Abstract
Celiac disease (CD) is a systemic disease, immune-mediated, caused by the ingestion of gluten. The risk of induction of celiac disease through infant diet containing gluten, applies solely to genetically susceptible individuals, i.e. those having at least one risk allele for this disease. Given we do not usually know if the child fits this criteria, at the time of introduction of cereal in the baby food, the recommendations regarding the risks and benefits of introduction of gluten in baby’s nutrition applies to all of infants. In 2008, the Committee on Nutrition of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) recommended that the introduction of gluten in the infant diet before 4 months and after 7 months of age should be avoided and that the introduction of gluten should happen during breastfeeding. However, new evidences found by ESPGHAN contradict those previous recommendations. While breastfeeding should be encouraged due to other great benefits, neither breastfeeding nor the introduction of gluten during breastfeeding seems to lower the risk of CD in childhood. Gluten can be introduced in infant diet between 4 and 12 months old. Data from observational studies indicate an association between the quantity of gluten ingested and the risk of celiac disease. Large amounts of gluten consumption should be avoided in the first few weeks, after introduction of gluten into the diet as well as during childhood. The optimal amount, however, has not been established.
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References
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