New infant feeding advice came out from researchers in Australia and surrounding countries (known as Australasia ) discussing that it is possible waiting longer to introduce top food allergens to a baby, may not actually prevent them from developing the allergy.
I know celiac disease is not an “allergy” to gluten, but many of us who have celiac or have children with celiac waited for at least the first year to give our babies any sort of gluten products, so I thought the celiac community would be interested to hear about this research and advice. Plus, I did some additional research specifically on gluten introduction which will hopefully educate parents about our options.
The Australasian Society of Clinical Immunology and Allergy‘s report published this month brought up some big points I think are worth highlighting:
Exclusion of allergenic foods from the maternal diet has not been shown to prevent allergies.
Infants are unlikely to develop a new allergy to any milk that is already tolerated, if it is given regularly.
There is insufficient evidence to support previous advice to specifically delay or avoid potentially allergenic foods for the prevention of food allergy or eczema. This also applies to infants with siblings who already have allergies to these foods.
From 4-6 months: When your child is ready, consider introducing a new food every 2-3 days according to what the family usually eats (regardless of whether the food is thought to be highly allergenic.
How does this compare to advice in the US? Earlier this year the American Academy of Pediatrics backed off its previous recommendation of delaying introduction of allergens to children. Another US study found 6 months to be a good time to begin introducing certain allergens into the diet.
Introducing Gluten
However, a 2005 study in the Journal of the American Medical Association looked much more specifically at celiac disease and introduction of gluten. It found the best time for gluten introduction was between 4-6 months. Introducing it before or after that time tended to increase the chance for celiac disease. But also breastfeeding appears to play an important role. A study out of Sweden recommended breast feeding while introducing small amounts of gluten, was an ideal way to go. A celiac group in Canada profiled the Swedish study saying “…continuing breast-feeding while gluten-containing foods (i.e., foods containing wheat, rye and barley) are being introduced into a child’s diet, protects toddlers and young children from presenting with the classic symptoms of celiac disease.”
So it’s a lot of information, what should you do? A one sentence summary says according to the research—gluten introduction for a baby between 4-6 months of age may be the best time. That timeline appears to also be good with some other food allergens as shown in the above cited studies, while other allergens could be introduced later in childhood. Clearly talk with your pediatrician, pediatric gastroenterologist or allergist about your desires and their clinical recommendations. Then you can decide what is best for you and your family.
Tags: advice, dairy, food allergies, gluten, guidelines, research
December 23rd, 2008 at 8:11 am
Amy
Hmmm. This makes me think. I was breastmilk only for the first 6-8 months with both my kids. We did try a little rice cereal at 4 months, but gave it up. (One officially diagnosed with cd and the other probably has it too. ) But, what about the elders of the family who probably had it and all the older people I meet with cd? The childrearing beliefs at that time didn’t delay solid food like my crunchy, attachment parenting, long-term breastfeeding circle did. Glad that all angles of cd and how we get it are being pursued agressively these days.
Wendy
December 23rd, 2008 at 9:33 pm
This was a big issue for my wife and I. It drove me to attend the last annual Celiac Symposium in New York City in 2007. This is a physician conference (I’m not a physician but have a biology background).
There were two different studies we found helpful;
(1) The first had been conducted in Scandinavia and talked about a large population (I recall it being about 8,000) of infants being observed. Avoiding early introduction of gluten didn’t reduce the likelihood of Celiac. Early introduction of gluten did show a reduced likelihood of Celiac symptoms. The oldest children in the study were in their late teens at the time the presenter had last updated her survey.
(2) A different survey had been done by a researcher in the mountain West (CO I believe) who followed a smaller population (<50) children to see the combination of nursing strategy and amount of gluten that they were given. I believe all of them had a genetic disposition to Celiac. The summary was that the group that nursed for a fairly long time (up to about 1 year) and was simultaneously exposed to a medium (yes, not a very scientific measure) amount of gluten had the lowest likelihood of becoming symptomatic.
We walked away with the following plan; (i) nurse our child for as long as possible, with the goal being out to one year, (ii) systematically introduce gluten in his diet at about 3 months. This wound up being a moot point, as we did the cheek swab DNA test by Kimball genetics the day he was born and he was not genetically pre-disposed.
April 23rd, 2012 at 4:18 pm
When my doctor said I should eliminate all grains from my diet it didn’t sound good. But after a few short weeks I started to get my energy back. The difference is remarkable! No longer have bloating and people have mentioned how much healthier and slimmer I look. Some people say it’s hard to adjust to a gluten diet, but I have had a wonderful time trying out all the new foods and methods of cooking.
January 7th, 2013 at 7:28 am
There was a 10 year study conducted which showed that of fifty one children who developed coeliac disease autoimmunity those who were exposed to gluten in their first three months of life exhibited a 5 times increased risk of coeliac disease autoimmunity than the children who were exposed to gluten later in life i.e. at four or six months old. Furthermore and unexpectedly, children exposed to gluten for the first time at age seven months or after, showed an increased hazard ratio when compared to children introduced to gluten at four to six months of age. This study indicated a connection to gluten introduction and the age ay which gluten was introduced into the childs’ diets and seems to indicate the existence of a “sweet spot period” for gluten introduction.