Breastfeeding and celiac disease: To breastfeed or not? That is the question!
Jean E. Guest, MS, RD, LMNT
The American Academy of Pediatrics strongly recommends breastfeeding as the preferred source of nutrition for all infants. In addition to being nutritionally complete breast milk provides immune factors not available in commercial formulas. Breast milk feedings also benefit the infant's gastrointestinal function, neurological development, and psychological well-being.
An interesting fact about breast milk is that nutrient composition changes as nutritional needs of the infant change. Breast milk analysis indicates that nutrient composition changes from beginning to end of a feeding and as the infant grows. Likewise, breast milk nutrient composition in mothers with premature infants is different from that of mothers with full-term infants. Maybe Mother Nature knows best!
More recent research into the relationship between breastfeeding and CD seems to support the conclusions of earlier researchers. In 2001, Peters et al., studied the duration of breastfeeding, age at first gluten introduction into the infant's diet, and the age of CD onset. In an age and gender case-control methods, these researchers evaluated 143 children with CD and 137 randomly selected non-CD children. Their results indicated that breastfeeding for at least two months significantly decreased (63 percent) risk of developing CD. Similar to the results of Greco et al., the age at first dietary gluten exposure was not significant in this study either.
However, in 2002 Ivarsson et al. in a much larger study were able to show that risk of CD was reduced in children less than two years of age if they were being breast fed at the time dietary gluten was introduced. The risk was also reduced if the amount of gluten introduced was a small or medium amount when compared to large amounts. Additionally, the protective effect of breastfeeding was pronounced if breastfeeding was continued after introduction of dietary gluten. These researchers concluded that gradual introduction of gluten-containing foods while infants are still being breastfed is beneficial in reducing risk of CD and this benefit may extend into early childhood.
American Academy of Pediatrics. Pediatric Nutrition Handbook , 5th ed. Ronald E. Kleinman, editor. American Academy of Pediatrics, 2004.
Auricchio S, Follo D, de Ritis G, Giunta A, Marzorati D, Prampolini L, Ansaldi N, Levi P, Dall'Olio D, Bossi A, et al. "Does breast feeding protect against the development of clinical symptoms of celiac disease in children?" J Pediatr Gastroenterol Nutr . 2(3):428-33, 1983.
Greco L, Auricchio S, Mayer M, Grimaldi MJ. "Case control study on nutritional risk factors in celiac disease." Pediatr Gastroenterol Nutr . May-Jun;7(3):395-9, 1988.
Greco L, Mayer M, Grimaldi M, Follo D, De Ritis G, Auricchio S. "The effect of early feeding on the onset of symptoms in celiac disease." J Pediatr Gastroenterol Nutr . Feb;4(1):52-5, 1985.
Ivarsson A, Hernell O, Stenlund H, Persson LA. "Breast-feeding protects against celiac disease." Am J Clin Nutr., May; 75(5):914-21, 2002.
Ozkan T, Ozeke T, Meral A. "Gliadin-specific IgA antibodies in breast milk." J Int Med Res. Sep-Oct;28(5):234-40, 2000.
CSA Library Series
CSA Library Series is a collection of articles that pertain to celiac disease and dermatitis herpetiformis. Most of these articles have appeared in CSA’s quarterly newsletter, Lifeline, which all CSA members receive. Historic articles included in these resources may or may not include updated notes. Updated information indicated in red type. Articles represent the work of the author.