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BREASTFEEDING & GLUTEN…LOTS OF QUESTIONS, NOT MANY ANSWERS

When is the best time to introduce gluten to my baby? Will breastfeeding protect my child from developing celiac disease later in life? These and many more questions families ask me in hope to get at least some answers, but unfortunately there is not enough science to give any definite advice.


In any case, we do know a few little things! And here are some useful points:


- It has long been thought that prolonged breastfeeding may help to reduce the likelihood of celiac disease in children; however, there is still no solid evidence to support this theory. You may come across a few studies that showed that the gradual introduction of gluten-containing foods to breastfed infants (4-6 months) may reduce the risk of celiac disease; however, a lot of those studies were observational and therefore cannot be used to support or dispute this theory.


- At this moment we believe that it is impossible for a baby to develop celiac disease while being breastfed, because to develop this disease you need to be exposed to an adequate amount of gluten. Even if mom is eating gluten-containing foods, and even if some amount of gluten gets into the milk, the amount that the baby will get will not be enough to trigger onset. In fact, some scientists believe that gluten that passed through the breast milk is helping to "train" a baby's immune system to cope with it better. Again, we are just guessing here. There are plenty of formula-fed babies who didn’t develop celiac disease despite being “at risk”, so it is definitely not an all or none case.


- Although there are no official guidelines, many health care providers who work with celiac disease families recommend to distinguish babies “at risk” (who have at least one first-degree family member with celiac disease) from babies “not at risk”. For babies at risk, they suggest that as part of a prevention strategy, gluten-containing foods should still be introduced as usual (4-6 months), but it may help if (until 2 years of age) the number of gluten-containing foods is relatively small and includes healthy grains, not processed (refined).⁠ I think this is decent advice regardless if it truly helps with prevention or not, as healthy grains will offer many important nutrients for a growing baby.


As ever, this is just a short recap. Always talk to your doctor and celiac disease dietitian to determine what is best in your case. Love you all and til next!



References:

Lebwohl, B., Murray, J. A., Verdú, E. F., Crowe, S. E., Dennis, M., Fasano, A., Green, P. H., Guandalini, S., & Khosla, C. (2016). Gluten Introduction, Breastfeeding, and Celiac Disease: Back to the Drawing Board. The American journal of gastroenterology, 111(1), 12–14. https://doi.org/10.1038/ajg.2015.219


Ivarsson A, Hernell O, Stenlund H, Persson LA. Breast-feeding protects against celiac disease. Am J Clin Nutr. 2002 May;75(5):914-21. doi: 10.1093/ajcn/75.5.914. PMID: 11976167




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