Infant feeding history shows distinct differences between Swedish celiac and reference children

Abstract

Infant feeding history was investigated in 72 celiac and 288 age-matched reference children in a retrospective questionnaire study. The reply rate was 100% in celiac and 91.6% in reference children. The celiac children were breast-fed for a significantly shorter time than reference children, and they were less often breast-fed at the introduction of gluten. The age of the children at gluten introduction was similar, but the celiac children were significantly more often introduced by a gluten-containing follow-up formula, while the reference children more often started on a gluten-containing porridge. The results can be interpreted in two ways. First, it could be argued that breast milk per se protects against symptoms of celiac disease in childhood. It could, however, also be claimed that breast-feeding merely modulates the gluten introduction, causing a less abrupt introduction of gluten in the baby diet and thereby fewer overt symptoms of the disease.

Timing of Introduction of Gluten and Celiac Disease Risk

“…The protective effect in children <2 years was stronger in those being breastfed beyond the introduction of gluten (OR = 0.36; 95% CI = 0.26–0.51). Two other studies [44,46] found similar results while a case-control study controlling for HLA status found no association between breastfeeding at the time of gluten introduction and CD; however, this study was only based on 8 cases with silent CD [45]. …”

“…However, randomized trials are lacking and with few exceptions [28,39,41], existing studies have been based on retrospectively collected data [42,43,44,45,46,47]. The largest case-control study so far is that by Ivarsson et al [46], where the authors found a reduced risk of future CD in children aged 0–1.9 years at diagnosis but not in children aged 2.0–14.9 years at diagnosis.…”

Gut Microflora Associated Characteristics in Children with Celiac Disease

“…1; modified from Ivarsson, 2000;. Other pathogenetic factors of importance for childhood CD are length of breast-feeding (Fälth-Magnusson et al, 1996;Peters et al, 2001;Ivarsson et al, 2002;Akobeng et al, 2006) and intercurrent infections (Ivarsson, 2003).…”

Studies of Mucosal Immune Regulation in Celiac Disease and Type 1 Diabetes

“…The major environmental trigger is ingestion of gluten, the protein fraction of wheat, barley and rye. Studies have shown that environmental factors such as breast-feeding as well as gluten introduction during weaning at the age of 4-6 months have a protective effect on early disease development [65][66][67][68], whereas infections, such as rotavirus infections, have been suggested to increase the risk for CD [69][70][71][72][73] and type 1 diabetes (T1D) [74]. Furthermore, differences in the composition of the microbiota have been reported in patients with active CD and patients on a GFD compared with healthy controls, and may be involved in CD pathogenesis [75][76][77][78].…”