The Celiac Series: Compliance with the GF Diet
How do I get my child to comply with the gluten free diet when they never had symptoms to begin with?
When I hear this question from parents, I really feel for them because it’s much harder for your child to understand the impact gluten has when they don’t have any concrete symptoms. This is one of the main reasons why I emphasize in Let's Talk Celiac Disease that at time of diagnosis, you need to help your child understand why they had an endoscopy and the results that came from it. Try out the book titled “My Amazing Body Machine” by Robert Winston if you’re looking for some great visuals of villi to help with your education.
BUT, before starting there, build curiosity around why your child may not want to comply… Do you know for certain that your child doesn’t want to follow the diet because they don’t have symptoms? Or is that just a hunch? What have they actually verbalized to you regarding their hesitancy with the gluten free diet? Here’s a few things that can possibly be affecting their desire to cooperate-
It makes them feel different from others
The change feels overwhelming for them at this time
They don’t have symptoms and “don’t want to deal”
Normalizing Celiac Disease
1) There is so much value in trying to “fit in” with others. It’s something that we can often forget as adults if it’s been awhile since those school days… We also don’t realize how prevalent bullying can be in our schools; if your child is experiencing bullying, check out this article by the Child Mind Institute. What we think might be no big deal can feel HUGE to children and teens so the feelings accompanied with “being different” need to be acknowledged.
One concept that is important to share with your newly diagnosed child is that “everyone is different.” We all have something that differentiates us from others such as an illness, allergy, our religion, our cultural practices, etc. When we normalize our differences, children can feel more at peace with the diagnosis.
Validating the Change
2) When a child or teen has to make this life-long commitment to eating gluten free, it is overwhelming. They have to be mindful of the food that is being served to them at all times-whether the food is coming from school, a friend’s house, a birthday party, grocery store or restaurant. If they’re at the age where they’re preparing some of their meals at home and you still have other members in the home eating gluten, they have to be mindful of using separate bakeware, utensils, cutting boards, etc. to ensure they aren’t accidentally exposing themselves to gluten. All of that in combination is a lot, regardless of their age. Furthermore, not all cosmetics are gluten free! Teens specifically can become frustrated if they have to find new cosmetics because some chapsticks, makeup, and lotions have traces of gluten. One thing I forget about from time to time is how gluten is in some of the things kids touch and play with, like playdoh!
Discussing Risks
3) When your child simply “doesn’t want to deal” and feels they don’t need to go gluten free, it’s important to discuss long term risks. I totally recognize that discussing long term risks with your child can be difficult because you want to protect them, not scare them. It’s important that you’re coming from a place of validation and understanding rather than trying to scare or take punitive action.
Keep it simple but share how celiac disease is an autoimmune disorder that can be linked to other diseases such as anemia, type 1 diabetes, and osteoporosis. If their small intestine looks okay now, it will not stay that way if they continue to eat gluten. To add, if they have those “cheat days” and do eat gluten here and there, that can still trigger damage to the intestine. Lastly, to help with compliance, allow for some control and ownership-let your child/teen do the picking at the grocery store; let them pick what’s for dinner and create some fun, normalizing opportunities. They may benefit from having some 1:1 quality time or need to play out some of the feelings they are having as a result of this big change they didn’t see coming.