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  • Jefferson Adams
    Jefferson Adams

    New Study Says Infant Gluten Introduction Not a Factor in Later Celiac Disease

    Reviewed and edited by a celiac disease expert.

    Celiac.com 03/30/2016 -  New guidelines reverse previous recommendations on infant gluten introduction to prevent celiac disease. What's going on?

    Photo: CC--Cupcake KitschenNew evidence shows that the age of introduction of gluten into the infant diet, or the practice of introducing gluten during breast-feeding, does not reduce the risk of celiac disease in infants at risk.

    Two earlier studies did claim to show that the time of introduction to gluten had an impact on later development of celiac disease. Based on those studies, in 2008, ESPGHAN issued a recommendation to introduce gluten into the infant diet between 4 months and 7 months, and to introduce gluten while the infant is still being breastfed. But since then, two randomized controlled trials have shown that the age at gluten introduction does not affect overall rates, nor does it affect the incidence or the prevalence of celiac disease during childhood.

    The latest findings show that "primary prevention of celiac disease through nutritional interventions is not possible at the present time," says Professor Szajewska of The Medical University of Warsaw, the lead author of the new guidelines. These new guidelines say that parents may introduce gluten into their infant's diet anytime between four to twelve months of age, and that the introduction does not need to be made via breastfeeding.

    It remains true that, according to study data, earlier gluten introduction does cause the celiac disease to present at an earlier age. However, current evidence indicates that neither breastfeeding, nor breastfeeding during gluten introduction can reduce the risk of celiac disease.

    The new evidence shows no difference in celiac disease risk when gluten is introduced while the infant is still breast-feeding, compared to after weaning. Because breastfeeding has many other health benefits, doctors recommend it for all infants, regardless of celiac disease risk.

    The updated recommendations are based on studies of infants with known risk genes for celiac disease. However, because parents don't often know this at the time solid foods are introduced, the recommendations apply to all infants.

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    When I first had my children, I kept them off gluten for their first year. Not because it might or might not help prevent later celiac disease - I actually hadn't heard any of these recommendations then, and besides they seem to change every year or so anyway - but because WHAT IF they actually had it right out of the gate? Not outside the realm of possibility with the genetic component, and it is wicked hard to diagnose celiac in infants. Obviously, I am more educated about celiac then most (having it myself), and would probably spot it faster than someone who didn't know what it was, but babies are just so tiny, and they're developing so much and so fast during that first year, I didn't want to risk malnutrition issues for even a short time. It was challenging, especially with my oldest, to find baby snacks (like crackers and stuff they can self-feed) that were gluten-free, but we managed. My kids are now 12, 8 and 5 and no sign of celiac in any of them yet, thank goodness, but I still think it was worth the effort to be sure.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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