copied from the WABA Task Force Newsletter (September 2012 issue
(posted by Renee in Vancouver)


Coeliac Disease and Breastfeeding

A systematic review and meta-analysis that compared the effect of
breastfeeding on risk of coeliac disease (CD) was carried out as an
update to a previous review. A systematic review of observational
studies published between 1966 and May 2004 on the subject was
previously reported. This update reviews observational studies published
between June 2004 and April 2011.

Four observational studies met the criteria and were included. Two of
three studies which had examined the duration of breastfeeding and CD
reported significant associations between longer duration of breastfeeding
and later onset of CD. Breastfeeding during the introduction of gluten to
the infant was reported to have a protective effect in two studies.
The authors conclude that their findings support the previously
published work that breastfeeding seems to offer a protection against the
development of CD in predisposed infants. Breastfeeding at time of gluten
introduction is the most significant variable in reducing the risk. Timing of
gluten introduction may also be a factor in the development of CD.
Henriksson C, Bostrom A, Wiklund IE (2012). What effect does
breastfeeding have on coeliac disease? A systematic review update.
Evid. Based Med. published 4 August 2012, 10.1136/eb-2012-100607
Comments from the editor: This study highlights one of the controversies
surrounding the timing of introducing complementary foods in developed
country settings. As it is clear that breastfeeding during the introduction
of gluten (which is present in most cereals) is protective against coeliac
disease, the question is whether to encourage mothers to continue
breastfeeding beyond 6 months or start introducing gluten depending
on the rates of breastfeeding in the specific country. A proactive or a
pragmatic approach?

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