Gluten-Free Diet for Children with Celiac Disease

The only treatment for people with celiac disease is lifelong, complete avoidance of foods containing gluten, a group of proteins found in wheat, rye, and barley. This prevents your child from having uncomfortable digestive symptoms, such as bloating and diarrhea, and can also reverse damage to the small intestine caused by gluten.

Maintaining a completely gluten-free diet can be difficult—these proteins are found in many foods and are used as additives in a number of unexpected products, such as toothpaste and crayons. Fortunately, new food labeling laws and the availability of a greater variety of gluten-free products has made it easier for parents and caregivers to help children stick to a gluten-free diet. In addition, many restaurants now offer gluten-free food options. 

Nevertheless, reading and understanding food and other product labels requires education and practice. Registered dietitians at NYU Langone’s Pediatric Gastroenterology Program teach families how to read nutrition labels on foods and ingredient lists on other products, so that they can make safe choices. Our dietitians can also advise you on how to maintain a nutritionally balanced, gluten-free diet to ensure your child’s optimal growth and development.

Because celiac disease can interfere with the body’s absorption of nutrients, children with this condition may need to take supplements, such as vitamin D, calcium, iron, and folic acid, to ensure that they are receiving enough of these essential vitamins and minerals. Your child’s doctor can advise you on the right supplements and dosage for your child’s needs. 

Many children with celiac disease or non-celiac gluten sensitivity—a condition in which children have some symptoms of celiac disease after eating foods that contain gluten but do not have signs of intestinal damage—feel better after only a few weeks of adhering to the gluten-free diet. However, in those with damage to the intestinal lining, it may take several months to completely heal, and signs and symptoms can return if there your child inadvertently ingests gluten.

After your child has been diagnosed with celiac disease and has fully adopted the gluten-free diet, our doctors monitor your child using blood tests. These tests can help the doctor to determine if antibodies, or proteins, that are produced in response to gluten, are still being produced by your child’s immune system. 

Blood tests are also used to make sure that your child has normal thyroid function and does not have a nutritional deficiency. The number of follow-up visits depends on your child’s progress, symptoms, and his or her ability to follow the gluten-free diet. 

If blood tests reveal the continued presence of certain antibodies, even after a child has adhered to a gluten-free diet, our doctors may recommend another upper gastrointestinal endoscopy to evaluate any intestinal damage. If they find that the intestine is healing, our doctors continue to monitor your child with blood tests to determine if the child’s body is producing fewer antibodies. If the intestine has not healed, however, our doctors work with you to identify possible sources of gluten contamination or exposure and perform additional blood tests to monitor your child’s antibody levels.

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