Wheat Allergy

What is a wheat allergy?

A wheat allergy is a reaction by your child's immune system to the proteins found in wheat. Our immune systems normally respond to invaders that attack the body such as bacteria or viruses. With a food allergy, the body's immune system mistakenly attacks harmless things, such as the substances found in wheat. Wheat is among the 8 foods that are responsible for most food allergies seen in children. The other foods include milk, soy, peanuts, tree nuts (such as walnuts and cashews), eggs, fish, and shellfish.

What are the symptoms of an allergic reaction to wheat?

If you suspect your child is having an allergic reaction to wheat or any other food, it is important to get a diagnosis from your health care provider or allergist. Allergic reactions to wheat usually begin within minutes or a few hours after eating or inhaling wheat (flour). There are 4 types of protein found in wheat, (albumin, globulin, gliadin and gluten). Your child may be allergic to any one of these proteins. Oats, rye, and barley also contain gluten and may cause symptoms. Ask your health care provider if your child needs to avoid these grains as well.

Common symptoms include:

• Skin reactions such as eczema, hives, swelling (typically eyelids and mouth)
• Abdominal cramps, nausea, vomiting
• Asthma, hay fever (runny or stuffy nose, itching eyes, sneezing).

An anaphylactic reaction is possible, but not common. This is a serious reaction that is sudden, severe, and can involve the whole body. The reaction can cause swelling of the mouth and throat, dangerously low blood pressure, and closure of the airway. This type of reaction calls for immediate medical attention. It is treated with epinephrine (a medicine that is given by injection). Usually parents or caregivers of children that have severe reactions to allergies carry their own shot kits in case of emergency.

How will this affect my child's diet?

Once your child is diagnosed with a wheat allergy, you will need to change the way you shop and prepare foods. The only treatment for someone with a wheat allergy is to completely eliminate wheat and foods that contain wheat from the diet. Wheat is a staple in the American diet and found in hundreds of foods such as most bread products, pastas, and items prepared with flour. Many processed foods contain flour-based thickeners.

You will need to prepare more meals from scratch using whole natural foods. Wheat-free food products, such as bread and pancake mixes, noodles and substitute flours such as potato, rice, soy and corn are often available in health food markets and the "natural foods section" of your grocery store. There are also food companies that can be accessed online that offer wheat-free convenience food products and a variety of bread mixes. To be on the safe side, choose products that provide an 800 number for consumers to inquire about ingredients.

Keeping your child's diet wheat-free is definitely a challenge. The first step to educating yourself in choosing safe, wheat-free foods is learning to read labels and becoming familiar with ingredients that contain wheat. Study the lists below to learn more about foods and ingredients to watch out for.

Foods that contain wheat

• Most breads, cakes, cookies, and pastries
• Bread crumbs
• Pasta
• Couscous
• Many breakfast cereals
• Kamut (cereal grain)
• Crackers
• Enriched flour
• Whole wheat flour
• Graham flour
• Wheat (bran, germ, malt, starch, gluten)
• Semonlina
• Spelt
• Farina
• Durum
• Bulgar
• Cracker meal
• Gluten (one of the wheat proteins)
• High-gluten flour; high-protein flour
• Vital gluten

Foods/ingredients that often contain wheat (check the label or ask)

• Modified food starch
• Gelatinized starch
• Hydrolyzed vegetables protein
• Natural flavorings
• Soy sauce
• Vegetable gum, vegetable starch

Hidden source of wheat

Cross contamination can be problem when trying to avoid wheat. Wheat can come in contact with other foods during processing and in preparation, even if not included in the recipe. At home, take care to use separate cutting boards, bowls and utensils and label all food containers.

Restaurant Meals

• When dining out, always tell the waitperson about the allergy. It is best to order simple dishes without sauces unless you're sure there is no wheat present.
• Food preparation equipment, such as food processors, cutting boards, pans, and knives may be used for recipes containing wheat or wheat flours as well as for other recipes.
• Deep fried foods, such as French fries are often cooked in the same oil as "breaded" items
• Chinese and Vegetarian dishes often include "meat substitutes" that may contain wheat.
• Some imitation crab products used in seafood salads

How can I provide my child with an adequate diet that tastes good?

Your child can still have a nutritionally complete diet as well as continue to enjoy some "kid favorites." The primary nutrients found in wheat are carbohydrate, protein, niacin, zinc, magnesium, fiber as well as fortification with folic acid and iron. Your child can get all these nutrients from other foods, but there is a risk for not getting enough B vitamins. Other sources of B vitamins include dark leafy vegetables, bananas, asparagus, oranges, peanuts, and other fortified grains such as corn meal and rice flours. It is a good idea to have your child's diet checked by a pediatric dietitian to evaluate the need for vitamin supplements.

How do I modify recipes?

Most any recipe can be modified to fit a wheat-free diet. Wheat-free flours do not provide the same results in standard recipes, so using combinations of flours usually works best. Finding pre-tested wheat-free recipes is the easiest way to learn how to modify. There are several good wheat-free or gluten free cookbooks and web sites that feature these types of recipes. The Gluten Free Gourmet series by Betty Hagman and Wheat-Free Recipes & Menus by Carol Fenster include excellent recipes and information about substitutions. The Gluten Free Mall at http://www.GlutenFreeMall.com offers many specialty food products. Organizations such as the Food Allergy and Anaphylaxis Network (http://www.foodallergy.org), The Celiac Foundation (http://celiac.org) and the Celiac Sprue Association (http://www.csaceliacs.org) also feature wheat free recipes and cookbooks. Wheat allergy and celiac disease are not the same, but both conditions require strict avoidance of wheat products.

How can I keep my child safe at school?

• Educate your child to the dangers of sharing foods (even young children can grasp this concept, especially once they have experienced feeling sick after eating a particular food).
• Prepare your child's lunch at home.
• Talk with teachers and the school administrator regarding your child's needs. Request that teachers keep an eye out and explain the situation to other children if appropriate.
• Have the teacher call you if there is a special event or party planned so that you can bring a few modified treats that your child can enjoy and share with other kids.
• Make a card that lists foods and ingredients that should be avoided and give one to the teacher. The card can also be helpful to older children in making decisions when out with friends.