24174 Late Not Early-Introduction of Gluten to Infants Seems to Increase Celiac Risk - Celiac.com
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Late Not Early-Introduction of Gluten to Infants Seems to Increase Celiac Risk

Celiac.com 11/23/2015 - A new study looks at the impacts of introducing gluten to infants and the development of celiac disease. A research team recently set out to assess the evidence regarding the effect of time of gluten introduction and breastfeeding on the risk of developing celiac disease.

Photo: CC--Sander Van der WelThe research team included MI Pinto-Sánchez, EF Verdu, E Liu, P Bercik, PH Green, JA Murray, S Guandalini, and P Moayyedi. Their team conducted a comprehensive review of studies from the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (Ovid); EMBASE (Ovid); and System for Information on Grey Literature in Europe (SIGLE). Two independent authors collected the data.

Their analysis included randomized controlled trials and observational studies that assessed proper timing for introducing gluten to the infant diet, appropriate quantity of gluten consumption at weaning, and the effect of breastfeeding on celiac disease risk.

Out of a total of 1982 studies they identified, 15 matched their criteria for data extraction. The team performed a meta-analysis on 2 randomized controlled trials, 10 cohort studies, and 1 case-control study. That analysis showed a 25% increase in celiac disease risk with gluten-introduction after 6 months, compared to the recommended 4 to 6 months (risk ratio [RR], 1.25; 95% CI, 1.08-1.45).

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There was no difference between breastfeeding vs no breastfeeding on celiac disease risk (OR, 0.55; 95% CI, 0.28-1.10), with substantial heterogeneity (I2 = 92%) among studies. There is currently no evidence to support that early introduction of gluten to the infant diet increases the risk of celiac disease.

However, introduction of gluten after six months of age might promote an increased risk of celiac disease.

More studies are needed that control for potential confounders and that evaluate environmental factors in low-risk families.

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2 Responses:

 
Laurel
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said this on
30 Nov 2015 4:50:47 PM PDT
This is similar to the results of the LEAP food allergy study which addressed introduction of peanuts and egg and found that toddlers who were introduced later to these foods had a greater chance of developing food allergies.

 
Maris
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said this on
02 Dec 2015 8:34:55 AM PDT
The tough thing here is that an infant can't communicate specifics about how they feel, where an older child can. I know friends who had their infant tested for the "celiac genes" knowing it runs in their family. When they found their child has the genes, they decided not to introduce gluten into the child's diet until the child could use words to describe how he was feeling, This has seemed to work for them, rather than taking a risk that their child would get ill at a developmentally critical point as an infant, had they introduced gluten right away. So far the child is doing well since gluten was gradually introduced into his diet building up to moderate, but not heavy rates, since no good can come of not practicing moderation. They have the child's blood tested at his annual checkup to look for any antibodies that would indicate the celiac gene has "turned on". And the child is old enough now to tell his parents if his tummy hurts after he eats certain things.




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So just to clarify had not consumed any gluten for about 4 days before testing. I was assured by my allergist that it wouldn't affect the test. But what was alarming was that she retested my food allergies (my most recent reaction was two weeks ago) and every food allergy I have came back negative. I don't understand how that is possible. These food allergies developed when I was 20 and I am almost 24 now.

Thanks! You too! I have learned from this experience to take charge of my own health. It's nice at least that we can try the gluten-free treatment without a firm diagnosis or a doctor confirming the disease. I've also felt some of the gluten withdrawal symptoms, and my stomach pain ebbs and flows, but I'm determined to stick with the gluten-free diet to see what a difference it makes. Gemini, thank you! This was really validating and useful for me to hear. I've felt so confused through this process and just want some answers. If the biopsy results do come back negative, I'm going to follow your advice and do the gluten-free diet with repeat blood testing after a while. If they come back positive, well, then I'll have my answer. I'm supposed to get them back next week.

I have celiac and eosinaphalic esophagitis. I was put on a steroid inhaler recently. I use it like an inhaler but swallow the air instead of breathing it in. You may want to look into EOE and it's relationship to celiac. Just a thought. My swallowing and celiac seem to be related.

You have eat gluten every single day until after testing. And the celiac blood test is supposed to be done as well.

If I was the big guy, there's no way I would have to wait 3 and a half weeks for a test lol. My GI doc never recommended the antibody test. He said doing it with the scope was the only sure way to know. Does anybody know if I should eat a little gluten the day before my test to see if I will get an accurate enough test? Or will it not matter, once the damage is done it's done?