Article

Introducing gluten-containing foods prior to or after 4 to 6 months of age could affect an infant's risk of developing celiac disease if he or she is already at risk for it, researchers say. Celiac disease is a digestive disorder that's caused by a sensitivity to foods containing gluten and characterized by chronic inflammation in the small intestine. The disease causes symptoms like diarrhea, abdominal pain, problems absorbing nutrients from food, and nutritional deficiencies.

Between 1994 to 2004, researchers from the University of Colorado at Denver and Health Sciences Center in Denver studied 1,560 children considered to be at increased risk for developing celiac disease or type 1 diabetes (people with type 1 diabetes and their relatives have an increased risk of developing celiac disease). The children's parents provided information about the children's nutrition and eating habits at 3, 6, 9, 12, and 15 months of age and when they introduced foods containing gluten, like wheat, barley, and rye in products like infant cereals, crackers, breads, tortillas, and pasta. The children in the study also had yearly blood tests for evidence of celiac disease. If blood tests indicated a child might have celiac disease, doctors examined small samples of the child's bowel tissue confirm the diagnosis.

In this group of at-risk children, 51 kids developed celiac disease. Researchers found that children exposed to gluten-containing foods within the first 3 months of life had five times the risk of developing celiac disease, compared to children exposed to gluten foods between 4 and 6 months of age. In addition, children who were first exposed to gluten foods after 7 months of age had a significantly increased risk of developing celiac disease, compared to children introduced to gluten foods between 4 to 6 months of age.

What This Means to You: According to the results of this study, children who are at increased risk of celiac disease (such as children with a parent who has type 1 diabetes) may be more likely to develop it if gluten-containing foods are introduced prior to or after 4 to 6 months of age. This study also did not look at whether age at introduction of gluten-containing foods increases the risk of celiac disease in infants who aren't at high risk for the condition. But the results of this study haven't affected what health organizations such as the American Academy of Pediatrics (AAP) recommend regarding the feeding of solid foods to infants. The AAP recommends starting an infant on solid foods - beginning with infant cereals, like rice cereal - around 6 months of age. If you have any questions about starting solids or other infant feeding questions, talk to your child's doctor.

Source: Jill M. Norris, MPH, PhD; Katherine Barriga, MSPH; Edward J. Hoffenberg, MD; Iman Taki, BS; Dongmei Miao, BS; Joel E. Haas, MD; Lisa M. Emery, MSPH; Ronald J. Sokol, MD; Henry A. Erlich, PhD; George S. Eisenbarth, MD, PhD; Marian Rewers, MD, PhD; Journal of the American Medical Association, May 18, 2005

Reviewed by: Steven Dowshen, MD
Date reviewed: July 2005