Celiac Disease in Children

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Celiac disease in children

Celiac disease can develop in children after weaning onto cereals based on wheat, barley and rye that contain gluten. It is ten times more likely to develop in a child if a parent has the illness. In this case gluten should not be introduced until at least six months of age. Celiac disease can develop in a child if introduced before this time. They should be introduced steadily into the baby's diet so that they can be monitored for signs of celiac disease. Breast milk is naturally free of gluten and infant milk formulas are gluten free also.

Celiac disease in children is diagnosed between 6 months and 2 years old since that is when they are getting their first taste of gluten in foods.

A good first indication of celiac disease is when there is a lack of appetite, delayed development, short stature and/or a failure to thrive. Other common symptoms include vomiting and diarrhoea, a swollen stomach, arms and leg muscles becoming thin and wasted and pale, bulky stools that have noxious smell. Symptoms can be mild or severe and can come and go.

A child may only have some of these symptoms or none at all until a trigger such as an injury or at times of stress. Although some of the more common ones above may not be seen, often slowed growth, iron deficiency anaemia, a skin rash or changes to the enamel of teeth will be.

Slowed growth comes about as celiac disease doesn't allow the intestine to absorb the goodness from food as well as a healthy one. The changes to the teeth tend to affect the permanent adult set and can lead to a yellowing of the enamel. The teeth can also develop grooves or become pitted.

Thin bones can occur in children with celiac disease as the gut can't absorb enough vitamin D and calcium.

Not all children need to be tested however if they show some of the signs above it is worthwhile discussing it with a healthcare provider especially if there are risk factors present. In children risk factors would include a family history of celiac and if they have one or more of diabetes mellitus, thyroid problems and syndromes such as Downs, Turner and Williams.

Testing for celiac is the same as in adults and gluten should be kept in the diet until testing is completed to ensure an accurate result. A blood sample is taken to check for antibodies and this may be followed up by a biopsy (tissue sample) of the intestine via endoscopy (a long thin camera fitted with a cutting tool that is inserted via the mouth). Whereas adults tend to have a local anaesthetic that numbs the throat, children would have it under a general anaesthetic (asleep).


Treatment of celiac disease by eating a gluten-free diet can resolve the problem in most cases as it allows the lining of the bowel to return to normal. Sometimes, vitamin supplements are also recommended if a child is lacking in nutrition. The damage can return as soon as gluten is introduced back into the diet. Foods to be avoided include bread, pasta, cereals, biscuits, cakes, pies and sauces.

It can be difficult for parents and children as they need to make adjustments to their lifestyle to adopt a gluten free diet. Meeting with a dietician who is experienced in treating celiac disease can help to provide a better understanding of which foods are safe, how to read food labels and where to find suitable alternatives for a child’s favourites.

Parents of children who are newly diagnosed will also need to speak to their school or day care provider about the condition indicating which foods are safe as well as what to do in case of illness. Thought should also be given to what to do when at parties and going on holiday.

Excellent gluten-free substitute foods are now widely available. After starting a gluten-free diet, most children begin to feel better within two weeks.