Food and IBD: What parents need to know

Food can become one of the biggest sources of worry after a child is diagnosed with Crohn’s disease or ulcerative colitis.

You might wonder:

“Is there a diet my child should follow?”

“Which foods are causing their symptoms?”

“Should we stop dairy or gluten?”

“Can food cause an IBD flare?”

The short answer is that there is no single IBD diet that works for every child. Food can affect symptoms, appetite and nutrition, but it is important to separate symptoms from inflammation. A food that makes your child feel worse doesn’t necessarily mean it is causing their IBD or an IBD flare.

For children, nutrition is particularly important because they are still growing and developing.

🍽️ Food and nutrition are not the same thing

It can help to think about two different things:

Diet is what your child eats.

Nutrition is whether their body is getting and absorbing enough energy, protein, vitamins and minerals to support health and growth.

A child can eat what appears to be a healthy diet but still have nutritional deficiencies or not be getting enough energy.

IBD can make nutrition more complicated because inflammation, reduced appetite, diarrhoea and some treatments can all affect nutritional needs.

🌱 Does food cause IBD?

No.

Parents sometimes worry that something their child ate caused their Crohn’s disease or ulcerative colitis. There is currently no evidence that a particular food or something your child ate caused their IBD. It is also important not to blame yourself or your child’s diet. IBD is a complex condition involving factors such as the immune system, genetics and the environment.

🔥 Can food cause an IBD flare?

Food and IBD can be complicated.

A particular food may make your child’s symptoms worse without causing the underlying inflammation.

For example, your child might notice more:

• diarrhoea

• bloating

• abdominal discomfort

• urgency

• gas

• nausea

after eating certain foods.

That doesn’t automatically mean the food has caused an IBD flare.

Active intestinal inflammation needs to be assessed by your child’s healthcare team using the overall picture, which may include symptoms, blood tests, faecal calprotectin and other investigations.

🥗 What should my child eat?

When IBD is well controlled, the aim is generally to provide a varied, nutritious diet that supplies enough energy and nutrients for growth.

Depending on your child’s individual needs and tolerance, this can include:

🍎 Fruit and vegetables

These provide vitamins, minerals and fibre.

Some children may tolerate certain fruits and vegetables better than others, particularly during a flare.

Changing the texture, preparation or portion size can sometimes make foods easier to tolerate.

🍞 Grains and carbohydrates

Bread, rice, pasta, oats, cereals and potatoes can provide important energy.

There is no reason to automatically remove gluten or grains unless your child’s healthcare team has identified a specific reason.

🥚 Protein

Protein supports growth and tissue repair.

Sources can include:

• eggs

• fish

• chicken

• meat

• yoghurt

• dairy or suitable alternatives

• tofu

• beans and lentils

• nuts and nut butters.

🥑 Healthy fats

Foods such as avocado, olive oil, nuts, seeds and oily fish can provide energy and important nutrients, depending on your child’s tolerance.

For children struggling to maintain their weight, energy-dense foods can be particularly useful.

🚫 Does my child need to avoid dairy?

Not necessarily.

Some children with IBD tolerate dairy without any problems.

Others may have lactose intolerance, particularly around periods of active symptoms.

If dairy seems to cause problems, speak with your child’s IBD team or dietitian before removing it permanently.

If dairy is removed, you’ll also need to consider where your child will get enough:

• calcium

• vitamin D

• protein

• energy.

Removing a food is only part of the solution. Replacing the nutrients is just as important.

🌾 What about gluten?

There is no general recommendation that all children with IBD should avoid gluten. If your child has coeliac disease or another specific reason to avoid gluten, their healthcare team can help you manage this safely.

Otherwise, removing gluten without a clear reason can unnecessarily restrict the diet and make it harder to meet nutritional needs.

🍬 What about sugar and processed foods?

You may see claims online that sugar or processed foods “cause inflammation” or that eliminating them can cure IBD.

The evidence is more complicated than that.

Research is continuing into how different dietary patterns, ultra-processed foods, additives and other dietary factors may influence IBD. At present, there isn’t evidence that one specific food can be identified as the cause of IBD inflammation in every child.

For children, it is usually more helpful to focus on the overall pattern of eating rather than becoming frightened of individual foods.

🔄 What about special IBD diets?

You may come across diets such as:

• the Crohn’s Disease Exclusion Diet (CDED)

• Specific Carbohydrate Diet (SCD)

• IBD-AID

• Mediterranean-style diets

• low-FODMAP diets

• exclusive enteral nutrition (EEN).

Some dietary approaches have been studied in IBD, and certain nutrition therapies may be recommended for specific children.

But they are not interchangeable, and they aren’t appropriate for every child.

Some can also be quite restrictive.

For example, exclusive enteral nutrition is a specialised nutritional treatment that can be used in some children with Crohn’s disease under medical and dietetic supervision. Other dietary approaches may have different evidence and purposes.

