Influence of early feeding practices on celiac disease in infants.
OBJECTIVE
To investigate whether duration of breastfeeding and timing of gluten introduction influence the age at diagnosis and severity of celiac disease.


METHODS
Medical records of 89 infants (59 girls and 30 boys; mean age of 14.2 months, standard deviation 4.80) diagnosed with classic celiac disease at the University Children's Hospital in Belgrade from 2000 to 2008 were retrospectively analyzed to determine the duration of breastfeeding and timing of gluten introduction. The severity of celiac disease was assessed based on weight loss, longitudinal growth retardation, anemia, and secondary lactose intolerance.


RESULTS
Longer breastfeeding significantly reduced the risk that celiac disease would manifest in the first year of life (odds ratio, 0.655; 95% confidence interval, 0.481-0.891; P=0.007), and duration of breastfeeding was the most significant predictor of developing celiac disease (B=0.49; 95% confidence interval, 0.131-0.768; P=0.007). There were no significant differences in age at diagnosis between infants who had started consuming gluten before the fourth month and those who had started between the fourth and sixth month. Neither breastfeeding nor timing of gluten introduction affected the severity of the disease.


CONCLUSIONS
Longer breastfeeding and continuation of breastfeeding after gluten introduction delay the onset of classic celiac disease. On the other hand, neither breastfeeding nor the timing of gluten introduction affects the severity of celiac disease.
Department of Gastroenterology and Nutrition, University Children’s Hospital, Belgrade, Serbia. drmladenovic@beotel.net
Nedeljko P
NP
Radlovic
Marija M
MM
Mladenovic
Zoran M
ZM
Lekovic
Zorica M
ZM
Stojsic
Vladimir N
VN
Radlovic
D001942:Breast Feeding; D002446:Celiac Disease / Q000175:diagnosis* / Q000503:physiopathology*; D005247:Feeding Behavior; D005260:Female; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D012189:Retrospective Studies; D055771:Serbia; D012720:Severity of Illness Index
D005983:Glutens