When is gluten introduced into the children's diet? How to do it to prevent celiac disease as much as possible? These two questions are those that experts have been trying to answer for years and, for now, there seems to be no way of knowing what the correct answer is.
If for some years the usual recommendation is to give gluten early, in small quantities, and to be able to be at a stage where the baby continues to drink breast milk, a current study seems to be able to demolish these recommendations because in it it has been seen that neither giving it in small amounts the first few weeks, nor doing it while the baby is breastfed decreases the risk of celiac disease.
The oldest recommendations
I go back to the time when my first child was born, now almost 9 years ago, and at that time what was recommended was delay gluten until 7 or 8 months. Nothing to give it before, the idea was to wait until the baby's intestine matured enough so that, at the time he started eating bread, biscuits or cereals with gluten, he could tolerate them well. The baby turned those 7-8 months and that same day he could already eat whatever it was that carried gluten, regardless of whether or not the baby drank breast milk and regardless of the amount.
The current recommendations
Time passed, new data and new studies appeared and the researchers saw that delaying gluten did not seem to be too useful. In fact, they saw that breastfeeding helped reduce the risk and saw that it seemed better to start earlier, but giving it to the baby little by little, that is, a small daily amount for about 3-4 weeks, because it was thought that in this way the baby's immune system gradually became accustomed to gluten.
The recommendation was established in the ideal introduction of gluten between 4 and 6 months of age and to be able to be while the baby is breastfed. However, as the recommendation of babies who breastfeed is to do so exclusively until 6 months, a variation was carried out that in many health centers was considered as ideal: start with gluten at 6 months of age. age, in small quantities, and continue with breast milk while the baby begins to eat it. If a mother intended to stop breastfeeding at 6 months, suggest that she continue at least until seven to reduce the risk of celiac disease.
But a new study denies these recommendations
With the new recommendations already active, with the majority of babies starting with gluten in small quantities at 6 months or earlier, a group of researchers decided to try to confirm that the recommendation was correct and that, in effect, the risk was reduced of celiac disease
For the study, published in the journal New England Journal of Medicine they have followed 944 children from eight countries and the Sant Joan de Reus and Sant Joan de Déu de Esplugues de Llobregat hospitals, which have studied 98 of the children, have collaborated.
The study began in 2007 and all children were susceptible to the disease, because they had the HLA-DQ2 and HLA-DQ8 genes and a first-degree relative with celiac disease.
Between four and six months of age, half of the children received 100 milligrams of gluten a day, while the other half received a placebo substance. Neither the families nor the researchers knew at any time which children were taking gluten and which children the placebo.
Then, after six months, all the children in the study began to eat gluten gradually and after 10 months of age the children could already eat without any restrictions and the researchers simply dedicated themselves to keeping track of what they ate.
According to the recommendations we have followed to date, the logical, the expected, what should have happened is that children who received gluten between 4 and 6 months had developed celiac disease in a smaller proportion than those who started with gluten at six months However, the results say that at the age of three of the children, 5.9% of those who had taken gluten were diagnosed with celiac disease, compared with 4.5% of children who took placebo. That difference is not significant and therefore one thing is not better than another, but it is considered that it is exactly the same to give them gluten before the six months that they do not.
In reference to breastfeeding, when they compared the results of infants who were breastfed and babies who were not, the researchers concluded that, regardless of whether it was exclusive at the time of introduction of gluten or if the baby took any other food , did not significantly influence the development of celiac disease in either group. Come on breastfed children suffered celiac disease just like those who drank formula milk.
And the group that received gluten from 7-8 months?
One group received gluten between 4 and 6 months and then, after 6, and up to 10 months, it was gradually increasing. The other began with gluten at 6 months, gradually increasing to 10 months, when they could eat everything. The only difference is the intake of gluten before 6 months and it has proven useless. My question is, And the group that received gluten from 7-8 months? Because as I explained a few paragraphs above, many health centers, many pediatricians, recommend the introduction of gluten at 6 months so as not to hinder exclusive breastfeeding until 6 months, because it is considered better than the introduction of old-fashioned gluten , later.
It would have been very interesting to know if a third group, receiving gluten later, would have developed celiac disease to a greater or lesser extent. Even sure it would be very interesting to know what the numbers would be in case of giving gluten at 6 months, but not gradually, but without any restriction: "eat cereals with gluten, bread, pasta, cookies, etc.".
The researchers believe that based on this study it is very possible that the recommendations change again, although the doubt is knowing how, where and until when. Because in the absence of more data it is possible that new studies arrive with new conclusions and everything changes again. In fact, researchers have decided to continue with the study and continue to collect data until the children are 12 years old.
