The nurse in a community health clinic is talking with the parent of a child with celiac disease. Which statement would require follow up by the nurse?

• A. I can feed my child oatmeal and eggs for breakfast.
• B. I can feed gluten-free pasta for lunch.
• C. I should avoid corn products.
• D. I can switch to rice cereal without worry.

Answer: (A)

In celiac disease, the goal is a strict gluten-free diet because even small amounts of gluten can trigger intestinal damage. Oats are tricky: they are naturally gluten-free, but they’re often processed in facilities that also handle wheat, barley, or rye, which can contaminate them with gluten. Some people with celiac disease can tolerate certified gluten-free oats, but many require confirmation of gluten-free labeling and sometimes a trial under medical guidance. Because the statement mentions feeding oatmeal, it would require follow-up to verify that the oats are specifically certified gluten-free and processed in a gluten-free facility.

The other options are compatible with a gluten-free plan. Gluten-free pasta avoids gluten-containing grains, corn products are naturally gluten-free (though one would still check labels for any additives), and rice cereal is also gluten-free. The important point is not to assume all oats are safe unless they’re clearly labeled gluten-free, and to assess the product’s processing for potential gluten contamination.