From the Clan Thompson newsletter--introducing gluten to an infant

rachelb · 10-21-2006, 02:25 PM

So someone write into the ask the dr column on the Clan Thompson newsletter saying they have celiac and have an infant and want to know when to introduce that child to celiac because she's heard it's problematic to wait too long.

The dr replies that 4 mos old while breastfeeding is the best time.

Say WHAT??

First of all I thought it was 6 months at least to introduce solids because introducing them earlier tends to lead to allergies. But even so, I don't understand why it would be "problematic" to wait until your child is older to introduce gluten, especially if you know you are celiac and celiac is genetic. I think I would keep the kid GF as long as possible, personally.

Just makes no sense to me at all. Anyway, I'm hoping someone will have more info for me about how this works. (Not mind you that I'll be having more kids, it just strikes me as really odd.)

Rachel

jccgf · 10-21-2006, 02:39 PM

I remembered seeing this come through~

Timing of initial exposure to cereal grains and the risk of wheat allergy.
Pediatrics. 2006 Jun;117(6):2175-82.
PMID: 16740862

Quote:

OBJECTIVE: Early exposure to solid foods in infancy has been associated with the development of allergy. The aim of this study was to examine the association between cereal-grain exposures (wheat, barley, rye, oats) in the infant diet and development of wheat allergy. METHODS: A total of 1612 children were enrolled at birth and followed to the mean age of 4.7 years. Questionnaire data and dietary exposures were obtained at 3, 6, 9, 15, and 24 months and annually thereafter. The main outcome measure was parent report of wheat allergy. Children with celiac disease autoimmunity detected by tissue transglutaminase autoantibodies were excluded. Wheat-specific immunoglobulin E levels on children reported to have wheat allergy were obtained. RESULTS: Sixteen children (1%) reported wheat allergy. Children who were first exposed to cereals after 6 months of age had an increased risk of wheat allergy compared with children first exposed to cereals before 6 months of age (after controlling for confounders including a family history of allergic disorders and history of food allergy before 6 months of age). All 4 children with detectable wheat-specific immunoglobulin E were first exposed to cereal grains after 6 months. A first-degree relative with asthma, eczema, or hives was also independently associated with an increased risk of wheat-allergy development. CONCLUSIONS: Delaying initial exposure to cereal grains until after 6 months may increase the risk of developing wheat allergy. These results do not support delaying introduction of cereal grains for the protection of food allergy.
PMID: 16740862

I don't have time to digest the 'math' on this one, so maybe someone else can summarize the finding here

~

Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease.
JAMA. 2005 May 18;293(19):2343-51.
PMID: 15900004

Quote:

CONTEXT: While gluten ingestion is responsible for the signs and symptoms of celiac disease, it is not known what factors are associated with initial appearance of the disease. OBJECTIVE: To examine whether the timing of gluten exposure in the infant diet was associated with the development of celiac disease autoimmunity (CDA). DESIGN, SETTING, AND PATIENTS: Prospective observational study conducted in Denver, Colo, from 1994-2004 of 1560 children at increased risk for celiac disease or type 1 diabetes, as defined by possession of either HLA-DR3 or DR4 alleles, or having a first-degree relative with type 1 diabetes. The mean follow-up was 4.8 years. MAIN OUTCOME MEASURE: Risk of CDA defined as being positive for tissue transglutaminase (tTG) autoantibody on 2 or more consecutive visits or being positive for tTG once and having a positive small bowel biopsy for celiac disease, by timing of introduction of gluten-containing foods into the diet. RESULTS: Fifty-one children developed CDA. Findings adjusted for HLA-DR3 status indicated that children exposed to foods containing wheat, barley, or rye (gluten-containing foods) in the first 3 months of life (3 [6%] CDA positive vs 40 [3%] CDA negative) had a 5-fold increased risk of CDA compared with children exposed to gluten-containing foods at 4 to 6 months (12 [23%] CDA positive vs 574 [38%] CDA negative) (hazard ratio [HR], 5.17; 95% confidence interval [CI], 1.44-18.57). Children not exposed to gluten until the seventh month or later (36 [71%] CDA positive vs 895 [59%] CDA negative) had a marginally increased risk of CDA compared with those exposed at 4 to 6 months (HR, 1.87; 95% CI, 0.97-3.60). After restricting our case group to only the 25 CDA-positive children who had biopsy-diagnosed celiac disease, initial exposure to wheat, barley, or rye in the first 3 months (3 [12%] CDA positive vs 40 [3%] CDA negative) or in the seventh month or later (19 [76%] CDA positive vs 912 [59%] CDA negative) significantly increased risk of CDA compared with exposure at 4 to 6 months (3 [12%] CDA positive vs 583 [38%] CDA negative) (HR, 22.97; 95% CI, 4.55-115.93; P = .001; and HR, 3.98; 95% CI, 1.18-13.46; P = .04, respectively). CONCLUSION: Timing of introduction of gluten into the infant diet is associated with the appearance of CDA in children at increased risk for the disease.
PMID: 15900004

KimS · 10-21-2006, 03:24 PM

My two reactors were both introduced to cereal between 4 and 6 months... so it certainly did not work for us.

I'm kind of wondering how they can really come to that conclusion. It doesn't make sense to me on so many levels that I don't even know where to start!

Similar Threads
Thread	Thread Starter	Forum	Replies	Last Post
Introducing the Brand New C500 RS!	BobbyB	ALS	1	10-26-2006 07:56 AM
Brick by Brick Newsletter	BobbyB	ALS	0	10-05-2006 02:20 PM

Site Navigation

NeuroTalk Online Support Groups

From the Clan Thompson newsletter--introducing gluten to an infant

NeuroTalk Forums