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Babies and Celiac: The Role of Genetics and Breastfeeding
We all dream of our babies inheriting what we consider our best qualities: patience, spontaneity, cleverness, or ocean blue eyes. What we don’t want is to pass celiac on to our little ones.
Many parents have this concern, and there is a lot of new research and information available that better clarifies what we need to know about babies and celiac.
What are the symptoms? When should my baby be tested? Should I give my baby gluten, or avoid it entirely?
Is there anything I can do to help prevent celiac from developing? There may just be.
Celiac, which results in inflammation in the lining of the small intestine and therefore malabsorption of nutrients, can be especially damaging to babies who are going through critical stages of physical and cognitive development. Since celiac is activated by gluten entering the body, it is not possible for a doctor to tell you if your newborn has celiac disease. It is therefore extra important to be informed of the warning signs, symptoms, and ways to test and treat the disease in babies.
The Genetics Factor
Babies with a family history of celiac have a genetic predisposition for it. If you have a close relative with celiac (sibling, parent or child), then you have a 1 in 10 chance of developing the disease. Additionally, children with Down Syndrome, Type 1 Diabetes, and other autoimmune diseases are more likely to develop celiac disease.
Recent research has also shown a correlation with the development of celiac disease and high incidences of colds, infections and flu in the first six months of life, although more research in this area is needed. Keep in mind that the genetic factor is the one piece of the puzzle that is necessary: if your baby is born without a genetic predisposition for celiac, there is no chance of developing it.
How Does Breastfeeding Fit In?
Research on the subject of gluten in breast milk is admittedly still scarce. The studies that have been done have determined that gliadin, which is the portion of gluten that passes through to breast milk, exists in very minimal amounts. These studies suggest that not only is this quantity not dangerous for your infant, but may even provide a protective effect, facilitating the build up of a tolerance to gluten. This may be more relevant in cases of gluten intolerance than it is for celiac.
Anecdotal evidence from breast feeding mothers provides a different picture, however. There are lots of stories about babies with terrible reflux, diarrhea, and colic getting better overnight after their mothers ceased eating gluten. Recent research has also illustrated a lower risk of celiac disease development in babies who were breastfeeding at the time they were introduced to gluten.
So When Should I Give My Baby Gluten?
Newborns receive all of the vitamins and nutrients that they need from either breast milk or formula. Currently, all infant formulas on the market are gluten-free. Infants are generally able to start tasting solids at around six months of age, depending on factors such as physical development and readiness. It is currently unclear when you should introduce gluten to your baby.
Past medical recommendations have been to avoid gluten if your baby has a genetic predisposition for celiac. However, new research shows that early introduction of gluten, between 4-7 months, may in fact help your baby and that delayed introduction of gluten actually increases the risk of developing celiac disease later on in life. Breastfeeding also appears to have a protective factor against celiac disease, and hopefully future studies will help us determine how. The amount of gluten that you give your baby is also significant, and it is recommended to start with small amounts. Something like barley cereal mixed with either breast milk or formula can be a good start.
Symptoms in babies can begin to develop when they begin to eat solid foods containing gluten. Symptoms include weight loss, fatigue, diarrhea, constipation, vomiting, abdominal bloating and pain, anemia, and failure to thrive. Babies who become especially fussy or irritable may also be exhibiting signs of celiac disease.
One important thing to note is you must resist the urge to start your undiagnosed baby on a gluten-free diet, since diagnosis is much more difficult when gluten is avoided.
How to Go About Testing My Baby for Celiac
Just like adults, babies can develop celiac at any time and should be tested if exhibiting symptoms. The test involves a panel of blood tests and it may be important to do additional testing for nutrient deficiencies, especially iron. If tests are positive, an endoscopy is often done to check for intestinal damage.
While the body of research concerning babies and celiac is steadily growing, it is by no means substantial and a lot of questions remain. I hope I was able to clarify some of the questions you had and hope to provide updates in the future as the body of research grows. I would also like to note that if you are pregnant and have celiac, it is even more important that you follow a strict gluten-free diet. Eating gluten during pregnancy will result in the malabsorption of nutrients not just for you but also your baby, so be extra diligent!
