As a primary caretaker of children, nannies are constantly on alert – from helping little ones avoid slipping in the bathtub to keeping a careful eye on them as they play at the playground. For children with gluten intolerance, it’s imperative that nannies are vigilant during meal times to safeguard them from harm.

Learning how to avoid ingredients that can cause the child discomfort and understanding the signs and symptoms of gluten intolerance will help ease the minds of the parents, the child and the nanny.

Defining Gluten Intolerance

Children with gluten intolerance, also known as non-celiac gluten sensitivity, are unable to tolerate gluten, a protein found in wheat, rye, barley and contaminated oats. According to Laura Cipullo, New York-based nutritionist, registered dietitian and founder of MomDishesItOut.com, those with gluten intolerance experience similar symptoms to those affiliated with Celiac Disease, where the intolerance can lead to inflammation that damages the intestinal lining, ultimately leading to malabsorption.

“Research suggests that non-celiac gluten sensitivity is a natural immune response to the ingestion of gluten and affects an estimated 18 million Americans,” says Cipullo.

If a child who is gluten intolerant ingests gluten, says Cipullo, they can experience some of the following symptoms:

* Stomach discomfort
* Diarrhea
* Cramping
* Gas
* Bloating
* Brain fogginess
* Joint pain
* Numbing of the extremities
* Headaches

When a child is sensitive to gluten, his body considers it a foreign substance and produces antibodies to eliminate it, says Dr. David Katz, founding director of Yale University’s Prevention Research Center and author of Disease Proof. “Inflammation from gluten sensitivity can result in damage to the villi, or tiny hair-like projections in the small intestine which absorb nutrients and cause problems with absorption of nutrients necessary for good health.”

Furthermore, if gluten sensitivity goes unmanaged, it can affect a child’s behavior and ability to grow and learn, says Debbi Beauvais, New York-based registered dietitian, nutritionist and spokesperson for the Academy of Nutrition and Dietetics. “For growth and development, children have very high energy and nutrient needs,” she says. “To manage a diet for children with this sensitivity, it is best to consult a registered dietitian to work with you and your child to plan meals that will ensure all energy and nutrient needs are being met.”

Ingredients to Avoid

One rule of thumb is to avoid any food with the word wheat in the ingredient list, says Beauvais. “Many foods now are clearly labeled gluten free and most food markets have specific food sections which contain gluten free foods clearly labeled as such,” she says.

However, you can never be too careful. Keep an eye out for the following ingredients:

* Barley (flakes, flour, pearl)
* Breading and bread stuffing
* Brewer’s yeast
* Bulgur
* Durum (type of wheat)
* Farro/Faro (also known as spelt)
* Graham flour
* Hydrolyzed wheat protein
* Kamut (a type of wheat)
* Malt, malt extract, malt syrup and malt flavoring
* Malt vinegar
* Malted milk
* Matzoh, matzoh meal
* Modified wheat starch
* Oatmeal, oat bran, oat flour and whole oats (unless they are from pure, uncontaminated oats)
* Rye bread and flour
* Seitan (a meat-like food derived from wheat gluten that is used in many vegetarian dishes)
* Semolina
* Spelt (a type of wheat also known as farro or faro, dinkel)
* Triticale
* Wheat bran, flour, germ or starch

According to Cipullo, common sources of gluten in packaged goods include bars, candies, fruit snacks and chips. “Hidden sources of gluten can lurk in ketchup, salad dressings, oats, dried fruits, sauces, soy sauce, processed meat products and certain ice creams,” she says.

What to Eat

With a long list of ingredients to stray from, it’s easy to get discouraged when trying to prepare meals for a child who is gluten intolerant. One common concern of parents and caretakers is ensuring their children with gluten sensitivity are getting the proper nutrition, says Dr. Katz. He suggests the following:

* Look for whole grain gluten-free products

* Aim for at least two servings of fruits and three servings of vegetables a day

* Incorporate beans, as they are a great source of gluten-free fiber and protein

One of the best ways to ensure a gluten intolerant child is getting his daily dose of nutrients is to enhance his diet with the very nutrients he needs, says Katz. “Boost the child’s diet with a gluten-free, nutrient-dense children’s multivitamin,” he says, “which combines a full multivitamin, Omega 3 DHA and EPA and more than 100 percent of Vitamin D.”

To avoid the symptoms and further enhance the child’s diet, it is essential to discuss the child’s gluten intolerance with his parents and ensure that appropriate gluten-free snacks are available for the child, recommends Cipullo. “This child’s intolerance to gluten should be a top priority and planning a safe and effective way to have safe snacks and meals available to him or her is beneficial to avoiding gluten,” she says.

– Submitted by Sara Dawkins of NannyPro.com