Gluten-Free Cafeteria?

Jolie, BSN · Mar 11, 2011

Steph,

If you do a search, you'll find a fairly recent thread in which this was discussed.

I had a number of kids with Celiac at my middle school, and one with both Celiac and diabetes. All of the parents chose to send food from home due to the difficulty in accomodating the dietary restrictions, primarily due to the potential for cross contamination.

One child was so sensitive that if a piece of bread was set on her plate, then removed, she would react. Her symptoms included a rapid onset of nausea, abdominal pain and diarrhea. Not worth risking.

I was asked to evaluate a commercial kitchen in our area to help point out possible areas of cross contamination for allergies and Celiac disease. This particular restaurant prepares a number of dishes that are technically gluten free, but due to the sharing of food prep stations, sufaces, utensils, dishes, and the way in which dishes were stacked and stored at work stations, I could not figure out a way to ensure that the finished products would actually be free of minute cross contamination. I advised the owners not to make any claims of "gluten-free" food.

In my experience, this is a far tougher situation than diabetes or food allergies.

LACA, BSN, LPN, RN · Mar 11, 2011

My thoughts on the situation are based on what I would do if it were my child. No school cafeteria can guarantee that the food is completely 100% free of any contact with gluten...I really think that's pretty much impossible. If it were my child that had the gluten intolerance, I would send food from home, as well as snacks and drinks and anything else that my child needed. That would be the only way that I would feel comfortable enough that my child was able to eat safely and not experience problems.

I don't think schools should be required to accommodate each individual student---and my reasoning is this---once you start accommodating individual diagnoses, you would have to accommodate for all of them and then you are looking at a lot of expense and a lot of extra work for cafeteria workers. I do think that cafeteria staff, administration, teachers, etc need to be aware of the allergy and what symptoms to look for. But I don't think you can legitimately expect a school cafeteria to be able to accommodate every single diagnosis.

Flare, ASN, BSN · Mar 11, 2011

Younger students should have food sent from home. OLder students that can make informed choices about food should be educated as to what they can and cannot have. Food should still be sent from home, but if the parent/ student insists on getting a lunch from school, a form should be signed that the student is buying food at their own risk and making their own choices.

schooldistrictnurse · Mar 11, 2011

I was involved in the earlier thread--we have accomodated our child with alternate meals or adjusted meals. One of the issues is that the child is eligible for free meals and so it gets sticky when you deny the free meal due to medical reasons. Spidey's mom--email me and I will send you our regular menu and our special student's menu and you can see where/how accomodations were made.

[email protected]

allnurses Guide · Mar 11, 2011

I was involved in the earlier thread--we have accomodated our child with alternate meals or adjusted meals. One of the issues is that the child is eligible for free meals and so it gets sticky when you deny the free meal due to medical reasons. Spidey's mom--email me and I will send you our regular menu and our special student's menu and you can see where/how accomodations were made.
[email protected]

That is exactly our issue. This child is eligible for free meals too.

I did speak with mom though and she is open to the idea of sending meals.

I'll email you. Thanks!

And thanks to the rest of you too. I'll check out that other thread.

steph

Arnu · Sep 30, 2011

In our district we do have children that have celiac, one that has celiac and type 1 diabetes. Celiac is considered a disability and is covered under the ADA. Its a disability that is covered under a 504 and accomidations MUST be made through a cafeteria IF the parents want the child to have school lunch. The school can not make the family pay the difference of the gluten free foods. If they are receiving free meals then the gluten free meals will be free as well. Its extremely important to work with this family to provide gluten free lunches if thats what they want and need. A family strapped for money is going to have an extremely hard time getting gluten free foods for their child because they are so much more expensive. One of the kids in our district really wanted to be able to get the hot lunch. He just felt so different (child also has type 1 diabetes) and didn't want to be any more different by having to bring in his lunch everyday. The mom worked very closely with the kitchen staff, explained cross contamination to them, which is a huge issue. Its not as difficult as you would think it would be. On the days where the lunch would be hard to do gluten free he will bring in a lunch from home. Mom goes over the menu with the child for the month, they send the menu in at the beginning of the month to the lunch cordinator so they can go over how everything will be done. Mom does supply the school with certain things, bagels for pizzas, and the bread the child likes the most. He's picky about his types of breads, so mom provides the specific kinds he like, it wasn't something she was made to do but rather she wanted to do, have a good relationship with the kitchen staff and to provide her child with some of the things he really likes.

They keep gluten free cookies/pretzels/breads/chicken nuggets/patties/noodles/ on hand as well as a few treats for those days the other kids get treats.. all fruits/veggies/milk are gluten free, so its usually the main meal that needs substituting.

If the child and family really want him to have school lunch its best to work with that family to provide that. These kids feel so different to begin with these 'little' things make a huge difference.

Purple_Scrubs, BSN, RN · Sep 30, 2011

Business venture idea: provide prepackaged (heat and eat), healthy, gluten and/or allergen free meals to school districts on an as needed basis. Student with special diet enrolls, cafeteria calls company who begins delivering labeled meals on a weekly basis. Could it work?

Arnu · Sep 30, 2011

Purple scubs, it could work.. it would take care of a lot of the issues with cross contamination and such. One thing a lot of the districts don't understand is that they have to provide what the other kids are having.. if its a ham and cheese sandwich, pretzels, fruit a cookie and milk they can't give the child with the gluten issues the ham and cheese with no bread.. they have to provide equal.. chicken nuggets, rice, mac n cheese, it would be made gluten free.. These things aren't hard to do, infact there are some great companies out there. Bell and Evans has great chicken nuggets/patties.. Amy's makes wonderful mac n cheese that is frozen so its pretty simple.

It can be easily done, you have to have people that are willing to take it on and to completely understand it. Just a crumb can send kids with celiac into a tail spin for a week.. Its not anaphlactic, but its affects the entire body and over time it can lead to cancers if gluten is continuously consumed.

nursejen63054 · Oct 2, 2011

I have 2 celiac students this year. The parents have agreed to packing lunches due to cross contamination. The student are able to get fresh fruit, chips, ice cream, milk, jiuce, etc. If the student would like to buy a hot lunch, we ask for a 2 week notice to allow us to get substitue gluten free replacement items.

We also have the parents supply a few cupcakes that we keep frozen incase birthday cupcakes are brought in with out advanced notice. We just microwave the cupcake and the student doesn't feel left out.

Classroom parties, the parents are provided a list of what is being brought in, and they supply replacement items for their child.