It is important that your school knows about your child’s needs. Celiac disease (CD) is considered a disability, therefore schools have to make appropriate accommodations for your child. If your child attends a public school or a charter school they have the right to have a 504 plan that lists accommodations specific to a child with CD.  Here are some suggestions for working with your school:

• Get a letter from your child’s doctor that states their diagnosis and needs for a gluten-free diet to give to your school
• Be prepared to talk to your child’s school nurse, teacher, art teacher and food service department, ask about:
  • Meals and snacks at school
  • Is sharing of food allowed?
  • Cleaning practices
  • Seating arrangements – will your child have adequate space to prevent cross-contact with gluten during meals?
  • Celebrations – are foods allowed?
  • Art classes and supplies – do they contain gluten, such as papier mâché, and play dough?

Check out this infographic on the steps to a 504 plan. 

Sample letter to teachers

Sample letter to cafeteria workers

The questions below are based on frequent questions we have received about school meals. Most questions address public and charter schools (both of which are required to follow the same regulations for school meals). About 90 percent of K-12 students in the United States attend public or charter schools and about 10 percent attend private schools.₁

Note: Each individual is treated on a case-by-case basis, the school should work with parents and the student to come up with suitable solutions. Implementing a 504 plan will give you more opportunity to tailor and communicate specific needs of your child.

Question:

Are there laws and regulations protecting children with celiac disease in relation to school meal accommodations?

Answer: YES

For public schools and charter schools:

• The Rehabilitation Act of 1973
• The Americans with Disabilities Act
• The Individuals with Disabilities Education Act
• USDA Regulatory Requirements

For private schools:

• The Americans with Disabilities Act

Question:

I would like my child with celiac disease to eat meals at school. The school has requested we provide them with a medical statement from our doctor. Are they allowed to ask for this? If so, what information has to be included in the medical statement?

Answer: YES, they can ask you to provide a medical statement. However, if you already have a 504 plan in place for celiac disease this can be used in place of the medical statement. A medical statement has to include three things:

• The allergen or food to be avoided
• A brief explanation of how the exposure affects the child (medical reaction)
• Recommended substitutes

Note that a medical statement only has to state the necessity for a gluten-free diet, the diagnosis itself is not required.

Question:

My child has celiac disease and attends public school. Our school says we have to bring a packed lunch daily, as they cannot accommodate a gluten-free diet. Does my child have the right to have gluten-free meals at school? 

Answer: YES, the school has to provide your child with a safe gluten-free meal free of cross contact. Celiac disease is considered a disability, and as such they have to make provisions for your child. However, you may be required to provide a written medical statement from your doctor that states the necessity for a gluten-free diet. If you already have a 504 plan in place for celiac disease then the medical statement may not be required. A medical statement has to include three things:

• The allergen or food to be avoided
• Brief explanation of how the exposure affects the child (medical reaction)
• Recommended substitutes

Note that a medical statement only has to state the necessity for a gluten-free diet, the diagnosis itself is not required.

Question:

My child attends public school and has non-celiac gluten sensitivity (NCGS), our school says they can only accommodate a gluten-free diet for those with celiac disease. Does my child have the right to gluten-free meals at school?

Answer: YES, the school has to provide your child with a safe gluten-free meal free of cross contact. Like celiac disease NCGS is also considered a disability by the USDA, and as such they have to accommodate your child. However, you may be required to provide a written medical statement from your doctor. If you already have a 504 plan in place that states the necessity the medical statement may not be required.

A medical statement has to include three things:

• The allergen or food to be avoided
• Brief explanation of how the exposure affects the child (medical reaction)
• Recommended substitutes

Note that a medical statement only has to state the necessity for a gluten-free diet, the diagnosis itself is not required.

Question:

My child has celiac disease, but goes to a charter school, do they have to accommodate the gluten-free diet?

