Hilary,

Two of my children and I have Celiac Disease so I have lots of experience
with this disease. The main issue with celiac disease is the lack of
absorption of nutrients so the main symptoms (beyond the immediate GI
symptoms) are nutrient deficiencies.  Most people with celiac disease need
to be on supplements for about the first 6 months after diagnosis to
recover from the deficiencies.  Some newly diagnosed people with celiac
disease take enzymes for a few months to optimize the nutrients they
obtain from their food while their gut is healing.  After the gut has
healed, most nutrients can be obtained from their food.  However, since
they are not eating whole grains anymore it can sometimes be more
difficult to get some nutrients.

Calcium should be easy to get from her diet.  Many celiac are temporarily
lactose intolerant at diagnosis but are usually fine after about 6
months.  Once her Hb is recovered she will be able to eliminate the
ferrous sulphate.  However, in Canada we recommend all women of child
bearing age take a supplement containing 1 mg of folic acid to prevent
neural tube defects as folic acid is difficult to obtain from diet at this
level.

So in general, if she is newly diagnosed supplements are more likely to be
needed.  If she has been gluten free for 12 months or more, she may just
need to have her diet checked by a dietician to be sure she is eating as
well as she can within her available choices.

Her baby will be protected for now even if he/she has celiac disease as
mum will not be passing on any gluten during breastfeeding.  Once she
starts solids she will need to decide when to introduce gluten containing
products.  Delaying gluten containing solids until the baby is 12 months
of age would be my suggestion.

Hope this is helpful,

Janet Vandenberg RN, BScN, IBCLC
Public Health Nurse
Newmarket, Ontario

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