While many experts recommend preventive measures for reducing a child’s risk for developing celiac disease, such as breastfeeding and delayed introduction to gluten — a protein found in wheat, rye, and barley — the prevalence of gluten intolerance has quadrupled over the past 50 years. A recent study conducted by researchers from the Center for Celiac Research and Treatment at MassGeneral Hospital for Children has confirmed that breastfeeding or a delayed introduction to foods containing gluten can prevent celiac disease.  

"One of our most important findings was that the timing of gluten introduction — whether early or late in the first year of life — made no difference to the subsequent development of celiac disease," Dr. Carlo Catassi, co-director of the Center for Celiac Research and Treatment, said in a statement. "While earlier studies led to the hypothesis that there was a time window, between 4 and 7 months of age, during which gluten could safely be introduced to at-risk children, our results indicate we can tell mother not to worry so much about when they introduce gluten into their children's diet."

Catassi and his colleagues gathered data using the Italian Baby Study on Weaning and CD Risk, which included over 700 infants who were at risk for celiac disease development due to a family history. Infants were assigned to two groups: The first group was introduced to foods containing gluten at 6 months of age and the second group at 12 months. Parents of the children provided their child’s diet information, such as the amount of gluten they ingested, breastfeeding, and other factors known to affect a child’s risk for celiac disease. During five years of follow up, children were tested for immune system factors that would indicate gluten-associated autoimmune responses.

Although infants who were introduced to foods containing gluten at 6 months of age showed signs of celiac disease at the two-year follow-up, there was very little difference between the two groups during the five-year follow up. At the end of the study, 64 infants from the 6-month introduction group and 53 infants from the 12-month introduction group had developed celiac disease. Around 80 percent of the children who developed celiac disease did so before they turned 3.

"Of the several factors we studied, it's very clear that genetic background is by far the most important in determining which infants will develop this autoimmune condition. We were particularly surprised that breastfeeding at any age provided no protective effect," said Dr. Alessio Fasano, director of the Center for Celiac Research and Treatment.

According to the Celiac Disease Foundation, one out of every 100 people around the world are affected by this autoimmune disorder. An estimated 2.5 million Americans are undiagnosed and run the risk of suffering from suffering from long-term complications. There is currently only one viable treatment for Celiac disease, a lifelong adherence to a strict gluten-free diet. Even crumbs of food containing wheat, rye, and barley can trigger damage to the small intestine.

Catassi and Fasano’s team did identify an inherited risk factor known to increase a person’s risk of celiac disease and other autoimmune disorders known as HLA molecules. Found in the immune system, HLA molecules are able to flag antigens for immune system attack. Conducting a blood test of HLA genotype could determine an infant’s risk for celiac disease. Fasano said these results will "pave the way for breakthrough studies that will capitalize on these findings and lead to preventive interventions."

Source: Fasano A, Catassi C, et al. New England Journal of Medicine. 2014.