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    Breast Feeding and Celiac Disease


    Scott Adams

    This article comes to us from Karoly Horvath, M.D., khorvath@POL.NET, who is one of the two directors of the celiac center at University of Maryland in Baltimore.


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    Breast milk contains antibodies against all the antigens the mothers immune system has met prior to or during the pregnancy and has produced antibodies to them.

    This system is the wisdom of nature and this is the way that mothers milk protects babies from all the antigens (infectious agents, toxins etc.) occurring in the environment where the mother lives. These antigens without this protection may enter the body through the digestive or respiratory systems. The best example is that breast milk protects babies from bacteria causing diarrheas in the underdeveloped countries.

    The antibodies are produced by the cells (plasma cells) localized in the gut and the lung. These cells are migrating to the lactating breast-tissue for hormonal trigger (enteromammal plasma cell circle) and they continue producing these antibodies in the breast. These antibodies appear in the breast milk. In brief, the breast milk may contain all the antibodies the mother has in her digestive and respiratory systems. The function of these antibodies is to block the entrance of antigens infectious agents, toxins, allergens etc) across the digestive or respiratory tract of babies.

    In case of celiac disease, it means that if the mother has circulating antibodies to gliadin, these antibodies appear in the milk. If the breast fed baby ingests gliadin (or the mother ingests accidentally and traces of gliadin appear in the milk) the antibodies in the milk blocks the gliadin and it will not able to cross the intestinal wall and meet with the babys immunosystem. Theoretically, the breast-fed infant do not have any immunoreaction to gliadin. If the mother accidentally ingests gliadin during breast feeding it is likely that the concentration of antigliadin antibodies become higher in the breast milk.

    To answer the question: the antibodies in breast milk are protective and do not "trigger" celiac disease in genetically predisposed babies. There are several data showing that breast-feeding has a protective effect in case of celiac disease. Furthermore, it is well documented that breast-feeding in the first year of life decreases the risk of allergies by 50% in babies whose parents have allergies.

    As far as the reaction after weaning concerned: it is also known that babies may have some reaction (loose stool or spit up or discomfort) transiently after introducing a new food, however, this is a temporary symptom and not allergy or immunoreaction to the food. It is likely that their digestive system should accommodate to the new foods.

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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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  • Related Articles

    Scott Adams
    I have a big issue with what I believe to be a misleading headline in a recent joint press release by Domino's Pizza and the National Foundation for Celiac Awareness (NFCA)...here is the headline:
    "Domino’s Pizza Becomes First National Pizza Delivery Chain to Offer Gluten Free Crust"
    When you read the release further, starting at the 5th paragraph, which many people will never get to, it says:
    "While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten."
    So my question is this: How can the NFCA, a national organization dedicated to supporting celiacs, actually get behind this? Domino's is obviously a big corporation that has decided it wants to cash in and profit on the new gluten-free gold rush, but they cleary don't want to spend the money that it would take to make their pizzas truely gluten-free, and safe for celiacs.
    The Designations area of the NFCA's web site begins with: "Restaurants that complete GREAT Kitchens earn a designation based on their ability to meet gluten-free needs and avoid cross-contamination with gluten."  Just below this it describes their "Green Designation" and its "Amber Designation," and describes its Amber Designation as follows: "This level requires ingredient verification and basic training of wait staff and managers. Kitchen practices may vary with this designation, level one of the tier system, meaning those with celiac disease and non-celiac gluten sensitivity should ask questions and exercise judgment when dining at an establishment with an Amber Designation. Domino's has earned this designation."  So how has Domino's met "gluten-free needs and avoid cross-contamination with gluten"?
    Also, I think any celiac who watches the video Domino's made for this release will find it a bit scary...the same ovens, pizza scoopers, topping areas, etc., as where they make their regular gluten pizzas.
    I would exclude Domino's as an advertiser on Celiac.com based on this release.
    Some might think that the NFCA has sold out here. I invite them to respond using the comment field below, and I invite you to respond.
     
