For Kids with Gluten Sensitivities

PediaSmart^® May Help Balance Feeding Issues

Celiac Disease and Non-Celiac Gluten Sensitivity

Celiac Disease (CD) is an autoimmune disease that occurs in all age groups, from infancy to adulthood. The body’s immune system has a negative response when gluten-containing foods are eaten. Gluten is a protein found in wheat, rye, barley, and possibly oats. The gluten damages the area of the small intestine, called the villi. These villi are responsible for absorbing the nutrients found in food. If the villi become damaged, the body cannot absorb the nutrients that are needed for growth and development, which is especially important in infants and children. The only treatment for CD is avoiding food products that contain gluten.

Non-Celiac Gluten Sensitivity (NCGS) is more difficult to pinpoint because the test for CD comes back negative but the child still has symptoms that are similar to CD. In other words, the villi of the small intestine are not damaged, but the person still experiences side effects when eating gluten. The only way to really diagnose NCGS is with a gluten free diet because the person feels better once gluten is removed from the diet. It is unclear whether children with NCGS need to follow a strict gluten-free diet like CD since the small intestine does not become damaged. However, not eating gluten-containing foods can help a child feel better and lead to a better quality of life.

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Although symptoms of CD can vary widely from person to person, the most common symptoms include diarrhea, abdominal pain, vomiting, bloating, and fatigue. Children may not gain height and weight as expected, which is referred to as failure to thrive. Deficiencies of the fat-soluble vitamins D, E, A, and K; iron; folic acid; and calcium are also common because of the poor absorption of nutrients, known as malabsorption, that is taking place in the small intestines. The loss of nutrients can have not only an effect on physical growth, but on learning skills in children as well. Symptoms can occur at any time in a child’s life whether it is the first time they are exposed to gluten or after eating products for years that contain gluten. To prevent further damage to the villi of the small intestine, it is important to start a gluten-free diet once diagnosis is made regardless of how minor or severe the symptoms.

Following a gluten-free diet may initially be challenging and frustrating for many children and their families, especially since wheat is an ingredient found in so many products. However, gluten-free products are becoming more widely available making it easier for those following a gluten-free diet. Many supermarkets and health food stores now have special sections for these products, recipes can be found on the internet, and many cookbooks are available.

Reading food labels is extremely important when following a gluten-free diet because an increasing number of products are stating that they are gluten-free even when they are not. According to U.S. government regulations, manufacturers must test for gluten at less than 20 parts per million to achieve a “gluten-free” claim on product packaging. Both PediaSmart^® and Baby’s Only Organic^® formulas are gluten-free.

People who suffer with gluten sensitivities should avoid any products that contain wheat, barley, rye, and oats. These ingredients are in many common foods such as pasta, bread, cookies, cakes, and breakfast cereals. Other foods to avoid include many snack foods, soups, gravies, and condiments such as ketchup and soy sauce. Look for ingredients such as wheat, wheat germ, semolina, barely, malt, rye, oats, durum, spelt, couscous, tabbouleh, cracker meal, and wheat flour. Avoiding oats and oat-containing foods, unless certified as gluten free, is usually suggested. Although oats are gluten free, they are often grown in fields parallel to wheat fields or processed on equipment that has also processed wheat. Cross contamination occurs unless the oats are grown in designated fields and processed on designated equipment. Gluten free certification is important if oats are to be part of the nutritional plan.

A balanced diet that includes gluten-free grain products, fruits, vegetables, low-fat dairy, and lean protein will help provide your child with the adequate nutrition for growth and development. Alternative gluten-free grain products are buckwheat, corn, quinoa, rice and tapioca. Fresh meats, fish, chicken, legumes, nuts, seeds, oils, milk, cheese, eggs, fruits, and vegetables are also good choices to help meet nutrient needs.

To make sure you always have the most recent and accurate information regarding celiac disease, consider joining one of the national celiac organizations such as The Celiac Sprue Association or the National Foundation for Celiac Awareness.

Autism and Gluten-free and Casein-free Diet

To reduce a child’s symptoms of autism, many parents look to alternative treatments such as specialized diets. Recently, the gluten-free/casein-free (GFCF) diet has grown in popularity. Although little is known about the diet and not much research has been done, some parents report improvements in autism symptoms, such as changes in speech and behavior, with this specialized diet. With a GFCF diet, foods that contain gluten and casein are removed in hopes of improving social and cognitive behaviors and speech in children with autism. A gluten-free diet means avoiding any food or beverage that contains wheat, barley, rye, and oats. A casein-free diet calls for the elimination of milk protein which includes all milk products such as butter, yogurt, ice cream, and cheese. Even if a milk product is lactose-free, it may contain casein if it has any milk derivatives in it like milk solids or whey.

