Dojčenie a celiakia
Existujú práce, ktoré naznačujú, že dojčenie spolu s neskorším zavedením gluténu do stravy dojčiat chráni pred rozvojom celiakie Zdá sa, že je vhodné zavádzať glutén do výživy dieťaťa ešte pod “ochranou” prolongovaného dojčenia.
Arch Pediatr 1998 Jun;5(6):621-6 |
Breast feeding effect relative to age of onset of celiac disease.
Bouguerra F, Hajjem S, Guilloud-Bataille M, Khlat M, Khaldi F, Bennaceur B
Unite de genetique epidemiologique, Hopital d'Enfants, Tunis Jebbari, France.
BACKGROUND: Age at onset and clinical presentation of celiac disease have often been related to the age of gluten introduction into the diet. It has also been shown that breast feeding delays the onset of the disease. PATIENTS AND METHODS: This retrospective study attempts to evaluate the respective contributions of these two parameters in the determination of the age at onset of the symptoms in celiac Tunisian children. RESULTS: One-hundred-sixty-nine children were studied. Mean duration of breast feeding in our population was 9.6 +/- 8.9 months and mean age of gluten introduction was 5.6 +/- 3.2 months. The mean age at onset of the disease was 15 +/- 8.7 months and mean latency time between gluten introduction and onset of the disease was 9.5 +/- 7.8 months. Both variables, duration of breast feeding and age at gluten introduction were strongly correlated to the age at onset of the disease (r = 0.47 and 0.40, respectively). Only breast feeding was correlated to the variable latency time (r = 0.33). Stepwise multiple regression analysis showed that the two variables independently influenced the age at onset with coefficients of regression of 0.90 +/- 0.20 and 0.26 +/- 0.07, respectively. Only breast feeding influenced the latency time with a coefficient of regression equal to 0.26 +/- 0.07. DISCUSSION: Our study confirms the independent effect of breast feeding in the determination of the age at onset of the disease. Breast feeding has two effects: an indirect effect, by delaying the introduction of gluten, and a direct effect, by increasing the latency time between gluten introduction and onset of the disease. CONCLUSION: Prolonged breast feeding, at least until the 6th month, and gluten introduction started at least at the 5th month of life, significantly delay the onset of the disease. Gluten introduction should be done progressively and under breast feeding protection. Introduction of gluten 2 months before weaning has a protective effect.
Bouguerra F, Hajjem S, Guilloud-Bataille M, Khlat M, Khaldi F, Bennaceur B
Unite de genetique epidemiologique, Hopital d'Enfants, Tunis Jebbari, France.
BACKGROUND: Age at onset and clinical presentation of celiac disease have often been related to the age of gluten introduction into the diet. It has also been shown that breast feeding delays the onset of the disease. PATIENTS AND METHODS: This retrospective study attempts to evaluate the respective contributions of these two parameters in the determination of the age at onset of the symptoms in celiac Tunisian children. RESULTS: One-hundred-sixty-nine children were studied. Mean duration of breast feeding in our population was 9.6 +/- 8.9 months and mean age of gluten introduction was 5.6 +/- 3.2 months. The mean age at onset of the disease was 15 +/- 8.7 months and mean latency time between gluten introduction and onset of the disease was 9.5 +/- 7.8 months. Both variables, duration of breast feeding and age at gluten introduction were strongly correlated to the age at onset of the disease (r = 0.47 and 0.40, respectively). Only breast feeding was correlated to the variable latency time (r = 0.33). Stepwise multiple regression analysis showed that the two variables independently influenced the age at onset with coefficients of regression of 0.90 +/- 0.20 and 0.26 +/- 0.07, respectively. Only breast feeding influenced the latency time with a coefficient of regression equal to 0.26 +/- 0.07. DISCUSSION: Our study confirms the independent effect of breast feeding in the determination of the age at onset of the disease. Breast feeding has two effects: an indirect effect, by delaying the introduction of gluten, and a direct effect, by increasing the latency time between gluten introduction and onset of the disease. CONCLUSION: Prolonged breast feeding, at least until the 6th month, and gluten introduction started at least at the 5th month of life, significantly delay the onset of the disease. Gluten introduction should be done progressively and under breast feeding protection. Introduction of gluten 2 months before weaning has a protective effect.
