Celiac Awareness Day and Breastfeeding

It is Celiac Awareness Day.   This is one issue close to my heart, because I have a child with celiac. 

 What is Celiac disease?  It involves an autoimmune reaction due to the presence of gluten in the small intestine.  Those with celiac cannot eat wheat, barley, rye or oats (some people can have limited amounts of oats) (1). 

A study in the American Journal of Clinical Nutrition in May 2002 found that by introducing gluten containing foods in the child's diet while still breastfeeding reduces his or her chances of celiac disease (2). A meta-analysis, which compares and contrasts several studies of the same topic,  published in 2005 in Archives of Childhood Disease showed a 52% reduction in gluten sensitivity when gluten containing cereal is begun during the breastfeeding period (3).  Scientists theorize that antibodies in breast milk diminish the body's immune response to the gluten.

Practically speaking, the AAP recommends exclusive breastfeeding for the first six months.  Then studies suggest offering gluten containing foods at six months while continuing to breastfeed.  If you continue breastfeeding for at least one month past introduction of gluten containing foods, the likelihood of celiac will be reduced further into early childhood (4). Of course, the AAP recommends continued breastfeeding at least until one year of age and longer if mutually desired.  UNICEF and WHO suggest at least two years of continued breastfeeding and longer if mutually desired.

What if your baby or toddler has celiac disease?  Can you still breastfeed?  Yes!  You will need to follow a gluten free diet, however, while still breastfeeding.  Also, it is best to continue breastfeeding at least one month past the introduction of solids.  If there is a family history of the disease, mothers should nurse exclusively for at least 5-6 months, because some women are carriers of the disease but do not actually have the disease themselves.

(1)  What Happens With Celiac Disease http://www.celiac.org/index.php?option=com_content&view=article&id=4&Itemid=10
(2) Breastfeeding protects against celiac disease. http://www.ncbi.nlm.nih.gov/pubmed/11976167
(3) Breastfeeding may protect against Celiac disease http://www.medpagetoday.com/PrimaryCare/DietNutrition/2178
(4) Breastfeeding with Celiac Disease http://www.idahomidwives.org/Breastfeeding_with_celiac_disease.htm

Written by Gina M. Peterson, BS, IBCLC