Last August, the National Foundation for Celiac Awareness (NFCA) hosted a back-to-school webinarwith Gabriela Pacheco, RD, LD, SNS, a school nutrition consultant with expertise in specialty diet accommodations. In honor of National School Lunch Week, we decided to circle back with Gabriela and get some more tips on how parents and schools can work together to provide gluten-free school lunches to celiac and gluten sensitive students.

NFCA: What is the biggest challenge schools face in offering gluten-free options? Is it the cost? Not enough demand? Staff training?

Gabriela Pacheco (GP): All of those challenges happen and are different in every district.

Staff training is certainly the biggest challenge. With or without a diet prescription, the foodservice staff must understand proper label reading and handling of all foods. This is especially challenging when a reaction to cross-contamination can have serious effects on the student.

Cost can be a challenge in some districts because the school cannot pass on the extra expense to the student. In other words, if a student gets free, reduced, or pays full price for school meals, the school cannot charge them for the extra expense to make the special meal.

The demand “should” not be an issue. One child or 100 students should be treated the same. However, some districts may push back if there is only one student or a few students needing the special meal. The U.S. Department of Agriculture (USDA) states that if a student has a food intolerance or allergy, the school can – but does not have to – modify meals, unless it is a life-threatening reaction such as anaphylaxis. It all lies on the diet prescription from a certified medical authority; if the diet prescription states that meals must be modified, then the district has no choice.

With or without a diet prescription, if the school nutrition staff works with parents of students with celiac disease or non-celiac gluten sensitivity, they demonstrate support of a segment of the community by helping them improve their quality of life and concentrate on school – not stress about food.

NFCA: What are some schools meals that meet the new USDA nutrition guidelines and are gluten-free?

GP: USDA – The National School Breakfast and Lunch Program ensures that your child eats a healthy meal, including meals for children with special dietary needs. Although a gluten-free diet limits some food options, schools can put together kid-friendly school meals. Having a diet different from that of his/her friends may cause your child to feel singled out. Get him/her and yourself involved with cafeteria staff to go over food preferences to make him/her feel more comfortable about school meals.

School meals must meet new meal pattern requirements, which include fruits and vegetables at every meal, as well as a meat/meat alternate (protein source), legumes, fluid milk and whole grains. Gluten-free foods include fruits, vegetables, poultry, fish, beef, nuts, eggs and more. Schools already have these onsite; however, preparation is the key. Purchasing gluten-free bread, for example, can be the only substitution the student requires to have a lunch which looks the same as his friends. Along with a side salad, a fruit and milk, the meal is complete!

Most schools now have salad bars that contain a wide variety of items such as kidney beans, fresh fruits and vegetables, cottage cheese, and some even have the protein available there to make a complete meal. Add milk and again, a complete meal. The student just has to make sure to watch the salad dressings or anything else which may have been cross-contaminated. If the student is old enough, they learn what to choose. If still young, a teacher or cafeteria staff can help with the salad selection.

There are several manufacturers who make gluten-free items specifically for schools. One good resource is Rich Products. They make pizza dough and other items that will fit into the school meals and meet guidelines.

NFCA: How can schools be more welcoming to special dietary needs? Should they post the information on their website? Ask the foodservice director to speak at parents’ night?

GP: Both of those options are a great start. The first step is to consider the needs of the student. Second, it really takes a lot of teamwork. The school nutrition department, the parents and the student should all be involved. Forming partnerships is key. Many districts already post carbohydrate counts/exchanges, PKU diets, etc. – why not add gluten-free options?

Keep in mind that they are not required to post gluten-free options, which is why communication is important. Asking for the menus so parents can go over it with their child and circle meals they like also helps. The cafeteria staff can then work with the student on proper gluten-free exchanges. This way, the meal is not so “special” and different from other students.

NFCA: What advice do you have for parents who are reluctant to contact the school about their child’s gluten-free needs? How can they approach the conversation with confidence?

GP: The first place to go is the foodservice/nutrition director. The cafeteria staff can refer you to him/her. Parents can discuss options with the director.

If the student has a diet prescription from a medical authority, then it is especially important that the director ensures the cafeteria staff, your child’s first line of defense, is trained and understands gluten-free diet and modifications. Even without a written medical statement, the school may provide the child with special meals, but is not required to.

Form a partnership with the cafeteria staff and offer to help choose your child’s meals. Remember that they have to order foods from approved manufacturers, so it may be that they have to order from outside vendors to provide gluten-free options. They cannot charge the student more for that meal, so they do have to consider the increased cost. A parent should never hesitate approaching the nutrition department about their child’s needs, but keep in mind that there are regulations.

NFCA: What’s one thing parents can do during National School Lunch Week to advocate for gluten-free needs in the lunchroom?

GP: Parents can form a partnership with the food and nutrition department to send out a newsletter or a side note on the month’s menu regarding children with celiac disease and non-celiac gluten sensitivity, and how the department can help with modifications. School administrators can also benefit from this, as they don’t always understand regulations.

For more articles on this topic, visit NFCA’s Gluten-Free Resources for National School Lunch Week 2012