Gluten is a protein that's present in wheat and other grains, like barley and rye. Gluten helps dough maintain its shape and gives it an elasticity or a chewy texture. Although it's commonly found in baked goods and pastas containing wheat (or barley or rye) flour, it can also be found in cereals, crackers, and sauces or in unexpected foods such as ice cream, pickles, and hot dogs.

But "a 'gluten allergy' is really a misnomer, because it's really a wheat allergy, and gluten is one of the components.

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A wheat allergy is an immediate onset allergic reaction caused when the body's immune system reacts against wheat proteins, and it usually occurs with every exposure. Wheat is one of the eight most common food allergies; the others are cow's milk, eggs, soy, peanuts, tree nuts, fish, and shellfish; together they account for more than 90 percent of allergic reactions. If your child has an allergy, he'll likely experience immediate and reproducible hives or swelling whenever the food is consumed. 

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How Can I Tell If My Child Has Celiac Disease, What Allergy, Or Gluten Sensitivity?

Diagnosis can be tricky, since these conditions have similar symptoms. It's essential to have your child evaluated by a doctor. There are major differences in how these conditions progress and are treated, so it's important to know exactly what you're dealing with.

• Your pediatrician will do a physical exam, ask questions about symptoms and your family medical history, and may order blood tests. For the blood tests to be accurate, make sure that your child continues to eat as he normally does. Don't eliminate foods that contain gluten or wheat unless your doctor specifically asks you to.
• If your pediatrician suspects a wheat allergy, she'll refer you to an allergist, who will do a skin prick test, blood tests, or a food challenge. Your child might be asked to eat a small amount of wheat under medical supervision and be observed for an allergic reaction.
• If your pediatrician suspects a gluten problem, she'll refer you to a pediatric gastroenterologist. This doctor may order more blood tests and do an endoscopy, passing a long, thin tube through the mouth and stomach into the small intestine and taking a tiny sample of tissue. If the sample reveals damage to the small intestine, your child will be diagnosed with celiac disease.

How Can I Make Sure My Child Has A Gluten-Free Diet?

Diagnosis can be a relief, but for many families, going gluten-free is a big lifestyle change. Grocery shopping, managing a gluten-free household, and eating out can all feel daunting, but there are some good guidelines and resources for parents.

Gluten-free diets are a popular trend, but just because a food is gluten-free does not mean it's healthy. It's important to make sure your child doesn't miss out on any essential nutrients. Your dietitian can help you develop a nutritious eating plan that fits your budget and lifestyle, and can also give you recipes and suggest substitutes for your child's favorite foods.

The goal is to stay away from wheat, rye, and barley, as well as additives that may contain gluten. Most pastas, pizza, crackers, cereals, breads, and baked goods are made using these grains.

Learn to read food labels. When you're shopping, check ingredients and avoid any products that include gluten-containing grains, for example:

• Wheat and wheat varieties such as spelt, kamut, durum, graham, and semolina
• Wheat bran, wheat starch, wheat germ, cracked wheat, hydrolyzed wheat protein
• Barley
• Rye
• Triticale
• Malt (unless it's derived from corn)

Oats are naturally gluten-free, but many oat products are contaminated with gluten during processing. So it’s worth experimenting with oats that are labeled gluten-free, but be aware that researchers have found that that some celiac patients can’t tolerate even those oat products.

Be wary of prepared and processed foods. Gluten can be found lurking in unexpected places, such as store-bought stews and soups, soy sauce, processed meats like hot dogs and cold cuts, salad dressings, medications, vitamins, and even lip balms.

Resist the urge to stock your kitchen with manufactured products. Gluten-free bread, cookies, and crackers tend to be more expensive and have added sugars, sodium, or fat to make them taste better. Whole foods such as meat and poultry, fish, fruit, vegetables, most dairy, and nuts are naturally gluten-free and healthier for your family.

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