Carefully managing gluten introduction to infants at risk for celiac disease, has been common practice for years. Doctors believed the timing of gluten introduction could actually offer protection against celiac.
But late last week, that thinking changed.
A report out of the Massachusetts General Hospital Center for Celiac Research and Treatment and published in the New England Journal of Medicine shows that timing of gluten introduction didn’t matter when it came to a child getting celiac disease. The news release from Mass General quoted Carlo Catassi, MD, co-director of the Center for Celiac Research and Treatment and principal investigator of the study, when it said the research found the loss of tolerance to gluten was actually a “dynamic process and that neither breastfeeding nor delaying the introduction of gluten-containing foods provides significant protection against the disorder.”
The magic age of 4-7 months old was supposed to be the “sweet spot” in gluten introduction in at-risk kids. But that too was debunked.
Alessio Fasano, M.D. Founder and Director of the Center for Celiac Research said in the news release, “Of the several factors we studied, it’s very clear that genetic background is by far the most important in determining which infants will develop this autoimmune condition. We were particularly surprised that breastfeeding at any age provided no protective effect.”
This study had 700 infants broken into two groups. One group introduced gluten at 6-months-old and another group introduced gluten at 12-months-old. Researchers found by year 5 of the study, there were 64 children diagnosed with celiac from the 6-month group and 53 diagnosed with celiac from the 12-month group. Researchers called the difference between the two numbers statistically insignificant. Researchers will continue to look into additional prevention efforts.
So what does this mean for parents out there who are in this situation now? I am not a medical professional. In the news release, doctors suggested HLA genotyping would at least let practitioners know if the child has the HLA DQ2 and/or HLA DQ8 genes which increases the chance of getting celiac disease. I would recommend talking with your gastroenterologist or a pediatric GI. You could even print up the news release and the abstract to the NEJM publication for them. Just see what they think.