Celiac Prevention for Babies

Celiac disease rates lower for infants who start gluten earlier

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Parents often wonder when to feed new foods to their baby. New research suggests that introducing wheat early can help babies avoid developing celiac disease.

Researchers in Sweden looked at how children’s early diet might play a role in the likelihood of developing celiac disease.

Children given gluten products at 4 months of age while still breastfeeding had significantly lower chances of developing celiac disease than children who started gluten at 6 months.

"Consult your pediatrician about best foods for babies."

Anneli Ivarsson, MD, of Department of Clinical Medicine at Umeå University in Sweden, and colleagues led a study to find out how babies' diets and the timing of new food introductions could influence their likelihood for getting celiac disease.

Between 1984 and 1996 there was a celiac disease epidemic among children under two years old in Sweden. Many more children developed the disease during this time than before or after.

In order to investigate what might have contributed to the epidemic, the researchers collected data from two groups of children.

The first group consisted of children born in 1993, during the epidemic. The second group of children were born in 1997, after the epidemic had ended.

A total of 13,279 children from five different sites in Sweden participated in the study. They were recruited from their schools when they were 12 years old.

The children that showed signs of celiac disease in their blood were then asked to go to a clinic so doctors could take a small sample of their intestines. These samples were then also tested for signs of celiac disease.

In addition to the medical testing, the children’s caretakers were asked to fill out a detailed questionnaire. This form asked them questions about how long their child breastfed and at what age the child first ate a gluten, or wheat, product.

The children born during the epidemic were breastfed for an average of seven months. The children born after the epidemic were breastfed for longer - an average of nine months.

Children in both groups were first introduced to gluten at an average age of 5 months. However, the babies in the after-epidemic group were more likely to continue breastfeeding after they started eating gluten.

A total of 70 percent of the children born during the epidemic continued breastfeeding after first eating gluten. In comparison, 78 percent of the children born after the epidemic continued breastfeeding after eating gluten for the first time.

The researchers found that the children born after the epidemic were significantly less likely to have developed celiac disease than the children born during the epidemic.

Of the children born during the epidemic, 2.9 percent developed celiac disease. Of the children born after the epidemic, only 2.2 percent had developed celiac disease.

“Our findings suggest that infant feeding affects the risk of developing celiac disease, at least up to the age of 12 years,” the authors wrote.

The researchers noted a potential problem with this study. Since the caretakers answered questions about their children’s diet 12 years after it happened, some might have not remembered the exact age of their baby when they first ate gluten.

This reporting issue was important because there was reason to believe that the children who were born after the epidemic might have started eating gluten products at an earlier age than their caretakers reported.

At the end of the epidemic, the Swedish health department changed its recommendations to parents about when to start feeding their babies gluten products. The new recommendations suggested starting gluten products at 4 months of age instead of the previously recommended 6 months of age.

Research at the time showed that the majority of the parents followed these guidelines. If this were true, the children born after the epidemic would have had a two months’ earlier introduction to gluten than the children born during the epidemic, even though the average reported in this study was closer to 5 months for both groups.

Based on this study, the researchers believe that the earlier introduction of gluten may have helped babies avoid developing celiac disease.

“Our findings suggest that the infant feeding recommendation (to gradually introduce gluten-containing foods in small amounts from 4 months of age, preferably during ongoing breastfeeding) is favorable,” the authors concluded.

The study was published February 18 in the journal Pediatrics.

The research was funded by the European Union, the Swedish Research Council as well as three other Swedish research councils.  The authors report no potential conflicts of interest.

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Review Date: 
February 19, 2013
Last Updated:
December 30, 2013