doiSerbia

Influence of breastfeeding and timing of gluten introduction on the onset of celiac disease in infants

Mladenović Marija (Health Centre “Valjevo”, Valjevo, Serbia)
Radlović Nedeljko (Serbian Medical Society, Academy of Medical Sciences, Belgrade, Serbia)
Leković Zoran (University Children’s Hospital, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Vuletić Biljana (Kragujevac Clinical Center, Pediatric Clinic, Kragujevac + University of Kragujevac, Faculty of Medical Sciences, Kragujevac)
Radlović Vladimir (University Children’s Hospital, Belgrade, Serbia)
Dučić Siniša (University Children’s Hospital, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Golubović Zoran (University Children’s Hospital, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Radlović Jelena (Institute for Health Protection of Serbian Railways Employees, Belgrade, Serbia)
Mahmutović Meho (Novi Pazar General Hospital, Novi Pazar, Serbia)
Petrović Jasna (Health Centre “Valjevo”, Valjevo, Serbia)

Introduction/Objective. The classic type of celiac disease (CD) is most common in children under two years of age. The aim of this study was to investigate whether breastfeeding, particularly breastfeeding during gluten introduction, and timing of gluten introduction, influence the onset of CD at this age. Methods. We retrospectively analyzed medical records of 93 children, 40 in the first and 53 in the second year, with a classic CD diagnosed at the University Children’s Hospital, Belgrade between 2000 and 2010. The diagnosis of CD was based on the criteria of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) from 1989. Results. Duration of breastfeeding reduced the onset of the CD in the first year p = 0.039 (OR = 1.43 95% CI 1.019–1.899). Also, breastfeeding at the time of gluten introduction significantly delayed the age at diagnosis (F = 1.671, t = 2.39, p = 0.029). The timing of gluten introduction did not affect the age of occurrence of CD in these group of children. Conclusion. Longer breastfeeding, and breastfeeding at the time of gluten introduction, postponed the onset of classic CD in patients up to two years. The association between the occurrence of CD and the time of introduction of gluten in this age group of patients has not been established.

Keywords: classic celiac disease, children up to 2 years, breastfeeding, age of gluten introduction