Eating during an IBD flare

When your child is having an IBD flare, food can suddenly become difficult.

They may have diarrhoea, abdominal pain, nausea, urgency or a poor appetite. Foods they normally enjoy may seem harder to tolerate, and you may find yourself wondering:

“What should I feed my child during an IBD flare?”

There isn’t one diet that works for every child with Crohn’s disease or ulcerative colitis. During a flare, the goal is usually to help your child stay hydrated, maintain nutrition and eat foods they can comfortably tolerate while their IBD team treats the underlying inflammation.

Food can affect symptoms, but avoiding a particular food does not necessarily mean that food is causing the flare.

🔥 Why eating can be difficult during a flare

Active IBD can affect appetite, digestion and how your child feels after eating.

Your child may experience:

• diarrhoea

• abdominal cramps or pain

• nausea

• bloating

• urgency

• fatigue

• reduced appetite

• feeling full quickly

• weight loss.

They may also start avoiding foods because they are worried about needing the toilet or developing pain afterwards.

This can make it difficult to get enough energy and nutrients — particularly when your child is growing.

💧 Fluids come first

If your child has frequent diarrhoea or vomiting, keeping them hydrated is particularly important.

Offer fluids regularly rather than waiting until your child is very thirsty.

Depending on your child’s situation, their healthcare team may recommend:

• water

• oral rehydration solutions

• other suitable fluids.

If your child is losing a lot of fluid, ask their IBD team what they recommend.

Signs of dehydration

Contact your child’s healthcare team promptly if you are concerned about dehydration.

Signs can include:

• passing urine less often

• dark urine

• dry mouth

• dizziness

• unusual tiredness or weakness

• sunken eyes

• being unusually sleepy or difficult to wake.

If your child cannot keep fluids down, is severely dehydrated or appears very unwell, seek urgent medical care.

🍽️ Small meals can be easier

Your child may find three large meals difficult during a flare.

Try offering smaller meals and snacks more frequently if that feels more manageable.

For example:

• breakfast

• morning snack

• lunch

• afternoon snack

• dinner

• evening snack.

Don’t worry if your child’s usual meal pattern changes temporarily.

The priority is helping them get enough nutrition in a way they can tolerate.

🥔 Choose foods your child tolerates

There is no universal “flare food list”.

Some children find softer, lower-fibre foods easier to tolerate temporarily, particularly if they are experiencing diarrhoea or abdominal discomfort.

Depending on your child’s individual tolerance, this might include:

• rice

• pasta

• bread or toast

• potatoes without skins

• oats

• eggs

• chicken or other tender meats

• fish

• smooth nut butter

• yoghurt or a suitable alternative

• cooked vegetables

• peeled or cooked fruit.

These are examples — not rules.

Your child may tolerate foods that another child with IBD cannot, and vice versa.

🥕 What about fruit and vegetables?

Fruit and vegetables are an important part of a nutritious diet, but their texture and fibre content can sometimes be difficult to tolerate during a flare.

Your child may find that:

• cooked vegetables are easier than raw

• peeled fruit is easier than fruit with skin

• soft fruit is easier than harder or fibrous fruit

• smaller portions are easier than large amounts.

If your child is struggling with fibre during a flare, ask their IBD team or dietitian what changes would be appropriate.

Avoiding all fruit and vegetables for a prolonged period without professional advice can make it harder to meet nutritional needs.

🧈 Don’t forget energy and protein

Children need enough energy and protein to grow and develop.

During an IBD flare, your child may be eating less than usual while their nutritional needs remain high.

Try to include protein and energy-dense foods your child tolerates.

These might include:

• eggs

• chicken

• fish

• meat

• tofu

• yoghurt

• cheese

• nut butter

• avocado

• olive oil

• suitable nutritional supplements recommended by your healthcare team.

If your child is struggling to eat enough, ask for help early rather than waiting for significant weight loss.

🥛 What about dairy?

You don’t automatically need to remove dairy because your child has IBD. Some children tolerate dairy without any problems.

Others may have lactose intolerance or find dairy harder to tolerate during certain periods.

If you think dairy is contributing to your child’s symptoms, speak with their healthcare team or dietitian before removing it completely.

If dairy is removed, make sure your child still gets enough calcium, vitamin D, protein and energy from other foods or supplements if recommended.

🚫 Should I avoid certain foods?

You may hear lots of advice about foods that supposedly “cause IBD flares”.

Be cautious about making major dietary changes based on general advice from social media or the internet.

There isn’t a universal list of foods that children with Crohn’s disease or ulcerative colitis need to avoid.

A food can also make symptoms feel worse without actually causing the intestinal inflammation that is driving the flare.

For example, a particular food might increase diarrhoea or abdominal discomfort while your child’s underlying IBD remains the same.

If you notice a consistent food-and-symptom pattern, discuss it with your child’s IBD team or dietitian.

📝 Keep track of patterns

A simple food and symptom diary can sometimes help you and your healthcare team understand what’s happening.