Arch Dis Child 1997 Sep;77(3):206-9 |
Changing infant feeding practices and declining incidence of coeliac disease in West Somerset.
Challacombe DN, Mecrow IK, Elliott K, Clarke FJ, Wheeler EE
Somerset Children's Research Unit, Taunton and Somerset Hospital.
An association was investigated between changing infant feeding practices and a declining incidence of childhood coeliac disease and transient gluten intolerance (TGI) in West Somerset, England during 1971-92. Dietary histories of 18 patients with coeliac disease were compared with 23 controls during 1971-80 and eight patients with coeliac disease and 39 controls during 1981-92. Our findings showed that the declining incidence of coeliac disease and TGI were associated with changing infant feeding practices, characterised by the later introduction of dietary gluten, an increased use of baby rice and gluten free foods for weaning, and an increased incidence of initial breast feeding.
Pediatr Allergy Immunol 1996 Feb;7(1):1-5 |
Infant feeding history shows distinct differences between Swedish celiac and reference children.
Falth-Magnusson K, Franzen L, Jansson G, Laurin P, Stenhammar L
Department of Pediatrics, Faculty of Health Sciences, Linkoping University, Sweden.
Infant feeding history was investigated in 72 celiac and 288 age-matched reference children in a retrospective questionnaire study. The reply rate was 100% in celiac and 91.6% in reference children. The celiac children were breast-fed for a significantly shorter time than reference children, and they were less often breast-fed at the introduction of gluten. The age of the children at gluten introduction was similar, but the celiac children were significantly more often introduced by a gluten-containing follow-up formula, while the reference children more often started on a gluten-containing porridge. The results can be interpreted in two ways. First, it could be argued that breast milk per se protects against symptoms of celiac disease in childhood. It could, however, also be claimed that breast-feeding merely modulates the gluten introduction, causing a less abrupt introduction of gluten in the baby diet and thereby fewer overt symptoms of the disease.
Falth-Magnusson K, Franzen L, Jansson G, Laurin P, Stenhammar L
Department of Pediatrics, Faculty of Health Sciences, Linkoping University, Sweden.
Infant feeding history was investigated in 72 celiac and 288 age-matched reference children in a retrospective questionnaire study. The reply rate was 100% in celiac and 91.6% in reference children. The celiac children were breast-fed for a significantly shorter time than reference children, and they were less often breast-fed at the introduction of gluten. The age of the children at gluten introduction was similar, but the celiac children were significantly more often introduced by a gluten-containing follow-up formula, while the reference children more often started on a gluten-containing porridge. The results can be interpreted in two ways. First, it could be argued that breast milk per se protects against symptoms of celiac disease in childhood. It could, however, also be claimed that breast-feeding merely modulates the gluten introduction, causing a less abrupt introduction of gluten in the baby diet and thereby fewer overt symptoms of the disease.
Arch Dis Child 1997 Feb;76(2):113-7 |
Influence of infant feeding and gluten intake on coeliac disease.
Ascher H, Krantz I, Rydberg L, Nordin P, Kristiansson B
Department of Paediatrics, Goteborg University, East University Hospital, Sweden.
OBJECTIVES: To study the impact of infant feeding habits and actual gluten intake on gluten induced enteropathy. METHODS: A case-referent design, controlling for the HLA alleles conferring increased genetic risk, was used. All 164 siblings of 97 probands were investigated. Eighty five of the siblings, carrying the genes DQA1*0501-DQB1*02 conferring susceptibility for the disease, were investigated by interview, food recording, and taking a small intestinal biopsy sample. Eight cases of silent coeliac disease were found and these were compared with the 73 siblings in whom the diagnosis was excluded. RESULTS: No statistically significant differences were found between cases and referents in terms of duration of breast feeding, age at introduction of cows' milk products, frequency of breast feeding after gluten introduction, and gluten consumption. CONCLUSIONS: The studies factors may be of less importance for the development of gluten induced enteropathy.
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