If you’re considering a specialised IBD diet, speak with your child’s gastroenterology team or an IBD-focused paediatric dietitian first.

⚠️ Be careful with restrictive diets

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

But children need enough nutrition to grow.

Restrictive diets can increase the risk of:

• inadequate calorie intake

• vitamin and mineral deficiencies

• weight loss

• poor growth

• reduced bone health

• anxiety around food

• disordered eating.

For this reason, significant dietary restrictions should ideally be planned with a healthcare professional who understands paediatric IBD.

📝 Could a food diary help?

Sometimes.

A simple food and symptom diary can help identify patterns.

You could record:

Food: What did my child eat?

Symptoms: What happened afterwards?

Bowel movements: How often? Any blood or mucus?

Pain: Was there abdominal pain or cramping?

Appetite: Were they hungry or eating less?

Other: Energy, nausea, urgency or bloating.

Try to look for repeated patterns, rather than assuming that one difficult day means a particular food is a trigger.

And remember: a food diary should be a tool for understanding your child’s symptoms — not a reason to become afraid of food.

🔥 What changes during a flare?

Your child’s diet may need to change temporarily when their IBD is active.

During a flare, some children find that:

• smaller meals are easier

• softer foods are easier to tolerate

• certain high-fibre foods cause more symptoms

• greasy or fried foods worsen symptoms

• some dairy products become harder to tolerate

• drinking enough fluids becomes particularly important.

But not every child needs the same changes.

Our guide Eating during an IBD flare can help you understand how food, fluids and nutrition may be managed when symptoms are active.

📈 Keep an eye on growth

For children with IBD, food isn’t just about managing symptoms.

It’s about growth.

Your child’s healthcare team may monitor:

• weight

• height

• growth pattern

• appetite

• nutritional intake

• iron and other nutrients

• puberty and development.

If your child is losing weight, falling away from their usual growth pattern or struggling to eat enough, tell their IBD team.

Nutrition problems can sometimes be an indication that your child’s IBD needs closer assessment.

🧲 What about vitamins and supplements?

Some children with IBD may develop nutritional deficiencies.

Depending on your child’s situation, their healthcare team may check things such as:

• iron and ferritin

• vitamin D

• vitamin B12

• folate

• calcium

• zinc.

Your child may need supplements if they have a confirmed deficiency or increased nutritional needs.

But more isn’t always better.

Don’t start high-dose vitamins, minerals or herbal supplements without discussing them with your child’s healthcare team.

Some supplements can interact with medications, and the right dose depends on your child’s age, weight, diet and blood results.

🧒 Help your child have a healthy relationship with food

IBD can make children feel like food is something they have to be afraid of.

They may worry about:

• needing the toilet after eating

• having an accident at school

• developing abdominal pain

• eating something “wrong”

• being different from their friends.

Where possible, try to keep food positive and normal.

Let your child:

• help choose meals

• participate in shopping

• prepare food

• eat with friends

• enjoy birthday parties

• choose foods they tolerate

• learn about their own symptoms without becoming fearful of food.

Food is part of childhood, culture, family and social life — not just nutrition.

🍕 What about restaurants, parties and holidays?

Your child doesn’t need to miss out on every social event involving food.

Planning ahead can help.

You might:

• check the menu beforehand

• bring a familiar food if necessary

• make simple adjustments to meals

• pack snacks

• ensure your child has access to fluids

• make sure they know where the toilets are.

The aim is to help your child participate rather than making food another reason to stay home.

💬 When should I see a dietitian?

Ask your child’s IBD team about an IBD-focused paediatric dietitian if your child:

• is losing weight

• isn’t growing as expected

• has a poor appetite

• avoids many foods

• has nutritional deficiencies

• struggles to eat during flares

• needs nutritional supplements

• is following a restrictive diet

• has suspected food intolerances

• is becoming anxious or fearful around food.

A dietitian can help you make dietary changes while protecting your child’s nutritional needs.

❤️ The big picture

There is no perfect food list for children with IBD.

Your child may have foods they tolerate well and foods that make their symptoms worse. Those can change over time.

The goal isn’t to create a diet where your child can only eat a handful of “safe” foods.

It’s to help them have enough variety, enough nutrition and enough flexibility to grow, develop and enjoy life.

Remember:

Food can affect symptoms without causing IBD.

There is no universal IBD diet for every child.

Restrictive diets can create nutritional problems.

Growth and nutrition are just as important as symptom control.

Your child’s IBD team and dietitian can help you work out what is right for them.

🌟 Most importantly

If food has become stressful in your home since your child’s IBD diagnosis, you don’t have to figure it out alone.

Ask your child’s IBD team for help.

A personalised nutrition plan can take into account your child’s Crohn’s disease or ulcerative colitis, symptoms, growth, nutritional needs, treatment, food preferences and family life.

The goal isn’t to make your child’s diet perfect.

It’s to help your child eat, grow, feel well and be a kid.