What should my child eat with IBD?

“What should my child eat?” is one of the first questions many parents ask after an IBD diagnosis.

It can be especially difficult when your child has Crohn’s disease or ulcerative colitis and certain foods seem to make their symptoms worse.

The good news is that there isn’t one universal IBD diet for children. What works for one child may not work for another, and what your child tolerates can change depending on whether their IBD is active or in remission.

For children with IBD, the goal isn’t simply to find foods that don’t cause symptoms. Good nutrition is also about getting enough energy, protein, vitamins and minerals to support growth, development, healing and everyday life.

🥗 There isn’t one “IBD diet”

Crohn’s disease and ulcerative colitis affect children differently, and food tolerance can vary enormously.

There is currently no single diet that every child with IBD should follow.

Your child’s food choices may depend on:

• whether their IBD is active or in remission

• where their inflammation is located

• their symptoms

• whether they have complications such as a narrowing of the bowel

• their growth and weight

• nutritional deficiencies

• food allergies or intolerances

• their medications

• cultural and family food preferences.

Some specialised nutrition approaches can be used in paediatric IBD, including exclusive enteral nutrition (EEN) for some children with Crohn’s disease. These should only be undertaken with guidance from your child’s IBD team and dietitian.

🌱 What should my child eat when they are well?

When your child’s IBD is well controlled, the aim is generally to have as varied and nutritious a diet as they can comfortably tolerate. A balanced diet can include foods from a range of food groups.

🍗 Protein

Protein helps children grow and repair body tissues.

Depending on what your child eats and tolerates, protein can come from:

• chicken and other poultry

• fish and seafood

• eggs

• meat

• dairy or dairy alternatives

• tofu and other soy foods

• beans and lentils

• nuts and nut butters

• seeds.

Children with active IBD may have increased nutritional needs, so adequate protein and overall energy intake can be particularly important.

🍞 Carbohydrates and grains

Carbohydrates provide energy for growing bodies.

Depending on your child’s tolerance, these might include:

• bread

• rice

• pasta

• oats

• cereals

• potatoes

• sweet potatoes

• other grains.

There is no need to automatically remove gluten or grains from your child’s diet unless their healthcare team has identified a specific reason to do so.

🍎 Fruit and vegetables

Fruit and vegetables provide important vitamins, minerals and fibre.

Some children tolerate them easily, while others may find certain types difficult during an IBD flare.

You may find that your child tolerates:

• cooked vegetables better than raw

• peeled fruit better than fruit with skin

• softer foods better than crunchy foods

• smaller portions better than large amounts.

This doesn’t mean your child needs to avoid fruit and vegetables permanently. Sometimes changing the type, texture or amount can make a food easier to tolerate.

🥑 Healthy fats

Fats provide energy and help the body absorb certain vitamins.

Depending on tolerance, examples include:

• avocado

• olive oil

• nut butters

• nuts and seeds

• oily fish.

For children who are struggling to maintain their weight, adding energy-dense foods can sometimes help increase calories without requiring a much larger meal. Your child’s dietitian can help you work out what is appropriate.

🔥 What about food during an IBD flare?

Eating during a flare can be difficult.

Your child may have:

• diarrhoea

• abdominal pain

• nausea

• urgency

• reduced appetite

• fatigue

• weight loss.

Some foods may make symptoms feel worse, even though the food itself isn’t causing the underlying inflammation.

During a flare, some children find that smaller, more frequent meals are easier to manage than large meals. Softer or lower-fibre versions of foods may also be better tolerated temporarily.

For example, your child might tolerate:

• cooked vegetables rather than raw vegetables

• smooth nut butter rather than whole nuts

• peeled or cooked fruit rather than fruit with tough skins

• white rice or pasta

• potatoes without skins

• eggs

• fish or tender chicken

• soups or smoothies, if tolerated.

These are examples rather than a required “flare diet.”

Your child’s individual tolerance matters.

💧 Don’t forget fluids

Diarrhoea and vomiting can increase the risk of dehydration.

Encourage your child to drink regularly, and ask their healthcare team what fluids or oral rehydration products are appropriate if they are losing a lot of fluid.

Signs of dehydration can include:

• very dark urine

• urinating less often

• dry mouth

• dizziness

• unusual sleepiness or weakness.

If your child is significantly dehydrated or unable to keep fluids down, seek medical advice promptly.

🚫 Does my child need to avoid certain foods?

This is one of the hardest parts of IBD nutrition.

You may hear that children with IBD should avoid:

• dairy

• gluten

• sugar

• spicy foods

• fruit

• vegetables

• fibre

• processed foods

• red meat.

But there isn’t a universal list of foods that every child with Crohn’s disease or ulcerative colitis needs to avoid.

Some foods can worsen symptoms for an individual child, particularly during a flare, but that doesn’t necessarily mean the food is causing their IBD or intestinal inflammation.

If you notice a consistent pattern with a particular food, talk to your child’s IBD team or dietitian before removing it permanently.

