A Case-Control Study of the Effect of Infant Feeding on Celiac Disease

Abstract

Aims: The aim of this study was to investigate the association between the duration of breast-feeding and the age at the first gluten introduction into the infant diet and the incidence and age at onset of celiac disease. Methods: In a case-control study, 143 children with celiac disease and 137 randomly recruited gender- and age-matched control children were administered a standardized questionnaire. Multivariate-adjusted odds ratios (OR) as estimates of the relative risk and corresponding 95% confidence intervals (95% CI) were calculated. Results: The risk of developing celiac disease decreased significantly by 63% for children breast-fed for more than 2 months (OR 0.37, 95% CI 0.21–0.64) as compared with children breast-fed for 2 months or less. The age at first gluten introduction had no significant influence on the incidence of celiac disease (OR 0.72, 95% CI 0.29–1.79 comparing first gluten introduction into infant diet >3 months vs. ≤3 months). Conclusions: A significant protective effect on the incidence of celiac disease was suggested by the duration of breast-feeding (partial breast-feeding as well as exclusive breast-feeding). The data did not support an influence of the age at first dietary gluten exposure on the incidence of celiac disease. However, the age at first gluten exposure appeared to affect the age at onset of symptoms.

Age at Gluten Introduction and Risk of Celiac Disease

“…10 However, 2 other studies from Sweden and Germany found no association between timing and risk for CD, suggesting that there might be differences in the risk factors by country of residence. 7,24 Because our study cohort comprised children from 4 different countries, we tested for this heterogeneity by applying a model that included the interaction between age at gluten introduction and country, and it was not statistically significant (data not shown), suggesting that the associations did not vary by country. We adjusted for country of residence in our analyses to remove possible effects such as country-specific infant feeding practices.…”

“…Several studies hypothesized that the age at first introduction to gluten could influence the onset of the disease. [6][7][8][9][10][11] Others claim that breastfeeding and its interaction with gluten during weaning could reduce the risk for CD. 12,13 Today, the general recommendation is to introduce small amounts of gluten while the infant is still breastfed, preferably between 4 and 6 months of age.…”

Effect of Breast-Feeding on Risk of Coeliac Disease: A Systematic Review and Meta-Analysis of Observational Studies

“…Greco et al compared children breast fed for at least 90 days with children breast fed for more than 90 days, 22 Peters et al compared children breast fed for more than 2 months with those breast fed for less than 2 months, 4 and Auricchio et al compared children breast fed for more than 30 days with those breast fed for less than 30 days. 5 Falth-Magnusson et al 23 and Ascher et al 6 compared the median time of both exclusive and partial breast feeding in cases and controls.…”

“…3 They found that the risk of the disease was reduced in children if they were breast feeding at the time of introduction of dietary gluten. Peters et al 4 and Auricchio et al 5 also showed that breast feeding was associated with a reduced risk of developing childhood CD. While these and other observational studies have suggested that breast feeding might reduce the risk of CD, at least one study did not find such an association.…”

Celiac disease. From the pathogenesis to the treatment

“…Риск, ве роятно, обусловлен наследственной тенденцией взаимодействия с различными факторами окружа ющей среды, включающими питание, распростра ненность гастроэнтерита и наличие грудного вскармливания [11]. Результаты нескольких иссле дований показывают протективные свойства груд ного вскармливания в отношении целиакии в дет ском возрасте [12][13][14].…”