Welcome to Kids Nutrition Advice, a weekly series where our resident registered pediatric dietitian, Ayelet Goldhaber, answers common questions parents have about feeding their children. Goldhaber specializes in pediatric and family nutrition. Have a question you want answered? Send it to us at info@cubpantry.com.

What is often referred to as a “Gluten Allergy” is actually Celiac Disease. Celiac, which affects 1 in 100 people, is actually not an allergy at all. It is a disorder which causes an autoimmune response with the ingestion of gluten. 

This is often confused with a Wheat Allergy, which causes more traditional symptoms of food allergies such as hives and anaphylaxis.

Symptoms of Celiac Disease are diverse, which is why it often goes undiagnosed for a long time. I also see kids with no symptoms at all who were tested because Celiac runs in their family, and in fact are found to have Celiac Disease.

Generally speaking, we have cause for concern when a child has several of these symptoms:

• Struggling to gain weight
• Consistent belly aches
• Rashes
• poor appetite
• Headaches
• Diarrhea
• Constipation
• Not showing age appropriate growth

Yes, because symptoms overlap with many other conditions, Celiac often goes unnoticed until adulthood. For example, belly aches, headaches, and even poor appetite may happen for lots of reasons without a true Celiac diagnosis. Though for a wheat allergy, this is usually noticed as the child begins to consume more wheat containing solid foods around 6 months.

Several blood tests are used to diagnose Celiac Disease, along with endoscopy (looking down the food pipe with a special scope). Some of the blood tests look at levels of inflammation in the body, and others look at an enzyme level that may be affected in those with Celiac Disease.

Wheat allergies are diagnosed like other food allergies. This can be done via blood test or skin patch testing with an allergist.

There is evidence that some people do not tolerate gluten even though they do not have Celiac Disease. There is actually no test for this other than one’s own self-reported symptoms. If a child tested negative for Celiac but is consistently having symptoms you may be advised by your doctor to trial a gluten-free diet in order to identify if gluten is in fact the symptom trigger.   

Ayelet Goldhaber is a registered pediatric dietitian and mother of two who holds a master's degree in clinical nutrition from New York University. She completed her clinical rotations at the Albert Einstein School of Medicine at Montefiore Medical Center and is currently part of the Pediatric Gastroenterology Team at a prominent children’s hospital in New York City.

Want more information about this topic? Get in touch with Ayelet here.