal distress. Nutritional treatment plans can effectively support a child’s ability to tolerate gluten.
Another point to consider is that it may not be the gluten. Many children consume far too much sugar and not enough fibre. This needs to be considered when treating a child’s symptoms. Consideration needs also to be given to the whole child’s and parents health history. Children inherit so much from us, including our intestinal microbiome which dictates so much of our wellbeing.
Nutritional medicine offers effective treatment of gastro intestinal dysfunction in children. In treating children, we consider healing the child’s gut and supporting their overall wellbeing. It is not just about giving the parents a list of Do and Don’t foods.
For further reading on symptoms of Ceoliac’s Disease: