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Timing Key When Introducing Gluten to Baby

By HospiMedica International staff writers
Posted on 31 Oct 2013
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The risk of celiac disease (CD) is higher in children introduced to gluten after six months of age and in those breastfed longer than 12 months, according to a new study.

Researchers at the Norwegian Institute of Public Health (FHI; Oslo, Norway) conducted a study to examine the optimal time window of gluten introduction with regard to the risk of CD in children. To do so, CD was identified in children participating the Norwegian Mother and Child Cohort Study, a prospective birth cohort including 107,000 children, using questionnaires and by linkage to the Norwegian Patient Register. Gluten introduction was reported monthly from 0–6 months of age, and breastfeeding from 0–18 months.

The researchers studied the 1,560 children identified with CD between 1994 and 2004, and followed them for a mean of 4.8 years; of these children, 51 had CD antigens. The analysis revealed that children who were exposed to gluten within the first 3 months of life were five-times more likely to have the antigens, compared with those introduced to gluten at 4-6 months. There was no significant impact on the development of CD in those who received gluten at 4 months of age or earlier, but children introduced to gluten at 7 months of age or beyond were 27% more likely to develop CD by age two. The study was published on October 7, 2013, in Pediatrics.

“We found a higher rate of celiac disease in infants who breastfed longer than 12 months compared with six months,” concluded lead author Ketil Stordal, MD, PhD, and colleagues. “The hypothesis of a protective effect of breastfeeding during gluten introduction could not be supported by our data, but the sample size in this part was too small to draw firm conclusions.”

CD is an autoimmune disorder of the small intestine that occurs in genetically predisposed people of all ages from middle infancy onward. It is caused by a reaction to gliadin, a gluten protein found in wheat, and similar proteins found in the crops of Triticeae, which includes other common grains such as barley and rye. Symptoms include a pale, loose, and greasy stool (steatorrhoea), pain and discomfort in the digestive tract, chronic constipation and diarrhea, failure to thrive (in children), anemia, and fatigue.

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Norwegian Institute of Public Health

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