Early Infant Feeding Practices May Influence the Onset of Symptomatic Celiac Disease

Abstract

PurposeTo study whether breastfeeding and breastfeeding status during gluten introduction influences the age at diagnosis of celiac disease (CD). In addition to study, whether the timing of gluten introduction influences the age at diagnosis of CD.MethodsIt was a hospital based observational study. Total 198 patients diagnosed with CD as per modified European Society of Pediatric Gastroenterology, Hepatology and Nutrition (2012) criteria, aged between 6 months to 6 years were included. Detail history taken with special emphasis on breastfeeding and age of gluten introduction. Standard statistical methods used to analyze the data.ResultsMean±standard deviation age of onset and diagnosis of CD in breastfed cases was 2.81±1.42 years and 3.68 ±1.55 years respectively as compared to 1.84±1.36 years and 2.70±1.65 years respectively in not breastfed cases (p<0.05). Those who had continued breastfeeding during gluten introduction and of longer duration had significantly delayed onset of disease. The age at onset of CD was under one year in 40.42% of the cases, who had started gluten before 6 months of age compared to only 12.58% of those who had started gluten later (p<0.001). The proposed statistical model showed that two variables, i.e., breast feeding status during gluten introduction and age at gluten introduction positively influencing the age at diagnosis of CD.ConclusionDelayed gluten introduction to infant's diet along with continuing breastfeeding, delays symptomatic CD. However, it is not clear from our study that these infant feeding practices provide permanent protection against the disease or merely delays the symptoms.

Diagnostic challenges of celiac disease in a young child

“…Therefore, a recent study performed by Vajpayee et al on pediatric patients found that breastfeeding at the time of gluten introduction to an infant's diet and beyond this moment will delay the age of CD diagnosis. [19] Similarly, a meta-analysis conducted by Akobeng et al also stated that infants still breastfed at the moment of gluten introduction to the diet presented a 52% lower risk of developing CD. [20] Nevertheless, prospective studies failed in proving the protective role of breastfeeding against the development of CD in small children.…”

Eosinophilic Esophagitis: Leaky Gullet or Leaky Gut?

“…Further, why should some atopic diseases such as asthma ( 12 ), atopic dermatitis ( 13 ), and celiac disease ( 6 ), be associated with altered small bowel permeability but not EoE? Th ey are all at least partly antigen driven, and may share similar microbiome risk factors such as lack of breast feeding, early exposure to antibiotics and higher likelihood of Cesarian section (14)(15)(16)(17). I would speculate these groups of diseases are more likely to have a similar core pathophysiology.…”