    Also, there is a lively discussion going on in our forum on this topic.  
    Here is the original press release:
    ANN ARBOR, Mich., May 7, 2012 – Domino's Pizza is responding to the needs of choice consumers, today launching a Gluten Free Crust available in all of its nearly 5,000 U.S. stores and becoming the first national pizza delivery chain to offer such a product.
    Domino’s Pizza (NYSE: DPZ) consulted with the National Foundation for Celiac Awareness (NFCA) to ensure its products and team member training meet the standards of the foundation’s GREAT Kitchens Amber Designation. NFCA’s GREAT Kitchens is an official credentialing program that has expanded to include restaurants offering gluten free products with varying kitchen practices, therefore suitable for those with gluten sensitivity under the Amber Designation.
    Domino’s new Gluten Free Crust provides a great-tasting option for consumers who previously could not enjoy pizza from the recognized world leader in pizza delivery because of sensitivity to gluten – a protein found in wheat, rye and barley.
    “Many of our customers have asked for a gluten free crust, and Domino’s is excited to offer a product to customers with mild gluten sensitivity – as well as partner with the NFCA, which has been instrumental to our learning more about how to take this step,” said J. Patrick Doyle, Domino’s Pizza president and CEO. “The prevalence of gluten sensitivity has become a real issue with significant impact on consumer choice, and we want to be a part of the solution. Now, the whole group can enjoy Domino’s with the addition of our new Gluten Free Crust.”
    While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten.
    “The NFCA is thrilled that Domino’s Pizza has developed a product that will improve the quality of life for many of the estimated 18 million Americans who are gluten sensitive,” said Alice Bast, NFCA founder and president. “Not only is Domino’s Gluten Free Crust a huge win for much of the gluten free community who can now get pizza delivered to their door, it’s also delicious. Customers aren’t going to believe they’re eating a pizza made on a gluten free crust when they try it. And the variety of fresh toppings that are available is a giant leap ahead.”
    In an effort to remain open and informative about Domino’s Gluten Free Crust, Domino’s has created a video on YouTube that allows customers to decide whether this product is suitable for their diet, found here: www.youtube.com/user/dominosvids.
    “Offering Domino’s Gluten Free Crust is a big step for us, and we wanted to make sure we were doing it right,” said Doyle. “Domino’s is doing that by partnering with experts at the NFCA and by empowering the gluten sensitive community with the information they need.”
    Domino’s new Gluten Free Crust is available in stores across the U.S. in a small, 10-inch size only, and prices vary by store.
    Domino’s pizza made with a Gluten Free Crust is prepared in a common kitchen with the risk of gluten exposure. The National Foundation for Celiac Awareness supports the availability of Domino’s Gluten Free Crust, but cannot recommend the pizza for customers with celiac disease. Customers with gluten sensitivities should exercise judgment in consuming this pizza.
    About Domino’s Pizza®
    Founded in 1960, Domino's Pizza is the recognized world leader in pizza delivery.  Domino’s is listed on the NYSE under the symbol “DPZ.”  As of the first quarter of 2012, through its global footprint primarily made up of locally-owned and operated franchises, Domino’s operated a network of 9,810 franchised and Company-owned stores in the United States and over 70 international markets.  During the first quarter of 2012, Domino’s had global retail sales of nearly $1.7 billion, comprised of over $830 million domestically and nearly $855 million internationally.  Domino's Pizza had global retail sales of over $6.9 billion in 2011, comprised of over $3.4 billion domestically and over $3.5 billion internationally. In May 2011, Pizza Today named Domino’s its “Chain of the Year” for the second straight year – making the company a three-time overall winner, and the first pizza delivery company to receive the honor in back-to-back years.  In 2011, Domino’s was ranked #1 in Forbes Magazine’s “Top 20 Franchises for the Money” list.  
     

    Jefferson Adams
    Celiac.com 03/28/2014 - Great news for some celiac and gluten-intolerant folks in Colorado! Legal marijuana sales began in Colorado on Jan. 1, 2014, and new shop owners have been surprised to find a strong the market for marijuana edibles. More and more, makers of these edibles are including gluten-free selections.
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    Firstcoastnews.com

    Jefferson Adams
    Celiac.com 06/13/2014 - As the number of students eating gluten-free continues to rise, colleges and universities are scrambling to keep up with an increasing demand for gluten-free options.
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    That means that interested UW students should call ahead if they plan to attend UW-hosted events that serve food. Once alerted, food services will be sure to provide a gluten-free option, Katz says.
    Kautz says she is pushing to have gluten-tolerance status included in the admission paperwork UW collects for each student.

    Nicole Vela
    Celiac.com 06/17/2014 - Ever notice how much our social lives are based around food? Or how much food is all around us? I took my son to a local children’s exhibit today with shops and about twenty different restaurants, cafes and bakeries we had to walk by. Do I feel bad always having to say no? Of course I do. What mom wouldn’t? There may have been some safe choices but I try to do my research ahead of time when I can call the places to see what their cross contamination procedures are.
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    Unfortunately there are going to be people that don’t food sensitivities seriously. Food allergies are being made fun of in the media too often. Always remember to put your health first.
    I hope that you find what I have shared helpful. Please feel free to share some of the ways you inform others and help the gluten-free community.

