Table of Contents:
- Accidentally Glutened at Preschool
- Teach Your Celiac Child to Self-Advocate
- Communicate with the Director and Teacher about Celiac Disease in Preschool:
Update: This content has been updated to include years of valuable personal experience in keeping my celiac child safe and gluten-free at school. If you need information on a 504 Plan for your child with celiac disease, check out my article for Celiac Disease in Kids: 504 Plan for Celiac Disease at School.
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Today, I met the mother of a homeschooled kindergartner, homeschooled because her mother is afraid to send her to school where she may be exposed to a deadly-to-her allergen: eggs. After her third visit to the hospital (not school-related incidents), the traumatized mom could not bear to take the chance of something happening to her little girl while out of her care
I get it. No judgment here, fellow mom. While, an epi-pen-required allergy is different from celiac disease in kids, in terms of the immediate danger to your precious child’s life, I get the concern. We both have to protect our children from crumbs and “near invisible”, dangerous, trace elements of their particular nemesis. How can we trust anyone else to do it for us?
Well, we’ve decided to do just that… but, last week, it happened. The inevitable and accidental glutening of Miss E at preschool.
Accidentally Glutened at Preschool
A couple of mornings a week, Miss E goes to a wonderful preschool, where the teachers love her and make gluten-free play-doh and always have a gluten-free treat on hand for birthday parties or other special celebrations. At that wonderful preschool, in the midst of the chaos of one of those birthday parties and a state-mandated, teacher break, my little girl was given a mini-cupcake, and she ate it. For me, that was the real surprise… this vigilant three-year-old, making sure that teachers do not even touch her snack with “gluten hands”… actually ate the cupcake.
“It was a super-mini cupcake” and “so far she seems fine” were the well-intended, words of reassurance from the genuinely caring preschool director. Miss E gets sick about two hours after glutening, so of course, after looking perfectly fine at preschool, she started vomiting on the way home from school.
Unlike a severe allergy with the acute and deadly risk of anaphylactic shock, celiac is slow and subtle in it’s most significant damage. It’s chronic nature makes it seem deceptively mild.
While “it was a super-mini cupcake” may mean she only throws up once (in this case, four times), her intestinal healing is set back a month. This setback likely means a month of short-term symptoms. For Miss E that means tummy aches, vitamin malabsorption, insatiable appetite with no corresponding growth, itching, fatigue, and behavioral challenges, along with long-term risks.
Being newly diagnosed, several months ago, the preschool and I are still learning how to navigate Miss E’s celiac disease at preschool. So we are taking this setback as an opportunity to review the protection plan we currently have in place.
Teach Your Celiac Child to Self-Advocate
The first line of defense is your child.
In preschool, this means Miss E and I reviewed always asking if I have checked the ingredients on any food she is given, to make sure it is gluten-free. Miss E knows the food that I check is safe.
While she can ask an adult if it is gluten-free, I have had an adult tell me that an item was safe for Miss E because “gluten” was not on the list of ingredients. So, I do not fully trust that simple safeguard, unless the adult is educated on label-reading for celiac disease.
When she can read, I’ll teach her to check labels. Her self-advocacy skills will build with age, ability, and experience.
Teaching your child to self-advocate is unequivocally the most important and life-long safeguard.
Miss E is typically amazing at this. At three, she knows about naturally gluten-free foods, gluten-free labeling, cross-contamination, and the importance of hand-washing.
Communicate with the Preschool
The second line of defense is the school team.
Go Gluten Freely has a helpful Teacher Letter/Email: Celiac Disease Fact Sheet that you can use for preschool and beyond. Miss E’s teachers and I reviewed it at a conference last week. Please note that the section of the sample email referencing a celiac 504 plan applies to most public preschools, but not most private preschools.
When it comes time for Miss E to move from preschool to kindergarten, I plan to review the teacher letter with her teacher, principal, and school nurse, along with most likely developing a 504 plan. You can expect a future post (or twenty) on that subject when the time comes. (Update: I did make a 504 Plan for Miss E when she transitioned to public school. Learn how to get one for your child in my article on 504 Plans for Celiac Disease.)
Miss E’s preschool director quickly adjusted their “party protocol” so this incident would not be repeated with Miss E or any other kiddo.
We also reviewed all areas of “gluten” safety previously discussed. When Miss E was first diagnosed, I addressed the following areas of concern with the school:
Celiac Disease in Preschool: Regular Meals and Snacks
Rather than eating the preschool-provided snacks, which usually contain gluten, Miss E brings her own snack to eat with washed hands on a wiped table. The teachers were informed of the risk of cross-contamination from their hands opening her snacks after serving gluten-containing snacks to other children and the risk of cross-contamination from little hands touching each other’s plates.
Celiac Disease in Preschool: Special Occasions
Miss E always has two gluten-free treats at school in case there are unexpected birthday cupcakes: a gluten-free cupcake in the freezer and a knock-off rice crispy treat (like the gluten-free Starbucks Marshmallow Dream Bar) in the classroom cupboard. If an event is planned, I discuss the menu with the teacher and try to match it, if possible. On the day of, I check labels myself, and try to volunteer in the class for holiday parties.
Celiac Disease in Preschool: Sensory Play
Play-doh contains gluten, and the risk of a preschooler ingesting even a small amount is pretty high. Her school is amazing and the teachers made gluten-free play dough for the class. Gluten-free play dough can be made or purchased.
I volunteered to clean all of their used play-doh utensils.
The teachers also make sure that items in the sensory table are gluten-free, as many preschool recipes for goo and such contain gluten.
Celiac Disease in Preschool: Crafts
We discussed the risk of gluten in items like pasta, and the preschool director decided to purchase gluten-free pasta for any pasta crafts, rather than risk cross-contamination in the classroom. Here’s a link to gluten-free craft supplies.
Celiac Disease in Preschool: Handwashing
There is always the risk of cross-contamination, but the preschool already enforces proper hand washing when kids enter the class, after using the restroom, and before eating. We just added hand washing after eating, as Miss E’s friends were eating gluten at snack time.
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