title: [The suitability of the current recommendations for introducing gluten to the diet].
abstract: BACKGROUND
  The habits of introducing gluten and the implementation of the ESPGHAN-2008 recommendations are evaluated.
  
  
  METHODS
  A retrospective cohort study was conducted in 2011 using a questionnaire containing various epidemiological variables and supplementary feeding that was completed by the parents of children between 12-18 months who were seen by the pediatrician. Central tendency measures were calculated for the quantitative variables, and non-parametric tests used for comparison of means (Mann-Whitney and Kruskal-Wallis). The Chi-squared or exact tests were used for analyzing the qualitative variables, analysis of frequencies and comparisons. Multivariate adjustment techniques were used for the significant variables.
  
  
  RESULTS
  A total of 46 primary care pediatricians, who collected 1,015 questionnaires, collaborated. The mean age of the introduction of gluten was 6.99 months (standard deviation 1.46, median 7). Only 45.1% (95% confidence interval [CI 95%]: 41.8-48.3) introduced it between 4-6 months, 0.2% before 4 months, and 54.7% after 7 months. Only 13.9% (CI 95% 11.6-16.1) introduced gluten between 4-6 months with breastfeeding. Multivariate analysis showed that the variables linked to lower compliance with the introduction between 4-6 months are mothers of 35 years of age or older (adjusted Odds ratio (aOR 1.44; CI95%: 1.11-1.88), celiac family (aOR 2.04; CI 95%: 1.11-3.72) and breastfeeding (aOR 1.55; CI 95%: 1.06-2.26), and for the introduction between 4-6 months coinciding with breastfeeding, breastfeeding and mothers who had studied at university (aOR 1.72; CI 95%: 1.17-2.53).
  
  
  CONCLUSIONS
  The ESPGHAN recommendation on the introduction of gluten among pediatricians in our sector has not yet been sufficiently implemented.
authors: Servicio de Pediatría, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. jmmarugan@telefonica.net
authors: J M
authors: JM
authors: Marugán de Miguelsanz
authors: C
authors: C
authors: Ochoa Sangrador
mesh_terms: D015331:Cohort Studies; D004032:Diet; D005260:Female; D005983:Glutens / Q000008:administration & dosage*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies
chemical_list: D005983:Glutens
keywords: Breastfeeding; Celiac disease; Enfermedad celíaca; Gluten introduction; Introducción de gluten; Lactancia materna