If you're one of the 1 in 133 Americans who has celiac disease, you must eat a diet free of wheat and other grains that include gluten. And if you're a new parent, you may be wondering if you should exclude gluten from your child's diet, too. When and how should you introduce foods with gluten, if you decide to do it at all?
Genetic Component to Celiac Disease
It is true that there is some genetic component to celiac disease and the inability to properly digest gluten. More than 90 percent of celiac disease sufferers have the HLA-DQ2 gene, and many of the remaining 10 percent have the HLA-DQ8 gene. These genes are responsible for producing an immune response to gluten in the digestive system; they program the body to make T cells when gluten is detected.
Blood tests exist to detect these genes, but they are expensive and generally not recommended unless your child is showing signs of gluten intolerance. You can ask your pediatrician about doing a blood test to see if the HLA-DQ genes are present, but that may not confirm that your baby has celiac disease -- only that he or she has a genetic predisposition toward developing it. There are other tests that can identify celiac disease, but they can be invasive or may not be very accurate in young children.
If you have celiac, or the child's other parent or a grandparent or sibling shows signs of the disease, keep a close eye on your baby and work with your pediatrician to identify symptoms if they occur.
Best Time to Introduce Gluten
If you decide to give your baby gluten-containing foods, a new study published in the Journal of Pediatrics provides some evidence that there is an ideal window for introducing gluten.
The study, which analyzed the results of several other studies performed over the past few years, did not find any increased risk of developing gluten intolerance if foods were introduced early. But they did identify a 25 percent increased risk of getting celiac if parents waited until after 6 months of age to give gluten-containing foods.
Based on the study's analysis, there wasn't a statistically significant difference between breastfed and formula fed babies, but other research has predicted that babies who are breastfed during the time when gluten-containing foods are introduced will fare better with tolerance.
Identifying Problems with Gluten Digestion
It can be challenging to identify gluten intolerance based on symptoms alone. Most experts recommend introducing gluten-containing foods, and then if symptoms are observed over time, removing them from the diet to see if the problems go away. Some of the symptoms to watch for and bring up with your pediatrician include:
- Bowel problems -- either diarrhea or constipation, or alternating of the two
- Rashes or skin issues
- Reflux or excessive spitting up
- Slow weight gain
- Bloating or continued gassiness
- Irritability, especially after eating
Your pediatrician can also provide you additional information on infant nutrition and help you decide when and how to introduce solid foods of all kinds. Visit Ada Pediatrics PA for more information.