Dr. Chandrasekar
My ten-year-old daughter has suddenly developed gluten allergy. She doesn’t have any other allergies. Should I cut out gluten foods completely from her diet or try to reintroduce them after three-four months?
— Sarah Thomas, Bengaluru
Gluten allergy or gluten sensitive enteropathy is also known as celiac disease, the severe form of which is diagnosed in the first two years of life. Almost 1 percent of the Indian population suffers from this illness. I would advise you to confirm the diagnosis with serum tests IgA TGA2. If the doctor wants to investigate further she may recommend intestinal biopsy.
If celiac disease is confirmed, she needs to be evaluated thoroughly by a pediatrician who will advise a gluten-food free diet at all times. She needs to avoid wheat, rye, barley, and oats. I would not advise restarting gluten foods if she is diagnosed with celiac disease.
My son is one year and two months of age. I stopped breastfeeding him when he was three months because he fell very ill. Thereafter I stopped lactating. However of late, he has started crying for breastmilk. Please advise.
— Mitali Sharma, Mumbai
At the age of 14 months, breastfeeds alone may not be of sufficient nutritive value. Also after a gap of 11 months, it may be difficult for you to restart lactating. A child of this age can be fed semisolid to solid foods of good calorific and nutritive value.
My nine-year-old daughter sometimes complains of stomach pain. A gynaecologist we consulted said it’s time for her to start menstruation. Could this be the cause of her stomach aches?
— Meenakshi Kannan, Chennai
Over 95 percent of girl children start menarche or menstruation between10.5 and 14.5 years of age. Pelvic pain is a common complaint of prepubertal girls. However the pain needs to be investigated and evaluated for its location, timing or actions that exacerbate or relieve the pain. Please consult a doctor to rule out other causes before concluding it is menstruation-related cramps or prepubertal pain.
My ten-year-old daughter has become very conscious of her physical weight. She is 4.7 ft tall and weighs 29 kgs. Is the weight ideal for her height and age?
— Rima Sen, Noida
Her growth is normal for her age group. To be more specific, her weight is between the 25th and 50th centile and height at 75th centile according to the growth charts we follow. So there’s no cause for anxiety. Encourage her to eat a balanced diet and exercise regularly and keep fit. Provide her a healthy and nutritious diet for optimal development of bones, muscles, and blood circulation.
(Dr. Chandrasekar is a consultant paediatrician, Narayana Multispecialty Hospital, and paediatrician, Swathi Kids Clinic, Bangalore)
Also read: Coping with food allergies
