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

Abstract

Background: Coeliac disease (CD) is a disorder that may depend on genetic, immunological, and environmental factors. Recent observational studies suggest that breast feeding may prevent the development of CD. Aim: To evaluate articles that compared effects of breast feeding on risk of CD. Methods: Systematic review and meta-analysis of observational studies published between 1966 and June 2004 that examined the association between breast feeding and the development of CD. Results: Six case-control studies met the inclusion criteria. With the exception of one small study, all the included studies found an association between increasing duration of breast feeding and decreased risk of developing CD. Meta-analysis showed that the risk of CD was significantly reduced in infants who were breast feeding at the time of gluten introduction (pooled odds ratio 0.48, 95% CI 0.40 to 0.59) compared with infants who were not breast feeding during this period. Conclusions: Breast feeding may offer protection against the development of CD. Breast feeding during the introduction of dietary gluten, and increasing duration of breast feeding were associated with reduced risk of developing CD. It is, however, not clear from the primary studies whether breast feeding delays the onset of symptoms or provides a permanent protection against the disease. Long term prospective cohort studies are required to investigate further the relation between breast feeding and CD.

Systematic review with meta‐analysis: early infant feeding and coeliac disease – update 2015

“…Tables to summarise the characteristics of the included studies. In addition to the previously identified 12 studies, 9 new publications were identified, including three RCTs described in four publications . Two publications described the same population at different time points.…”

Regional variation in celiac disease risk within Sweden revealed by the nationwide prospective incidence register

“…CD has a multifactorial aetiology, but still the environmental and life‐style contribution is largely unexplored, besides studies on infant feeding. There is ample evidence that ongoing breastfeeding at the time of gluten introduction reduces CD risk in children younger than 2 years of age (3,4). The duration of this protection is not clear, but the gap in CD risk at 6 years of age, between Swedish birth cohorts differing with respect to infant feeding, supports a long‐term preventive effect (5).…”

“…In addition, breastfeeding duration had increased. These changes resulted in a larger proportion of children gradually introduced to gluten while still breastfed, a pattern suggested reducing CD risk (3,4). Hence, birth cohorts of the epidemic and postepidemic periods differ with respect to infant feeding, and the gap in CD risk between such birth cohorts was still striking at 6 years of age, the longest follow‐up so far available (5).…”

Celiac Disease

“…[4] As for breast feeding, infants who are breast-fed at the time of gluten introduction and beyond are less likely to The recent availability of sensitive and specific serologic tests develop celiac disease later in life. [5] Finally, there is evidence that has now made it possible to assess the true prevalence of celiac repeated rotavirus infections are more frequent in children later disease, as such tests are able to detect cases with the typical who later go on to develop 'celiac disease autoimmunity' than in mucosal changes that are minimally symptomatic, or even asympmatched controls, [6] thus suggesting that such infections may set tomatic. We have therefore learned from screening studies that the stage for later development of celiac disease.…”

“…All rights reserved.Mol Diag Ther 2008; 12(5) Risk Assessment, Diagnosis, and Monitoring of Celiac Disease…”