Special diets for children

Why might my child need a special diet?

Your child might need a special diet for various reasons, such as:

• a metabolic condition they are born with
• a condition they may develop, such as coeliac disease or diabetes
• food allergies
• your cultural or religious beliefs

No matter the reason for the special diet, it’s important that your child has the nutrients and energy they need:

• to be healthy
• to grow and develop properly

If your baby is born with a genetic condition that affects their ability to process a certain nutrient, they will need a special diet for life.

If your child does not need a special diet, give them a variety of foods from the five food groups. Be sure to avoid fad diets for children.

How do I know if my child needs a special diet?

There are many ways you may find out your child needs a special diet, including:

• neonatal screening, which may discover a condition that requires a special diet
• your child has an abnormal reaction to a food indicating they have a food intolerance
• your child has an allergic reaction to a food and has had allergy testing to diagnose them
• your child is diagnosed with a medical condition that requires a special diet, such as diabetes, cystic fibrosis

When your baby is about 6 months of age, you should start introducing them to foods, including foods that commonly cause allergies. It's recommended that you start giving allergy foods before your baby reaches 12 months old. This can reduce their chance of developing an allergy. If you think your child has an allergy, their doctor can confirm a food allergy with tests such as:

• skin prick test
• blood test

Read more on introducing ‘allergy foods’.

There are no specific tests to diagnose a food intolerance. Your child’s doctor can diagnose a food intolerance based on:

• your child’s symptoms
• checking for other conditions
• suggesting an elimination diet to see if symptoms go away when the suspect food is stopped

Read more about food allergies in children.

Read more about how to introduce allergy foods.

What do I do if my child needs a special diet?

If your child needs a special diet, their doctor will refer you to an accredited practicing dietitian. A dietitian is best qualified to help you manage your child’s dietary requirements so they can:

• enjoy healthy foods
• get the nutrients they need
• avoid foods that can be dangerous to them

Your child’s healthcare team will work together with you so that you feel you can support your child in getting the care they need.

Sometimes your child may outgrow their food allergies.

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What changes may be needed in my child’s diet?

Your child’s special dietary requirements will depend on:

• their health conditions
• any allergy they have
• your family’s beliefs

Coeliac Disease

Coeliac disease is an immune disease. When gluten (a type of protein) is eaten, the gut becomes inflamed. This prevents your body from absorbing nutrients properly, and can cause:

• an upset tummy
• weight loss
• tiredness
• skin problems
• anaemia

If your child has coeliac disease, they will need to eat gluten-free foods at all times. Symptoms such as an upset tummy are common to many health conditions, so before you exclude gluten from your child’s diet, check with their doctor or a dietitian.

Phenylketonuria (PKU)

In Australia, all babies are tested at birth for phenylketonuria (PKU). Babies with PKU lack an enzyme needed to break down one of the amino acids (phenylalanine) in protein. High levels of the amino acid can lead to problems with the development of their brain.

If your baby tests positive for PKU, they will need to eat a special diet for life that has:

• low protein
• foods with low levels of phenylalanine

Glutaric acidaemia (GA1)

GA1 is a genetic disorder that occurs when there’s not enough of a specific enzyme. This leads to a build-up of 3 amino acids:

• lysine
• hydroxylysine
• tryptophan

High levels of these amino acids can damage your child’s brain. A child with GA1 will need to eat a high calorie, low protein diet, and avoid these 3 amino acids.

Maple Syrup Urine Disease (MSUD)

In Australia, babies are screened for MSUD as part of their neonatal screening. MSUD is a rare genetic condition where there’s not enough of the enzyme that breaks down:

• leucine
• isoleucine
• valine

These 3 amino acids can cause brain damage if they build up. MSUD is treated with a low protein diet, and supplements for other amino acids.

Galactosaemia

Babies with galactosaemia lack an enzyme needed to break down the sugar galactose, which is found in:

• breast milk
• milk from cows, goats and sheep

This genetic condition can cause vomiting, liver problems and intellectual disability.

If your child has galactosaemia, they will have to avoid foods made with milk or milk products for their whole life.

Soy and chickpea products should also be avoided, as they can contain some galactose.

Food allergies

The most common food allergies are to:

• eggs
• peanuts and nuts that grow on trees
• shellfish
• sesame seeds
• wheat
• soy
• milk

Your child will need to avoid foods that trigger a reaction.

Read more on allergy foods and diets.

Food intolerance

Unlike allergies, food intolerances don’t involve your immune system. They generally do not cause severe reactions. Intolerance to lactose, a type of sugar found in milk is common.

If your child has a food intolerance, they may need to avoid that food.

Vegan and vegetarian diets

You may wish to feed your child a vegetarian or vegan diet due to your personal beliefs. There are many variations of vegetarian and vegan diets. If you keep a vegetarian diet, you most likely do not eat red meats, poultry and fish.

Vegan diets exclude meats and any animal products including:

• milk
• cheese
• yoghurt
• eggs
• honey

Animal products are high in:

• vitamins such as B12
• protein
• iron
• zinc

A vegan and vegetarian diet, if planned properly, can provide your child with all the nutrients they need to be healthy and grow. An accredited practicing dietitian or your GP can guide you. You may need to supplement vitamin B12 and other nutrients.

Your child is at the highest risk of lacking calcium and vitamins B12 and D. If your child is deficient in some nutrients, this can affect their development.

A well-balanced vegetarian diet shouldn’t cause any nutritional problems and can have health benefits. The nutrients found in animal products can be gained from:

• legumes
• tofu
• seeds
• nuts
• leafy green vegetables

Vitamin B12 is only found in animal products. To get this vitamin, your child can:

• drink vitamin B12 fortified plant-based milk
• take a vitamin supplement

Children should be given full fat dairy until they are 2 years old.

Read the vegetarian and vegan feeding guide for babies.

Read the vegetarian and vegan feeding guide for toddlers.

How do I manage my child’s diet outside of the home?

It can be difficult to explain to children that they need to stick to a special diet. It is important that they understand this as early as possible.

Tips to help you manage your child’s diet outside of the home are:

• write them a simple list of foods they can and can’t eat
• give a copy to your child’s childcare or school
• share it with your child’s friends and their parents
• use a smartphone app to help them identify problem foods

When you are eating out, here are tips you can teach your child to stay safe:

• Tell the waiter about your child’s dietary requirements.
• If you are not sure what is in the food, ask the waiter.
• If the staff are unsure, eat somewhere else.
• Avoid self service areas as they could be contaminated.
• If your child has an adrenaline auto-injector (EpiPen or Anapen) for their allergy, take it with you.

Read about how to use an adrenaline autoinjector.

Resources and support

Speak to your doctor or child health nurse for more information on allergy foods.

• 'Nip Allergies in the Bub' is an initiative from the National Allergy Strategy that has information for both parents and health professionals.
• Learn more about allergies from the Australasian Society of Clinical Immunology and Allergy.
• Read more about avoiding food allergies in babies from the Royal Australian College of General Practitioners.

Other languages

Nip Allergies in The Bub has translated resources about introducing common allergy causing foods to your bub into a variety of community languages.

Aboriginal and/or Torres Strait Islander peoples

Get up and grow is a resource for Aboriginal and/or Torres Strait Islander people that talks about the first foods you will feed your baby.