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The thought behind the diet is that children with autism have problems digesting certain foods properly and may have “leaky gut” syndrome. “Leaky gut” means a person’s intestines are unusually permeable which allows extra-large molecules (such as proteins) to leave the intestines. These large molecules enter the bloodstream and travel to the brain and induce a similar state to that of a drug-induced high. When gluten and casein are removed from the diet, the child may no longer experience this high and improvements in behavior, lack of focus, and even speech problems can be seen. The bottom line is more research needs to be done to understand how dietary changes, such as a GFCS diet, can improve behavior in children with autism, but for now, some parents have seen positive results.

It is important that children following a gluten-free diet or GFCF diet receive adequate nutrition since many foods are being eliminated which can lead to nutrient deficiencies. PediaSmart^® Dairy or Soy may be of benefit to the child on a gluten-free diet. With a GFCF diet, PediaSmart^® Soy can be a useful addition to help ensure proper nutrition along with other gluten-free and casein-free healthy foods and beverages. All ingredients used in PediaSmart^® Soy are gluten-free and casein-free.

Baby's Only Organic^® Formulas and PediaSmart^® Complete Nutrition Beverage for Gluten Sensitivities

Vitamin D, K, and calcium are important for maintaining bone health but children with gluten sensitivities are often deficient in these nutrients. These deficiencies are the result of both diet restrictions and malabsorption. Children with CD are more likely to have low bone densities which means they could be at risk for fractures and osteoporosis later in life.1 Deficiencies in Vitamin B12, iron, and fiber may also be present due to the restriction of certain grain products that are typically fortified in these nutrients.

Adequate nutrition is vital for a child’s growth and development. For parents who are looking for a healthy nutrition option for their children with gluten sensitivities, Nature’s One ^® offers complete organic nutrition that is gluten-free for infants and children up to 13 years of age. Baby’s Only Organic^® Formulas provide organic nutrition for infants, under the guidance of a healthcare professional, and young toddlers. For children ages 1 to 13 years, PediaSmart^® Complete Organic Nutrition Beverage contains 29 vitamins and minerals and the protein, fat and carbohydrates necessary for complete nutrition. Below are the nutritional values in one serving size for Baby’s Only Organic^® and PediaSmart^® for the important nutrients that are often lacking in the diets of children with gluten sensitivities:

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Baby's Only Organic^® per 5 fl oz Servings
Nutrients	Amount per Serving	% Daily Value
Vitamin D	75 IU	15 %
Vitamin E	2 IU	15 %
Vitamin A	300 IU	10 %
Vitamin K	8.5 mcg	NA
Iron	1.8 mg	15 %
Folic Acid	15 mcg	6 %
Calcium	135 mg	15 %
Vitamin B12	0.2 mcg	6 %

Click to learn more about Baby's Only Organic^® Toddler Formula.

PediaSmart^® per 8 fl oz Serving
Nutrients	Amount per Serving	% Daily Value
Vitamin D	120 IU	30 %
Vitamin E	5.4 IU	20 %
Vitamin A	380 IU	8 %
Vitamin K	14 mcg	20 %
Iron	3.3 mg	20 %
Folic Acid	71 mcg	20 %
Calcium	230 mg	25 %
Vitamin B12	1.4 mcg	25 %

Click to learn more about PediaSmart^® Complete Nutrition Beverages.

Can Children with Celiac Disease Benefit from Taking a Probiotic?

When children with CD eat foods that contain gluten, the small intestine becomes inflamed and damaged; this prevents the proper absorption of nutrients. There is also a deficiency of healthy bacteria in the small intestine. A probiotic provides healthy bacteria for the intestinal tract, gives protection against harmful bacteria, and improves absorption of essential nutrients. For people with CD, providing probiotics in the diet may reduce inflammation in the small intestine and provide a better quality of life.2 Taking a probiotic supplement is not meant to take the place of a gluten-free diet, but may be a useful addition.

Baby’s Only Essentials^® Probiotic is a live, safe and active friendly bacteria uniquely blended for the specific needs of children using three types of Bifidobacterium. The culture used to grow the bifidobacteria in Baby’s Only Essentials^® Probiotic may or may not contain wheat. Testing has shown that the amount of gluten per dose is far less than the current guidelines for meeting the “gluten-free” claim. Please consult your healthcare professional before using this or any other probiotic product. Baby’s Only Essentials^® Probiotic is intended for children 1-year of age or older. When supplements are directed and supervised by and infant’s healthcare professional, parents should seek specific advice on supplementation for an infant who is ill or immune compromised. Click here for more information on Baby’s Only Essentials^® Probiotic.

1. D R Mager, J Qiao, J Turner. Vitamin D and K status influences bone mineral density and bone accrual in children and adolescents with celiac disease. European Journal of Clinical Nutrition. 2011; doi: 10.1038/ejcn.2011.176
2. De Palma G, Cinova J, Stepankova R, Tuckova L, Sanz Y. Pivotal Advance: Bifidobacteria and Gram-negative bacteria differentially influence immune responses in the proinflammatory milieu of celiac disease. J Leukoc Biol. 2010; 87(5):765-78.