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 make wheat-free meals.

Wheat is everywhere. Sometimes it's in foods you don't expect:

• All breads, cakes, pies, cookies, pastries, doughnuts, 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, lunch 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 or barley 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.

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. Cross-contamination occurs when equipment that has traces of a food allergen then contaminates other food processed on that same equipment. Federal law requires food makers to note on the label if a food contains a major food allergen, such as wheat. But the law doesn't require a list of cross-contamination ingredients. Many food makers voluntarily include this information.

Children with wheat allergies can usually 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 made 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 nonwheat 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

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 online. Check natural food stores, grocery stores, specialty shops, and online for products made without wheat.

When cooking from scratch, you may need to experiment. A combination of flours often 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 1 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 making food. If you use flour or other wheat products for other family members, carefully clean utensils, bowls, pans, and work surfaces before making wheat-free food for your child.

Celiac disease, nonceliac gluten sensitivity and wheat allergy are all conditions whose primary treatment is staying away from dietary components. Some children who are sensitive to wheat may have celiac disease, not wheat allergy. Here are some differences between the two:

• Is a sensitivity to the protein gluten in grains, including wheat, barley, rye, and other grains
• Often causes digestive symptoms, such as diarrhea, upset stomach (nausea), bloating, and gas
• Is lifelong
• Can be linked to other issues, such as anemia, inability to have children (infertility), stunted growth, and rash.

• Is a sensitivity to several proteins in wheat. Children with wheat allergy may be able to eat other grains, such as barley or rye. If a child is allergic to wheat and you don't know about other grains, talk with your child's healthcare provider or allergist.
• May cause symptoms all over the body, including anaphylaxis
• Sometimes goes away as children get older

Act quickly if your child has any of the symptoms below. If epinephrine medicine has been prescribed, use it right away. Then call 911 or emergency services.

• Trouble breathing or cough that won't stop
• Mouth or face swelling
• Dizziness or fainting
• Vomiting or severe diarrhea