You could record:

What they ate

What foods and drinks did they have?

Bowel movements

How often? Any blood or mucus?

Symptoms

Pain, nausea, bloating or urgency?

Appetite

Were they hungry, eating less or refusing food?

Fluids

How much were they drinking?

Medication

Were doses taken as prescribed?

You don’t need to record every bite of food forever.

The purpose is to identify useful patterns and give your healthcare team helpful information.

⚖️ Don’t let food restrictions take over

When a child is unwell, it can be tempting to keep removing foods until you find something that seems “safe”.

But long lists of food restrictions can make it difficult for a growing child to get enough nutrition.

Restrictive eating can increase the risk of:

• inadequate calorie intake

• nutritional deficiencies

• weight loss

• poor growth

• anxiety around food

• missing out on social activities involving food.

If your child is avoiding many foods, ask for help from an IBD-focused paediatric dietitian.

🥤 What if my child isn’t eating much?

A temporary drop in appetite can happen during a flare.

You can try:

• small portions

• frequent snacks

• favourite foods that your child tolerates

• energy-dense additions where appropriate

• drinks or smoothies if your child tolerates them

• eating together without pressure.

Try not to turn every meal into a battle.

If your child consistently can’t eat enough, is losing weight or is becoming increasingly weak or tired, contact their healthcare team.

They may recommend nutritional support, such as an oral nutritional supplement or, in some children with Crohn’s disease, exclusive enteral nutrition (EEN).

EEN is a specific medical nutrition treatment and should only be undertaken under the guidance of the child’s IBD team and dietitian.

💩 What if eating makes diarrhoea worse?

It can be frightening when your child eats and then quickly needs the toilet.

Remember that this doesn’t necessarily mean the food has “gone straight through them”.

Eating can naturally stimulate bowel activity, and an inflamed bowel can be particularly sensitive.

If your child’s diarrhoea is worsening, especially if there is blood, significant pain, fever or dehydration, contact their IBD team.

Don’t assume that changing their diet alone will treat an IBD flare.

🩺 Food doesn’t replace IBD treatment

One of the most important things to remember is that food and IBD treatment are not the same thing.

A child may eat a very nutritious diet and still have active intestinal inflammation.

If your child is having an IBD flare, their healthcare team may need to assess their symptoms and arrange blood tests, faecal calprotectin or other investigations.

Their treatment may also need to be adjusted.

Don’t stop, reduce or change your child’s IBD medication because of food or dietary changes unless their healthcare team tells you to.

🚩 When should I contact the IBD team?

Contact your child’s IBD team if they are:

• having significantly more diarrhoea than usual

• passing blood

• experiencing increasing abdominal pain

• refusing most food

• drinking very little

• losing weight

• unusually tired or weak

• vomiting repeatedly

• having symptoms that are getting worse rather than better.

Your child’s team may want to determine whether their symptoms are due to active IBD, an infection, medication effects or another cause.

🚨 When is urgent medical care needed?

Seek urgent medical attention if your child has symptoms such as:

• severe or rapidly worsening abdominal pain

• a swollen or very tender abdomen

• heavy or persistent rectal bleeding

• repeated vomiting with an inability to keep fluids down

• signs of significant dehydration

• fainting or severe weakness

• being difficult to wake or unusually confused

• a high or persistent fever with your child appearing very unwell.

If you’re unsure whether your child’s symptoms are urgent, seek medical advice.

❤️ Keep food as normal as possible

A flare can make life feel very medical very quickly.

If you can, try to keep some normality around food.

Let your child choose between foods they tolerate. Eat together when possible. Keep favourite foods available. Allow treats when appropriate.

Your child doesn’t need to feel like every meal is another part of their treatment.

Food should still be food — something that provides nourishment, comfort, connection and enjoyment.

🌱 When the flare improves

As your child’s symptoms settle, you may be able to gradually return to a wider range of foods.

You don’t necessarily need to stay on a restrictive “flare diet” once your child is feeling better.

Your child’s IBD dietitian can help you work towards a varied diet that supports:

• growth

• energy

• nutrition

• healthy development

• school and activities

• family meals

• enjoyment of food.

The takeaway

When your child is having an IBD flare, focus on the basics:

💧 Keep them hydrated.

🍽️ Offer small, manageable meals and snacks.

🥚 Include energy and protein where tolerated.

🥕 Adapt texture and fibre if your child needs to.

🚫 Avoid unnecessary long-term food restrictions.

🩺 Stay connected with their IBD team.

📈 Keep an eye on weight, growth and overall nutrition.

There is no perfect flare diet for every child.

The right approach is the one that helps your child stay nourished and hydrated while their healthcare team manages the underlying IBD.

This article is for general education and does not replace personalised medical or nutritional advice. Dietary needs can vary depending on your child’s Crohn’s disease or ulcerative colitis, symptoms, growth, nutritional status, complications and treatment. Speak with your child’s IBD team or a qualified paediatric dietitian before making significant dietary changes or starting a restrictive diet.