Does Your Child Have a Food Intolerance? Signs to Look Out For

Does your child complain of tummy pain or headaches? Do they have itchy skin or diarrhoea?

These are common signs of food intolerance, but because they overlap with symptoms of so many other conditions, the intolerance itself often goes unrecognised.

Types of intolerances

Three intolerances I commonly see in children are gluten, lactose and salicylates.

Gluten Intolerance

Signs and symptoms:

• Bloating, gas or abdominal pain after eating

• Diarrhoea or constipation

• Fatigue, especially after meals

• Headaches or brain fog

• Joint or muscle aches

• Skin issues like eczema or general rashes

• Irritability or mood changes

Foods to avoid: wheat, barley, rye (and anything made from wheat, barley or rye), e.g. bread, pasta, cereals, baked goods and processed foods or sauces thickened with wheat flour or malt.

(Note: gluten intolerance is different from coeliac disease, which is an autoimmune condition and worth ruling out, particularly if symptoms are more severe or there is a strong family history)

Lactose Intolerance

Signs and symptoms:

• Bloating and gas

• Diarrhoea

• Stomach cramps

• Symptoms that get worse with larger amounts of dairy (especially milk), but are often fine with small amounts or harder cheeses

(Note: more serious reactions like hives or swelling indicate an allergy rather than intolerance and need different management)

Foods to avoid: high-lactose dairy, including milk, ice cream, custard, condensed and evaporated milk, cream and soft or fresh cheeses like ricotta and cream cheese. Foods that are lower in lactose may be tolerated, for example, aged cheeses like cheddar, parmesan and Swiss cheese, butter, plain or Greek yoghurt (the fermentation process partially breaks down the lactose), kefir and lactose-free milk.

Salicylate Intolerance

Salicylates are a natural food chemical found in many fruits, vegetables, herbs and spices. Salicylate intolerance is a less commonly known food sensitivity, and the elimination diet used to manage it was developed by the Allergy Unit at Royal Prince Alfred Hospital, based on decades of clinical experience. I have experienced salicylate intolerance personally with my own children when they were younger.

Signs and symptoms:

• Hyperactivity or trouble concentrating

• Headaches

• Hives or skin rashes, particularly around the mouth

• Stomach aches

• Sleep disturbances

• Asthma-like symptoms

Foods commonly restricted during elimination: many fruits (for example, berries, dried fruit, citrus), tomatoes, some vegetables, herbs and spices, honey, mint and various flavoured or packaged foods. As a hint, fruits and vegetables that are brightly coloured are often higher in salicylates.

My approach to managing intolerances

Gluten intolerance

For gluten sensitivity, my approach is to eliminate gluten for a specified period of time (2-6 weeks, depending on the individual) while working on healing the gut (addressing nutrient deficiencies and imbalances in gut bacteria; introducing foods and supplements that support the gut lining). A lot of children still struggle with gluten even once the gut has healed, and ongoing avoidance may be needed. This is not a bad outcome though, as gluten-free whole grains, legumes and other nutrient-dense foods can be eaten instead.

Lactose intolerance

Lactose intolerance needs a slightly different approach. Unless it developed suddenly after something like a tummy bug, in which case gut healing can genuinely help, lactose intolerance is usually caused by a lifelong reduction in the enzyme that breaks down lactose, so gut healing on its own is not going to resolve it. Instead, we focus on finding the individual tolerance threshold through careful, gradual exposure.

Salicylate intolerance

My approach to managing salicylate intolerance follows two steps: eliminating foods containing salicylates for a specified period of time, while working on healing the gut, then slowly reintroducing foods to determine the individual tolerance threshold. I don't believe in strict salicylate-elimination long term. Since salicylates are found in such a wide range of fruits, vegetables, herbs and spices, avoiding them all means cutting out many of the most nutrient-dense foods in a child's diet, foods that provide vitamin C, folate, potassium, fibre and a range of antioxidants. Over time, this can affect a child's growth, immunity and gut health, which is the opposite of what we're trying to achieve. This is exactly why I believe in healing the gut alongside temporarily eliminating the problematic foods, rather than avoiding them indefinitely.

If your child is showing signs of food intolerance, please remember that it is manageable, with the right support. This is something I help clients with in my practice and I’d be happy to help your child too.