Answer: YES, a charter school falls under the same regulation as public schools for special meals as they receive funding from the USDA. They have to provide your child with a safe gluten-free meal free of cross contact. Celiac disease is considered a disability and as such they have make provisions for your child. However, you may be required to provide a written medical statement from your doctor that states the necessity for a gluten-free diet. If you already have a 504 plan or IEP in place that states the necessity the medical statement may not be required.

A medical statement has to include three things:

• The allergen or food to be avoided
• Brief explanation of how the exposure affects the child (medical reaction)
• Recommended substitutes

Note that a medical statement only has to state the necessity for a gluten-free diet, the diagnosis itself is not required.

Question:

My child attends a public school and has both autism and celiac disease, they are extremely selective in what they eat related to the autism. Our school will provide a gluten-free meal, but the child will often not eat it as it does not include foods that my child finds acceptable due to their selective eating disorder. Does the school have to accommodate the selective eating disorder as well?

Answer: YES, if the child has two or more conditions that are also disabilities such as autism they have to provide meals that accommodate all conditions. However, you may be required to provide a written medical statement from your doctor that states the necessity for a gluten-free diet, as well as the for the selective eating disorder. If you already have a 504 plan or IEP in place that states the necessity the medical statement may not be required. The diagnosis itself is not required in the medical statements.

A medical statement has to include three things:

• The allergen or food to be avoided
• Brief explanation of how the exposure affects the child (medical reaction)
• Recommended substitutes

You would have to work with the school food services to come up with a menu that is acceptable to your child. One way this can be achieved is by a cycle menu with appropriate meals that takes the selective eating disorder into consideration.

Question:

My child attends a public school and has type 1 diabetes and celiac disease. Can we request a menu ahead of time, as it is hard to calculate the carbohydrates last minute to determine the appropriate dosage of insulin? Also, sometimes my child does not like the offering so it would be good to know ahead of time so we can pack a lunch for those days.

Answer: You should work with the school to develop an appropriate cycle menu that lists the carbohydrate content for each meal, which will enable you to calculate the carbohydrates ahead of time. You should also work with the school with suggestions of what meals your child find acceptable, although they are not required to accommodate meal preferences.

Question:

The school serves pizza every Friday, is my child entitled to gluten-free pizza?

Answer: No, the meal does not have to mirror the regular menu offering of the day, it only has to meet the specific nutrient guidelines that are required by the USDA.

Question:

Can I request a certain brand of pasta or bread for my child?

Answer: No, you may not require certain brands, only if there is a specific medical reason for using this particular brand.

Question:

My child does not want to eat at school every day. Can they still get a gluten-free meal on the days they decide they want to eat the school meal?

Answer: YES, the school has to provide your child with a safe gluten-free meal free of cross contact, even if they choose to participate in the school lunch program occasionally. Celiac disease is considered a disability, and as such they have make provisions for your child. However, you may be required to provide a written medical statement from your doctor that states the necessity for a gluten-free diet. If you already have a 504 plan or IEP in place that states the necessity the medical statement may not be required. If your child only has a meal occasionally, you may need to give advance notice to the foodservice department the days that your child wants to eat school meals.

Question:

My child has celiac disease and attends a private school, do they have to accommodate the gluten-free diet?

Answer: Private schools only have to follow the Americans with Disabilities Act. They are only required to accommodate a gluten-free diet if every student is required to purchase a meal plan or if meals are included in the tuition. However, if the meal program is voluntary they are not required to accommodate special meals, however many may do anyway.

References

1. Council for American Private Education (CAPE). CAPE Website. Updated 2018. Accessed December 11, 2018.

2. US Department of Agriculture (USDA). Accommodating Children with Disabilities in the School Meal Programs. Published July 25, 2017. Accessed December 10, 2018

Pick at least one item from each category to make packing lunches a snap. Try to pack the night ahead to reduce stress in the morning rush. If you are super organized prepare all components on Sundays for the week ahead. Using a “bento” style lunch box makes packing your lunch a breeze.

Make sure to read all labels for gluten-free status.

