Gluten is a pretty common word these days. Whether it’s good or bad for you is a popular topic of discussion, and all the information out there can be hard for parents to sort through.

For some children, a gluten-free diet is medically advised, but for most other kids, it is not recommended.

“Before you take your child off gluten, have a conversation with your pediatrician,” says Dr. Pilar Bradshaw.

Understanding gluten
Gluten, a protein found primarily in wheat, rye and barley, is linked to celiac disease-an autoimmune condition in which the lining of the small intestine becomes damaged by consuming gluten. Celiac disease can cause a long list of symptoms including diarrhea, constipation, vomiting, stomach aches, rash, irritability, fatigue, stunted growth, anemia, migraines and hyperactivity.

It’s estimated that one-half to 1 percent of people in the U.S. has diagnosable celiac disease.

In addition to celiac disease, there are two other classes of gluten-related disorders: wheat allergy and non-celiac gluten sensitivity.

According to the American Academy of Pediatrics, a wheat allergy is an immediate, allergic response to wheat protein (IgE-mediated). It can lead to gastrointestinal symptoms and other symptoms seen with celiac disease.

Non-celiac gluten sensitivity is not well defined, and some doctors believe it may only be caused by an intolerance to wheat and not to all gluten-containing grains. The type of intolerance seen in non-celiac gluten sensitivity does not lead to intestinal inflammation, like in celiac disease.

Getting an accurate diagnosis
It’s important to know if what your child has is a true intolerance or allergy. Parents should not be the ones to diagnose celiac or gluten allergies in their kids, says Dr. Bradshaw. Often, another underlying medical issue is the culprit. Celiac disease can be screened with a simple blood test, and if that is the diagnosis, there is support available for families.

“A lot of parents are trying to figure all this out on their own, but there are others who can help you, specialists in the field of feeding and gastroenterology for kids, who can help you put together a plan for your child,” says Dr. Bradshaw.

Talk with your health care provider before you remove gluten entirely from your child’s diet. Starting a gluten-free diet before testing could lead to results that are falsely negative. Even after a positive test kids should continue eating gluten until a procedure called an endoscopy officially confirms the diagnosis. Banning gluten beforehand, then reintroducing it before testing will make most kids who have celiac disease feel much sicker.

Social issues to consider
Removing all gluten-containing products without a diagnosis or dietary plan in place can leave big holes in a child’s nutrition. Severe changes in diet can also be socially isolating for children.

“A lot of kids who have food sensitivities or who are told they can’t eat this or that become highly anxious about exposure to that food,” she says. “I see a lot of behavioral health consequences of telling a kid, ‘Johnny, you can’t have gluten. These are all the foods you can’t eat.'”

If your child is diagnosed with one of these issues, work closely with your child’s pediatrician, and focus on what your child can eat rather than what they can’t.