HEALTH INSIGHTS

When Your Child Has a Food Allergy: Wheat

March 22, 2018

When Your Child Has a Food Allergy: Wheat

Foods containing wheat.When a child has a wheat allergy, even a small amount of wheat can cause a life-threatening reaction. For that reason, your child must stay away from all foods that contain wheat. This sheet tells you more about your child’s wheat allergy. You’ll learn what foods to stay away from, what to look for on labels, and how to prepare wheat-free meals.

Foods to not eat

Wheat is everywhere—sometimes in foods you don’t expect:

  • All breads, cakes, pies, cookies, pastries, donuts, rolls, bagels, and breakfast cereals made with whole wheat, enriched, or white wheat flour

  • All breaded or floured meats, chicken, and fish; meats that contain fillers such as meatloaf and meatballs; hot dogs, sausage, luncheon meats, bologna, and meat patties

  • All types of pasta, including spaghetti and macaroni, unless labeled wheat-free

  • Chocolates and other candy containing malt

  • Commercial mixes for breads, cookies, cakes, pancakes, waffles, biscuits, and rolls, unless labeled wheat-free

  • Corn bread, corn muffins, rye bread, and specialty breads unless labeled wheat-free

  • Cottage cheese, yogurt, ice cream, and other dairy foods that contain modified food starch

  • Imitation seafood such as crab or shrimp. This is often used in Asian cooking.

  • Malted milk and other milk drinks containing wheat products

  • Pancakes, waffles, french toast, dumplings, bread stuffing, biscuits, and popovers made with wheat flour

  • Pretzels, crackers, graham crackers, pizza dough, crostini, and snack foods made from wheat flour

  • Salad dressings, soups, sauces, and gravies thickened with wheat flour or containing wheat noodles

  • Seitan (wheat gluten, wheat meat), a wheat-based meat substitute

  • Wheat bran, wheat germ, wheat gluten, cracked wheat, bulgur (a type of cracked wheat), wheat berries, wheat sprouts, couscous

  • Worcestershire sauce, some mustards, soy sauce unless labeled wheat-free, monosodium glutamate (MSG), and prepared foods seasoned with MSG

Some children with wheat allergies also react to tree nuts and peanuts. Ask your child’s healthcare provider if nuts are safe for your child.

What to look for on labels

Wheat can go by different names. Watch for these terms:

  • Bran

  • Bulgur

  • Cracker meal

  • Durum. This is a variety of wheat.

  • Enriched flour

  • Farina. This is finely ground wheat.

  • Gluten. This is the protein part of wheat.

  • Graham flour. This is a type of whole wheat flour.

  • High-gluten or high-protein flour

  • Hydrolyzed vegetable protein

  • Malt. This is a sprouted grain, which may be wheat.

  • Modified food starch, modified starch, wheat starch, gelatinized starch

  • Natural flavoring. This may contain a wheat protein.

  • Phosphated or bromated flour

  • Semolina

  • Spelt and kamut. These are ancient types of wheat.

  • Vegetable gum, vegetable starch

Keep in mind that food labels may not always show if a food product contains wheat. This is because the food making process may accidentally contaminate a food with allergens. Different foods are often processed on the same production lines. Equipment may have traces of a food allergen. This can then contaminate another food processed on that same equipment. This is called cross contamination. Federal law requires food makers to note on the label if a food contains a major food allergen, such as wheat. But the law does not require a list of cross contamination ingredients. Many food makers voluntarily include this information. 

Allowed foods

Children with wheat allergies can safely eat these foods:

  • All fresh, frozen, canned, or dried fruits and vegetables

  • Baked, broiled, or roasted beef, pork, poultry, and fish without breading

  • Breads, rolls, and baked goods made only with flour from corn, rice, barley, oats, arrowroot, millet, or potato starch

  • Corn or rice pastas

  • Corn tacos and tortillas made without wheat flour

  • Custard, tapioca, rice pudding, sherbet

  • Eggs prepared any way

  • Milk, cheese, cream, half-and-half; yogurt and cottage cheese without modified food starch

  • Oatmeal, cream of rice, puffed rice, puffed corn, puffed millet, or any other cereals with no added wheat

  • Pancakes, waffles, and French toast made with non-wheat flours

  • Popcorn

  • Rye crackers, rice cakes and rice crackers, pure arrowroot biscuits with no added wheat

  • Soups made without wheat

  • Wheat-free soy sauce (tamari)

  • White and sweet potatoes; white, brown, and wild rice; grits

Wheat-free meal planning

Dropping wheat from your child’s diet can be a challenge. Fortunately, wheat-free cookbooks and products can make meal planning easier. You’ll find wheat-free diet books in the library and on the Internet. Check natural food stores, grocery stores, specialty shops, and the Internet for products made without wheat.

When cooking from scratch, you may need to experiment. A combination of flours usually works best. Keep in mind that most flours don’t rise as well as wheat flour does. Add baking powder or extra egg whites for a lighter texture in baked goods. In your regular recipes, for each cup of wheat flour, substitute one of the following:

  • 7/8 cup rice flour

  • 5/8 cup rice flour plus 1/3 cup rye flour

  • 2/3 cup brown rice flour plus 1/2 cup tapioca flour

  • 5/8 cup potato starch

  • 1 cup corn flour

  • 1-1/4 cups rye flour

  • 1-1/8 cups oat flour

Be careful of cross contamination when preparing food. If you use flour or other wheat products for other family members, be sure to carefully clean utensils, bowls, pans, and work surfaces before making wheat-free food for your child. 

How does celiac disease differ from wheat allergy?

Some children who are sensitive to wheat may have celiac disease, not wheat allergy. Here are some differences between the two:

Celiac disease

  • Is a sensitivity to the protein gluten in grains, including wheat, barley, rye, and other grains

  • Usually causes digestive symptoms such as diarrhea, nausea, bloating, and gas

  • Lasts throughout life

Wheat allergy

  • Is a sensitivity only to the gluten in wheat. Children with wheat allergy can usually eat other grains.

  • May cause symptoms throughout the body

  • Often goes away as children get older

If your child has ANY of the symptoms listed below, act quickly!

If one has been prescribed, use an epinephrine autoinjector right away. Then call 911 or emergency services.

  • Trouble breathing or cough that won’t stop

  • Swelling of the mouth or face

  • Dizziness or fainting

  • Vomiting or severe diarrhea

Updated:  

March 22, 2018

Sources:  

Guidelines for the Diagnosis and Management of Food Allergy in the US: Report of the National Institute of Allergy and Infectious Diseases. Boyce JA. Journal of Allergy and Clinical Immunology 2010;126(6):s1-s58.

Reviewed By:  

Berry, Judith, PhD, APRN,Blaivas, Allen J., DO,Image reviewed by StayWell art team.,Pierce-Smith, Daphne, RN, MSN, CCRC