Proteins

• Canned salmon salad (instead of tuna which is high in mercury)
• Chicken salad
• Cold bean salad
• Hard boiled eggs
• Hummus
• Lunch meat (make sure it is nitrate free)
• Nut or seed butters such as sunflower or peanut butter (lots of schools do not allow nut/peanut butters, but sunflower butter is a great alternative)
• Tofu

Dairy/Dairy Alternatives

• Cheese/cheese sticks
• Cottage cheese
• Lactaid milk for lactose intolerance
• Milk
• Soy, coconut or almond milk for dairy intolerance/allergies
• Yogurt/Greek yogurt (frozen sticks stay cold longer)

Fruits

• Apples
• Applesauce
• All types of berries – strawberries, blueberries, raspberries etc.
• All types of melon – watermelon, cantaloupe, honeydew etc.
• Bananas
• Drived fruit
• Dried fruit pounches
• Grapes
• Oranges – clementines and mandarines are easy to peel and eat
• Pears
• Raisins/Craisins

Veggies

Tip: Using whole “mini” versions of veggies eliminates the need to cut them up so they will be crisper and less mushy than cut up veggies. Pick as many as you want from this category.

• Carrot sticks
• Celery sticks
• Cherry tomatoes
• Fresh or cooked green beans
• Lettuce wraps
• Mini peppers
• Mini cucumbers
• Snow peas/snap peas

Grains/Starches

Tip: Try to pick GF whole grains, they are more nutritious! 

• GF corn tortillas
• GF muffins
• GF pasta
• GF pretzels
• GF whole grain bagel
• GF whole grain bread
• GF whole grain cereal
• GF whole grain crackers
• Quinoa
• Sweet corn

Make sure to read all labels for gluten-free status.

Arts and craft supplies can contain gluten. Even though gluten cannot penetrate the skin, it is important to know if your child will be handling supplies containing gluten. It is always best to work with a gluten-free version of the product.

Handwashing carefully after using the product is adequate for older children who do not put their hands in their mouths, unless the product could be dispersed through the air. Some flours and grains used in art supplies present a risk because they could be ingested and make their way to the digestive tract through the mouth, nose and throat.

It is important that you never allow your child to work with gluten-containing flours and grains. Younger children especially should never play with any supplies containing gluten, given the high risk of them putting their hands in their mouths.

Here are some art supplies commonly used that contain gluten (this is not a complete list):

• Play dough
• Papier mâché
• Pasta and cereals
• Loose flours and grains (also common in sensory tables)

It is important to have a discussion with your child’s teacher and art teacher about the probability that art supplies and foods in the curriculum will contain gluten. Advise them to notify you ahead of time so that an appropriate alternative can be provided for your child or preferably the whole class. Also make sure that adequate cleaning practices are followed after activities. It is recommended to wipe down surfaces carefully with a water and detergent solution.

Celebrations and classroom parties at school present challenges for students with celiac disease. It can be hard for kids to be the only one left out at a celebration because it usually involves foods with gluten. There is also a risk that students with celiac disease are mistakenly given a food containing gluten, or that they are tempted to eat a food that is off limits because they want to fit in with their peers. Additionally, celebrations often present awkward situations where students have to talk about their celiac disease and answer uncomfortable questions.

When it comes to celebrations schools usually fall into one of these three categories:

1. Schools that only allow non-food celebrations.
2. Schools that allow food celebrations, but have requirements in terms of how often and what types of foods.
3. Schools that allow food celebrations and have no requirements on frequency and what types of foods are brought in.

The best alternative for students with celiac disease are schools that only allow non-food celebrations. Many schools have switched to non-food celebrations to protect students with food allergies, as well as to promote healthier lifestyles. Ask your school about their policy.

Having a 504-plan with accommodations for celebrations is strongly recommended if your child attends a school that allows food celebrations.

