See Appendix 1.
Systematic review: early infant feeding and the prevention of coeliac disease
Version of Record online: 21 AUG 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 36, Issue 7, pages 607–618, October 2012
How to Cite
Aliment Pharmacol Ther 2012; 36: 607–618
This uncommissioned systematic review was subject to full peer-review.
- Issue online: 11 SEP 2012
- Version of Record online: 21 AUG 2012
- Manuscript Accepted: 31 JUL 2012
- Manuscript Revised: 18 JUL 2012
- Manuscript Revised: 29 JUN 2012
- Manuscript Received: 6 JUN 2012
- European Union project PreventCD. Grant Number: FP6-2005-FOOD-4B-36383-PreventCD
- Komitet Nauki. Grant Number: NN407171534
Vol. 37, Issue 2, 287, Version of Record online: 17 DEC 2012
PREVENTCD, Prevent Coeliac Disease, is an international project investigating the hypothesis of possible induction of tolerance to gluten in genetically predisposed children through introducing small quantities of gluten during the period of breastfeeding.
To summarise current knowledge on the possible relationship between early feeding practices and the risk of coeliac disease (CD).
The Cochrane Library, MEDLINE, and EMBASE databases were searched in May 2011, and the search was updated in January 2012, and again in July 2012.
Breastfeeding (BF) and CD: some studies show a protective effect of BF, while others show no effect. No studies have shown a long-term preventive effect. BF at the time of gluten introduction and CD: Results from a meta-analysis of five observational case-control studies suggest that BF at gluten introduction is associated with a lower risk of CD compared with formula feeding. It is unclear whether BF provides a permanent protection or only delays the onset of CD. Timing of gluten introduction: The data suggest that both early (≤4 months) and late (≥7 months) introduction of gluten may increase the risk of CD. Amount of gluten at weaning (and later) and CD: One incident case-referent study documented that the introduction of gluten in large amounts compared with small or medium amounts increased the risk of CD.
In the absence of clear evidence, in order to decrease the risk of later coeliac disease, it is reasonable to avoid both early (<4 months) and late (≥7 months) introduction of gluten, and to introduce gluten while the infant is still being breastfed. Future studies may clarify the remaining uncertainties.