  • Recent Articles

    Christina Kantzavelos
    Celiac.com 07/20/2018 - During my Vipassana retreat, I wasn’t left with much to eat during breakfast, at least in terms of gluten free options. Even with gluten free bread, the toasters weren’t separated to prevent cross contamination. All of my other options were full of sugar (cereals, fruits), which I try to avoid, especially for breakfast. I had to come up with something that did not have sugar, was tasty, salty, and gave me some form of protein. After about four days of mixing and matching, I was finally able to come up with the strangest concoction, that may not look the prettiest, but sure tastes delicious. Actually, if you squint your eyes just enough, it tastes like buttery popcorn. I now can’t stop eating it as a snack at home, and would like to share it with others who are looking for a yummy nutritious snack. 
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    Directions (1.5 Servings):
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    Jefferson Adams
    Celiac.com 07/19/2018 - Maintaining a gluten-free diet can be an on-going challenge, especially when you factor in all the hidden or obscure gluten that can trip you up. In many cases, foods that are naturally gluten-free end up contain added gluten. Sometimes this can slip by us, and that when the suffering begins. To avoid suffering needlessly, be sure to keep a sharp eye on labels, and beware of added or hidden gluten, even in food labeled gluten-free.  Use Celiac.com's SAFE Gluten-Free Food List and UNSAFE Gluten-free Food List as a guide.
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    Jefferson Adams
    Celiac.com 07/18/2018 - Despite many studies on immune development in children, there still isn’t much good data on how a mother’s diet during pregnancy and infancy influences a child’s immune development.  A team of researchers recently set out to assess whether changes in maternal or infant diet might influence the risk of allergies or autoimmune disease.
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    They found a high bias risk in nearly half of the more than 250 milk feeding studies and in about one-quarter of studies of other dietary exposures. Evidence from 19 intervention trials suggests that oral supplementation with probiotics during late pregnancy and lactation may reduce risk of eczema. 44 cases per 1,000; 95% CI 20–64), and 6 trials, suggest that fish oil supplementation during pregnancy and lactation may reduce risk of allergic sensitization to egg. GRADE certainty of these findings was moderate. 
    The team found less evidence, and low GRADE certainty, for claims that breastfeeding reduces eczema risk during infancy, that longer exclusive breastfeeding is associated with reduced type 1 diabetes mellitus, and that probiotics reduce risk of infants developing allergies to cow’s milk. 
    They found no evidence that dietary exposure to other factors, including prebiotic supplements, maternal allergenic food avoidance, and vitamin, mineral, fruit, and vegetable intake, influence risk of allergic or autoimmune disease. 
    Overall, the team’s findings support a connection between the mother’s diet and risk of immune-mediated diseases in the child. Maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitization to food, respectively.
    Stay tuned for more on diet during pregnancy and its role in celiac disease.
    Source:
    PLoS Med. 2018 Feb; 15(2): e1002507. doi:  10.1371/journal.pmed.1002507

    Jefferson Adams
    Celiac.com 07/17/2018 - What can fat soluble vitamin levels in newly diagnosed children tell us about celiac disease? A team of researchers recently assessed fat soluble vitamin levels in children diagnosed with newly celiac disease to determine whether vitamin levels needed to be assessed routinely in these patients during diagnosis.
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    Children with newly diagnosed celiac disease showed significantly reduced levels of vitamin D and A. The team recommends screening of vitamin A and D levels during diagnosis of these patients.
    Source:
    BMC Pediatrics

    Jefferson Adams
    Celiac.com 07/16/2018 - Did weak public oversight leave Arizonans ripe for Theranos’ faulty blood tests scam? Scandal-plagued blood-testing company Theranos deceived Arizona officials and patients by selling unproven, unreliable products that produced faulty medical results, according to a new book by Wall Street Journal reporter, whose in-depth, comprehensive investigation of the company uncovered deceit, abuse, and potential fraud.
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    SEC recently charged the now disgraced Holmes with what it called a 'years-long fraud.’ The company’s value has plummeted, and it is now nearly worthless, and facing dozens, and possibly hundreds of lawsuits from angry investors. Meantime, Theranos will pay Arizona consumers $4.65 million under a consumer-fraud settlement Arizona Attorney General Mark Brnovich negotiated with the embattled blood-testing company.
    Both investors and Arizona officials, “could have picked up on those things or asked more questions or kicked the tires more," Carreyrou said. Unlike other states, such as New York, Arizona lacks robust laboratory oversight that would likely have prevented Theranos from operating in those places, he added.
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    Read more at azcentral.com.