Suggestions for accommodations:

• Notify parents ahead of time (seven days is recommended) if there is going to be a celebration with food or foods used in the curriculum, which will allow you time to suggest or provide alternatives.
• Provide parents with labels ahead of time (seven days is recommended) for any foods that are going to be served or used in the curriculum.
• Some parents provide snacks and treats for the school to keep for unplanned celebrations. However, keep in mind that all snacks and treats need to be stored properly to prevent cross-contamination with gluten. Also, make sure that they are labeled clearly with your child’s name.

Does Your School Have a Wellness Policy?

Public and charter schools are required to have a wellness policy that include clear instructions for classroom parties, celebrations and foods given as incentives. Schools are also required to have a wellness committee to determine the guidelines within the wellness policy. If you want to impact your school district’s policies, the best way is to join the wellness committee or petition the committee to institute a non-food celebration policy.

Read more about wellness policies here:

https://www.fns.usda.gov/tn/local-school-wellness-policy

Ideas for non-food celebrations:

https://www.verywellhealth.com/non-food-birthday-celebrations-at-school-3972244

It is important to talk to all staff at your preschool and daycare provider about your child’s diagnosis and dietary needs. Have a meeting with the staff.

Ask about:

• Meals and snacks at school – do they provide them? Can you bring your own packed lunch?
• Is sharing of food allowed?
• How will your child’s food be stored?
• Do they have procedures for handling your child’s food while serving?
• What are their cleaning practices
• Seating arrangements – is there an appropriate amount of safe space for your child to prevent cross-contact?
• Celebrations – is food allowed? If so, can they notify you ahead of time so you can bring in a gluten-free treat for your child and can you keep a supply of gluten-free snacks and treats available at school for your child?
• Art classes and supplies – do they contain gluten, such as papier mâché, and play dough?
• Sensory tables – they often contain grains

Article by Carla Carter:

It’s the tug and pull of your heart strings, your anxieties, fears and hopes that when your young loved one with celiac disease leaves the house to go, well, anywhere, that they do not get sick.

In this column, I frequently discuss the difficulty of “doing for them” vs. “learning for themselves.” Initially, we have to take responsibility for reading labels, calling ahead, and talking for our children at restaurants, thereby modeling for them what is needed to become pillars of strength, of self-advocacy and confident decision makers. However, this also includes educating other caregivers who will also be helping them to make safe decisions and, more likely, making the decisions for them. It’s tough not to have that over-bearing and protective response so I am hoping to give you a couple of tips to have a successful initial conversation to further discourse with caregivers, whether it be teachers, coaches, babysitters, bus drivers, friends, or family members. Read full article here.

NCA’s ROCK’n GF Play Dough Recipe

Ingredients:

2 cups of water

2 tsp. vegetable oil

4 tsp. cream of tartar

1 cup of salt

1 cup of cornstarch

1 cup of gluten-free flour + 1 Tbs. (can use a cup-for-cup GF flour or plain rice flour)

Food coloring, if desired. You can try these natural colors:

Red: beet juice; Yellow: turmeric; Green: Matcha

Directions:

• Mix all ingredients together in a pot.
• Once mixed, cook on low heat, stirring regularly for 8-10 minutes or until a ball forms.
• Place dough on a plate and cut it with a knife if you would like to make multiple colors.
• Add coloring to each mass as desired.
• Cool completely. Store in a plastic bag or plastic ware.

If you are looking for a summer camp for your child with celiac disease or gluten intolerance, please check out our list of camps. Some have dedicated gluten-free weeks while others are able to accommodate gluten-free campers.

Staying safe while dining out requires a little homework ahead of time. The bedrock of this is your knowledge of the gluten-free diet and how food is prepared. For a list of gluten-free and gluten-friendly restaurants, click here. Many smartphone apps are available to help you find suitable restaurants. 

