Celiac disease: Can you introduce gluten too early?

A recent study suggests that babies who receive gluten for the first time after 6 months of age are more a little more likely to contract celiac disease, an autoimmune disease in which eating gluten triggers an immune response. We talked to Dr. Mark Corkins, chief of Pediatric Gastroenterology at Le Bonheur, about his thoughts on this research. He shares some helpful information below.

What are your thoughts on this study?

This study confirms some older epidemiology data. Introducing gluten in a baby’s diet too early or too late increases the risk of developing celiac disease. Somewhere around 5-6 months of age, there is a window when the GI tract’s immune system is programmed to learn about things that are OK and should be “ignored” by the immune system. That is when we normally introduce solids into an infant’s diet for that reason.

How common is celiac disease, and why does it seem like we hear so much about it these days?

It is more common than we used to realize. It was previously taught it was a rare disease, and then studies the last few years have shown it to be more common than we thought. One study found it was present in one in 133 persons. Of course, what we have learned is that not everyone presents with the classic symptoms (mentioned below).

The trouble with the increased awareness of the disease is that it is now a “fad” to be gluten-free and blame a variety of vague symptoms or behaviors on gluten. There is no published evidence to support a lot of the general claims that we see floating around and are made by a variety of less than reliable sources.

When do you recommend a child get tested and what does testing involve?

A child should be tested if they have any of the classic symptoms:

• diarrhea
• poor weight gain
• unexplained nutritional deficiencies

It is also recommended if there is a primary relative with celiac disease. There is a very good blood test to screen for the disease. But the blood test is not perfect so the gold standard for the diagnosis of celiac is an upper endoscopy with biopsy of the small intestines if the antibody is positive.