Gluten free meals?

[schooldistrictnurse]

Do your schools accomodate students with celiac disease with gluten free meals in the cafeteria? A parent has requested accomodations and I have not been involved in this kind of accomodation before. We have over 10 students who eat gluten free in our district, but they always bring food from home.

thanks

[Jolie, BSN]

To my knowledge, the parents of students in our district with Celiac disease have always sent food from home as well. I'm not aware of anyone requesting accomodations, but I imagine the food service department would have to meet that request if made, especially since they provide accomodations for other dietary needs such as allergies and diabetes.

My daughter's friend has Celiac disease and is incredibly sensitive to even the slightest cross contamination. She will become ill if someone handles bread and then touches her food without washing their hands. It must be very difficult to manage this in a cafeteria setting.

[LACA, BSN, LPN, RN]

My thinking on this would be that the cafeteria should have to make accomodations (can't single out a child for a disease) BUT if it were my child who had a severe enough allergy, I'm not going to leave it to the fact that they may or may not have been completely on top of things. I would send food from home regardless, just to make double sure that my child is safe.

[Jolie, BSN]

I Googled "dietary accomodations for Celiac Disease in school" and found a number of good links. This one is pretty comprehensive:

http://www.enjoylifefoods.com/img/media/school_lunches_fact_sheet.pdf

[Neveranurseagain, RN]

Here is a couple of websites that discuss the legality of accommodations with a gluten free diet: Navigating The School System | NFCA

http://www.celiaccentral.org/SiteData/docs/504%20Roadmap/e4630d030351770a8cc47e9280fb19bd/504%20Roadmap.pdf

At School | American Celiac Disease Alliance

At a camp I worked at, a few campers needed gluten free meals. To avoid cross contamination issues, prepackaged meals were served to these campers. Trader Joe's and even your grocery store may offer gluten free meals in the frozen food section--you may have to look for them.

[schooldistrictnurse]

Thank you for all your responses. I will post again to let you all know how this is resolved.

[BunnyBunnyBSNRN, ASN, BSN]

I have not had this request, but I did learn a little about our district policy last year when I had a parent request low fat, low cholesterol for their child. In my district, we must have a doctor's order for any dietary accomidation. The food services department requires they have one on file. Once we got the doctor's order, the cafeteria manager and I went over the (rotating) menu and picked out what he could eat based on the fat and cholesterol counts.

As far as diebetic students, again, we have a doctor's order that states they have diabetes and we do the carb counts with the menu. This is done directly with the student if they are old enough.

[schooldistrictnurse]

Just wanted to let you know how this request for accomodation was handled in my district.

Since the lunch program is optional, it was determined that the district did not have to provide special meals for the child. Just as we don't provide special meals for students with diabetes, just additional information. The carb counts are printed right on the menu. They also print "P" for items containing pork.

The parent has access to the monthly lunch menu. She will request the nutritional information from our food service dept, who has access to a print out of labels of all items in the food service. If she chooses to have the child take hot lunch, she circles the item on the menu. We have a lunchroom aide who will walk the line with the child to be sure she is taking what mom approved.

The child sits at the end of the table for her grade (less waving around of food than in the center) with a placemat that the aide wipes down before and after the meal. This, hopefully, lessens the judgement call for staff to make.

thanks

[nursejen63054]

Our district had a similar request and our response was the same too, until the parents showed them the Federal Law. If your district received any funding, especially food, they are required to provide substitue food for celiac. Our district has now changed its policy after the attorney confirmed the information the parents provided.

[schooldistrictnurse]

Final chapter on this story:

The food service boss, principal, parent and I met this morning. We WILL provide a lunch daily (actually a breakfast also) to the child. The menu will rotate from 5 choices, with things like yogurt, cheese sticks, gluten free pretzels, fruit cups, fresh veggies, salad with chicken cubes. Food service MIGHT consider a frozen dinner at times, but I strongly cautioned against doing this often due to the high sodium content. After investigation, I learned that all food service employees are trained in avoiding cross-contamination. We're going to try to use sealed items as much as possible. There are mixed feelings among the players regarding this "special treatment" but what tipped the scales for me was a signed order by an MD. NurseJen's response also helped me push forward.

thanks