Tips for dining out gluten-free:

Ordering

• Review menus in advance to get an idea of which items are likely to be safe and which are to be avoided.
• Call the restaurant at a quiet time to inquire about gluten-free options.
• Always bring a gluten-free dining card that explains the diet.
• Let the staff know that you have CD, NCGS, or DH; this diet is medically necessary, not a choice.
• Tell the staff that you must avoid food, sauces, soy sauce, marinades, and salad dressings that contain or come into contact with wheat, rye, and barley, even in tiny amounts.
• Emphasize the need to avoid cross-contact.
• If you are ordering fried food, make sure it is prepared in a dedicated fryer (one not used to fry anything with gluten).
• Always confirm that your food is gluten-free when you receive it.  If something doesn’t look right, do not hesitate to question it.
• Never take a chance with the food. If your salad arrives with croutons or your hamburger with a bun (not gluten-free), insist that this dish needs to be re-made from scratch because of the cross-contact.
• If you have any doubts about the restaurant’s ability to feed you, order as plainly as possible (plain broiled fish, chicken or steak, plain steamed vegetables and a baked potato).
• If the restaurant staff makes a genuine effort to respect your diet, make sure to show your appreciation by thanking them sincerely and by tipping generously.

Other Tips

• Soups are rarely gluten-free.
• Au jus almost always contains gluten.
• Believe it or not, some restaurants add flour to mashed potatoes or eggs; double check this.
• Rice dishes are often enhanced by spices, broth, or other hidden gluten, such as orzo (wheat). Make sure yours is gluten-free.

Holidays and celebrations can be a challenge for kids with celiac disease. You definitely need to plan ahead. It is hard to just do things at the spur of the moment. Here are some tips to make it easier at celebrations:

• Find out in advance what will be served and prepare your child ahead of time
• Pick out special treats to bring
• Talk about what foods will be served
• Offer to help the host with cooking or providing the food
• Potlucks are great!
• Bring an appetizer, entrée and dessert so you are sure there will be a complete meal for your child!
• Be the host! Invite people to your home and let them try gluten-free foods
• Gluten-free can be delicious and you do not need “special” foods to eat gluten-free
• Make the whole party gluten free!
• Parties are more fun if everyone can participate and eat everything, it is not always possible for all types of situations, but it is definitely appreciated when it happens
• Beware of cross-contact when eating away from home
• Buffets may seem like a good idea, but there can be cross-contact between foods
• Make sure there are separate serving spatulas for each dish
• Make sure foods containing gluten are not next to gluten-free foods
• Beware of double dippers! Ask to be the first to serve your child from a buffet to decrease the risk of cross-contact
• Teach your child to ask to be served first at events to prevent cross-contact

Birthday Parties

Click here to view a step-by-step list for successful birthday parties.

Click here to read an article on how to navigate parties and celebrations as a parent or caregiver of a child with celiac disease or non-celiac gluten sensitivity.

Most cities have stores that carry gluten-free foods. For convenience and comfort, you might want to carry GF cereals, snacks, breads, pastas, energy bars, and crackers.

Good snacks to carry when traveling

• Fruit and GF nut bars
• Cheese sticks
• Whole fruits
• GF sandwiches
• GF crackers/rice cakes
• GF beef jerky
• Rolled up ham and cheese sticks

*Note that some foods may not be allowed to be brought to certain destinations. Make sure to check before traveling.

A few additional tips:

• For car travel, fill a cooler with gluten-free goodies. GF snacks, breads, bagels, frozen waffles, energy bars, sandwiches, and cookies will ensure that you won’t go hungry.
• Some international airlines offer gluten-free meals. Ask and arrange for one when you reserve your flight (and identify yourself as soon as you get on the plane so someone else doesn’t get your meal!). Bring some GF staples in your carry-on in case you are delayed.
• At hotels/motels, ask for a room with a refrigerator and microwave. Some places may let you store your gluten-free items in their kitchen refrigerators.
• Contact your tour company or travel agent before booking a trip to find out how gluten-free needs will be accommodated.
• Look for travel companies that cater to gluten-free clients.
• Contact local NCA celiac support groups for restaurant and shopping recommendations or look over the restaurant list on NCA’s website.
• If renting a house, consider bringing your own toaster bags (they can be found on-line) and a few utensils, pots, and pans that you know will be safe.