📝 Keep a food and symptom diary

If you’re struggling to work out whether certain foods are affecting your child’s symptoms, a simple food and symptom diary can be useful.

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?

Other: Appetite, energy, nausea or urgency.

Try to look for patterns over time, rather than assuming that one difficult day means a particular food is a problem.

A food diary can also help your dietitian identify whether removing a food has created a nutritional gap.

⚖️ Be careful about restrictive diets

It’s understandable to want to try anything that might help your child. But removing lots of foods can create problems, particularly for growing children.

Restrictive diets can increase the risk of:

• inadequate calorie intake

• vitamin and mineral deficiencies

• weight loss

• malnutrition

• anxiety around food

• disordered eating.

This is particularly important in children because nutrition supports both growth and development.

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

📈 What about weight and growth?

Growth is an important part of managing paediatric IBD.

Your child’s healthcare team may regularly monitor:

• weight

• height

• growth patterns

• appetite

• nutritional intake

• puberty and development

• iron and other vitamin or mineral levels.

Poor growth or unexpected weight loss can sometimes be a sign that your child isn’t getting enough nutrition or that their IBD isn’t adequately controlled.

If you’re worried that your child isn’t eating enough, don’t wait until their next routine appointment to ask for help.

🧲 What about vitamins and minerals?

Children with IBD can be at risk of nutritional deficiencies.

Depending on your child’s IBD, diet and treatment, their healthcare team may monitor nutrients such as:

• iron

• vitamin D

• calcium

• vitamin B12

• folate

• zinc.

Some children may need supplements, but don’t automatically start a long list of vitamins or supplements.

The right supplement and dose depend on your child’s age, diet, blood results, medication and individual needs. Some supplements can also interact with medications.

🥛 What if my child can’t eat dairy?

Some children with IBD tolerate dairy perfectly well.

Others may have lactose intolerance or another reason to avoid dairy.

If dairy is removed, it’s important to think about what will replace the nutrients it provides, particularly calcium, vitamin D and protein.

A dietitian can help you choose suitable alternatives.

The same principle applies to any food group your child needs to avoid.

Don’t just remove it — replace the nutrients.

🍽️ What if my child barely wants to eat?

A poor appetite can happen during an IBD flare.

Rather than expecting your child to eat three large meals, you could try offering smaller meals and snacks throughout the day.

Energy and protein can sometimes be increased by adding nutrient-dense foods your child tolerates.

For example:

• nut butter

• avocado

• eggs

• olive oil

• yoghurt or a suitable alternative

• cheese or a suitable alternative

• smoothies

• nutritional supplements recommended by your healthcare team.

If your child is losing weight, eating very little or struggling to meet their nutritional needs, ask for help from their IBD team or dietitian.

Some children may need nutritional support therapy, including oral nutritional supplements or, in some circumstances, enteral nutrition.

🧒 Let your child have a say

Food can quickly become a source of stress after an IBD diagnosis. Where possible, involve your child in decisions about food.

Depending on their age, they can:

• choose meals

• help with shopping

• prepare simple foods

• read food labels

• help plan school lunches

• identify foods they tolerate

• learn what their body feels like when they’re hungry or full.

This can help children gradually develop the skills they’ll need to manage food and nutrition independently as they grow older.

🎂 Can my child still eat birthday cake and have treats?

Yes.

Having IBD doesn’t mean your child can never enjoy birthday parties, holidays, restaurants or their favourite foods.

Food is about much more than nutrition. It’s also about family, friendships, culture, celebrations and enjoyment.

If a particular food regularly causes symptoms, you can work with your child and their dietitian to find an alternative.

The goal isn’t to make food frightening or complicated.

It’s to help your child get the nutrition they need while still enjoying food and participating in everyday life.

🏫 What about school lunches?

School can make food more complicated.

Your child may need:

• access to the toilet

• extra snacks

• access to fluids

• a packed lunch

• medication during the school day

• flexibility around eating during a flare.

If your child has significant dietary or nutritional needs, speak with their school and healthcare team about what support would be helpful.

💬 When should I ask for help?

Speak with your child’s IBD team or dietitian if your child:

• is losing weight

• isn’t growing as expected

• has a significant drop in appetite

• is avoiding many foods

• has ongoing diarrhoea or vomiting

• is struggling to eat during a flare

• has ongoing abdominal pain around meals

• has suspected food intolerances

• has nutritional deficiencies

• is becoming anxious or fearful around food.

You don’t have to work this out on your own.

❤️ The most important thing to remember

There is no perfect IBD diet for children.

Your child’s nutritional needs will change as they grow, and what they tolerate may change between a flare and remission.

Rather than focusing on a long list of foods your child can’t eat, try to focus on:

Enough food.

Enough nutrients.

Enough variety.

Enough fluids.

Enough flexibility to enjoy being a kid.

And if you’re worried about your child’s nutrition, ask for help.

An IBD-focused paediatric dietitian can work with your child’s gastroenterology team to create a plan that supports growth, nutrition and IBD treatment while fitting your child’s individual needs.