Breastfeeding Decreases Celiac and Diabetes
Weaning After First Food Protects against Autoimmune Diseases
Dec 26, 2008
Celiac/coeliac is a permanent sensitivity to gluten, a major protein in wheat, barley and rye. It is an autoimmune disease with a strong genetic component, that results in a gluten-triggered immunological attack on the small intestines. Recent epidemiological research focused on the initiation of the disease in populations with a high proportion of the predisposing genes. Of particular interest has been analysis of the Swedish celiac epidemic of 1985-95. This epidemic revealed the protection against autoimmune diseases provided by breast milk during the introduction of solid food.
Swedish Celiac Epidemic 1985-95
The Swedish celiac epidemic was unique for its sudden increase and subsequent decline ten years later. During the epidemic, children with predisposing HLA DQ2 or DQ8 genetic markers showed increasing incidence of celiac beginning at six months and plateauing at two years of age. Summer births showed higher incidence. Development of celiac required exposure to gluten-containing solid food. The age at the time of introduction of gluten was not as important as whether the baby was still breastfeeding when solid food was first introduced.
Breastfeeding with Solids Protects Against Celiac and Diabetes
There has been a general tendency to introduce solid later, as evidence accumulates associating the early introduction of solid foods with increasing incidence of subsequent allergies and autoimmune diseases. This view is now being refined in response to the analysis of the Swedish celiac epidemic. That analysis showed that early introduction of gluten was not the trigger for celiac, but rather that celiac resulted when solids were introduced with formula rather than with continuing breastfeeding. Similar results are found in other studies with type I diabetes.
Recommendation: Continue Breastfeeding after Gluten Is Introduced
Dr. S. Guandalini from the Department of Pediatrics, University of Chicago, reviewed the celiac literature and concluded:
"Based on current evidence, it appears reasonable to recommend that gluten be introduced in small amounts in the diet between 4 and 6 months, while the infant is breastfed, and that breastfeeding is continued for at least a further 2-3 months."
Studies Reinforce Extended Breastfeeding Recommendations
These studies of celiac and breastfeeding further substantiate the recommendation of the American Academy of Pediatricians that breastfeeding continue for at least a year. Short term breastfeeding and the use of formula prior and during the introduction of solids provides a explanation for the high level of allergies and autoimmune disease. A minimal recommendation would be to encourage breastfeeding for at least three months after the baby is introduced to solids.
References:
Olsson C, Hernell O, Hörnell A, Lönnberg G, Ivarsson A. 2008. Difference in celiac disease risk between Swedish birth cohorts suggests an opportunity for primary prevention. Pediatrics. 122(3):528-34.
Ivarsson A. 2005. The Swedish epidemic of coeliac disease explored using an epidemiological approach--some lessons to be learnt. Best Pract Res Clin Gastroenterol. 19(3):425-40.
Guandalini S. 2007. The influence of gluten: weaning recommendations for healthy children and children at risk for celiac disease. Nestle Nutr Workshop Ser Pediatr Program.60:139-51.
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