Amy Keller, MS, RDN, LD, a dietitian and celiac support group leader from Bellefontaine, Ohio, answers your questions on all things gluten in this column from Gluten-Free Living. Amy is the Chief Clinical Dietitian at Mary Rutan Hospital in Ohio. She is also a past chair of the Dietitians in Gluten Intolerance Disorders practice group for the Academy of Nutrition and Dietetics.
My 4-year-old daughter was diagnosed with celiac disease late last year. We’re getting the hang of the gluten-free diet, but she’s becoming increasingly picky about what I serve at dinner. She often refuses to eat what I cook, so I end up making gluten-free mac and cheese or chicken nuggets after dinner so she’ll eat something. It’s made dinnertime stressful. Help!
Most young kids are picky, at least to some extent, about what they eat. It can lead to many of the complaints you are experiencing. It can be even more complicated when your child requires a special diet. One way to approach the issue is to make sure you are doing your job as the parent—providing regular meals and snacks. It is her job to decide whether and how much she will eat. This is called the “division of responsibility” in feeding and was developed by Ellyn Satter, an internationally respected registered dietitian and feeding therapist. We, as parents, often end up trying to do our children’s jobs for them by pressuring or bribing them to eat or short-order cooking favorite foods when they refuse what is served.
Limit eating to mealtime or planned sit-down snacks, with water only between. This allows her to come to the table hungry and ready to eat. If you are serving something she’s never tried before, serve some other familiar foods along with it. Reassure yourself that it can take many attempts for a child to try new food; it’s totally normal. Try to avoid insisting on a “no thank you” bite. It’s a form of pressure that can make children more resistant to trying new foods.
If she doesn’t eat what’s been served, say “you don’t have to eat,” but let her know that you will not be making different food for her after dinner. This can test your mettle as a parent, but it’s worth it. Be prepared as she will test you to see if you’ll give in. Eventually, this will lead to a more relaxed mealtime for everyone and allow her to feel more comfortable around all foods.
For more information about the division of responsibility and feeding, check out Ellyn Satter’s website at ellynsatterinstitute.org.
My 11-year-old daughter has had celiac disease since she was little. Recently, her dad and I have noticed that she is more self-conscious about eating gluten free around her friends. Will she grow out of this? Is there anything we can do to help?
No kid wants to be different, and it can be tough as a parent to watch them feel that way. Just like adults, kids who eat gluten free often feel like they are always in the spotlight at mealtime, which can make them feel very uncomfortable. Try not to let your daughter avoid typical social situations, such as sleepovers or amusement parks. Instead, look for ways to help build her confidence. For these events, talk to the parents who are hosting about what snacks will be served and make a look-alike item that she can enjoy. Help her to recognize that there are lots of naturally gluten-free foods that she can enjoy right along with her friends, such as fruit, veggies, corn tortilla chips and popcorn. You might want to rehearse together what she will say if someone does offer her food that contains gluten. Learning to speak up and say “no thank you” can go a long way. Finally, consider finding a kid-focused celiac support group such as Generation GF (gluten.org/kids).
I’ve heard the gluten-free diet is good for kids on the autism spectrum. Is this true?
There has been much buzz about the gluten-free, casein-free (GFCF) diet as a treatment for autism. Unfortunately, the research on this approach has produced decidedly mixed results. Some children may respond to the GFCF better than others, but if there is no improvement seen in a few weeks, it may not be the right approach. Some children with autism may also have celiac disease, so, as always, test before starting the diet.
Because the GFCF diet is very restrictive, there is a risk of nutritional deficiencies. It’s crucial to find a registered dietitian who is experienced in working with kids on the gluten-free diet to ensure that they receive enough calories and other nutrients needed for proper growth and development.