title: Systematic review with meta-analysis: early infant feeding and coeliac disease--update 2015.
abstract: BACKGROUND
  New evidence emerged on early feeding practices and the risk of coeliac disease.
  
  
  OBJECTIVE
  To systematically update evidence on these practices to find out whether there is a need to revise current recommendations.
  
  
  METHODS
  MEDLINE, EMBASE and the Cochrane Library were searched from July 2012 (end of last search) to February 2015 for studies of any design that assessed the effect of gluten consumption and breastfeeding on the development of coeliac disease and/or coeliac disease-related autoimmunity.
  
  
  RESULTS
  We identified 21 publications, including two, new, large, randomised controlled trials performed in high-risk infants. Exclusive or any breastfeeding, as well as breastfeeding at the time of gluten introduction, did not reduce the risk of developing coeliac disease during childhood. For infants at high risk of developing coeliac disease, gluten introduction at 4 months of age in very small amounts, or at 6 or 12 months of age, resulted in similar rates of coeliac disease diagnosis in early childhood. Later gluten introduction was associated with later development of coeliac specific autoimmunity and coeliac disease during childhood, but not total risk reduction. Observational studies indicate that consumption of a higher amount of gluten at weaning may increase the risk for coeliac disease development.
  
  
  CONCLUSIONS
  Infant feeding practices (breastfeeding, time of gluten introduction) have no effect on the risk of developing coeliac disease during childhood (at least at specific timeframes evaluated in the included studies), necessitating an update of current European recommendations.
authors.affiliation: The Medical University of Warsaw, Warsaw, Poland.
authors.forename: H
authors.initials: H
authors.lastname: Szajewska
authors.forename: R
authors.initials: R
authors.lastname: Shamir
authors.forename: A
authors.initials: A
authors.lastname: Chmielewska
authors.forename: M
authors.initials: M
authors.lastname: Pieścik-Lech
authors.forename: R
authors.initials: R
authors.lastname: Auricchio
authors.forename: A
authors.initials: A
authors.lastname: Ivarsson
authors.forename: S
authors.initials: S
authors.lastname: Kolacek
authors.forename: S
authors.initials: S
authors.lastname: Koletzko
authors.forename: I
authors.initials: I
authors.lastname: Korponay-Szabo
authors.forename: M L
authors.initials: ML
authors.lastname: Mearin
authors.forename: C
authors.initials: C
authors.lastname: Ribes-Koninckx
authors.forename: R
authors.initials: R
authors.lastname: Troncone
mesh_terms: D001942:Breast Feeding; D002446:Celiac Disease / Q000453:epidemiology* / Q000209:etiology; D005247:Feeding Behavior / Q000502:physiology*; D005983:Glutens / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007223:Infant; D013997:Time Factors; D014886:Weaning
chemical_list: D005983:Glutens