[The introduction of gluten into the infant diet. Expert group recommendations].
At present there is a degree of uncertainty regarding when, how and in what form gluten should be introduced into the infant diet. For years the recommendations of the ESPGHAN Committee on Nutrition have prevailed, which include avoiding early introduction, before 4 months, and late, after 7 months, and gradually introducing gluten into the diet while the infant is being breastfed, with the aim of reducing the risk of celiac disease, diabetes and gluten allergy. However, 2 independent studies published in The New England Journal of Medicine in October 2014 reached the conclusion that the age of introduction of gluten does not modify the risk of developing celiac disease, and that breastfeeding at any age does not confer protection against celiac disease development. On the other hand, according to available scientific evidence, the introduction of foods other than breast milk or formula into the infants diet is generally recommended around 6 months of age, since the introduction before 4 months could be associated with an increased risk of food allergy and autoimmune diseases, and delaying it beyond 7 months would not have a protective effect. In this context, a group of experts has considered it appropriate to produce a consensus document based on the current scientific evidence and present general recommendations for daily clinical practice on the introduction of gluten into the diet.
Servicio de Gastroenterología Pediátrica, Hospital Universitari i Politècnic La Fe, Valencia, España. Electronic address: ribes_car@gva.es.
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Ribes Koninckx
Unidad de Nutrición-Metabolopatías, Hospital Universitari i Politècnic La Fe, Valencia, España.
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Dalmau Serra
Unidad de Nutrición Clínica, Servicio de Pediatría, Hospital 12 de Octubre, Madrid, España.
J M
JM
Moreno Villares
Sección de Gastroenterología y Nutrición Pediátrica, Área de Gestión Clínica de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
J J
JJ
Diaz Martín
Unidad de Gastroenterología Pediátrica, Hospital Universitari Sant Joan de Reus, Reus, Tarragona, España.
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Castillejo de Villasante
Departamento de Pediatría, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España.
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Polanco Allue
D000818:Animals; D001942:Breast Feeding; D002446:Celiac Disease / Q000517:prevention & control; D004032:Diet; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008895:Milk, Human
D005983:Glutens
Gluten; Infant; Introducción; Introduction; Lactante