Gluten, Celiac Disease and Your Baby: When You Should Worry
Learn how gluten sensitivity can affect your infant and what to do about it.
You hear a lot these days about gluten, a protein that’s found in wheat, barley and rye. Gluten-free diets are all the rage and celebs seem to eschewing the stuff left and right. But giving up gluten isn’t about being trendy: For people with celiac disease and non-celiac gluten sensitivity, eating gluten can mean painful consequences.
Adults aren’t the only sufferers; children and even infants can have trouble with gluten. How do you know if your baby’s discomfort is caused by gluten sensitivity? BabyZone asked Dr. Ivor Hill, a leading researcher on childhood celiac disease and the director of the Celiac Disease Center at Nationwide Children’s Hospital in Ohio, sat down to give us the goods on gluten and how it may affect your infant. Check out our Q&A below.
Q.: What is the earliest age that gluten problems can manifest in a child?
A: Celiac disease (and non-celiac gluten sensitivity) will only manifest after gluten is introduced into the diet. Therefore it is unusual to see celiac disease before about 6 months of age as most babies only start to ingest solids between 4 and 6 months of age.
Q: What’s the difference between celiac disease and non-celiac gluten sensitivity?
A: Celiac disease is an autoimmune disorder, which means there is a genetic component and “trigger” component and disease manifests when both factors are present. The characteristic hallmark of celiac disease is a progressive destruction of the lining of the small intestine and development of a variety of antibodies.
Non-celiac gluten sensitivity is an emerging condition that appears to be over diagnosed at present. The symptoms are varied and can be similar to those of celiac disease but there is no damage to the lining of the intestine and affected individuals do not develop any antibodies.
Q: What are the symptoms?
A: They’re highly variable. Some are related to the gastrointestinal tract and so you can have diarrhea, pain, abdominal bloating, weight loss or poor weight gain and even constipation. Other symptoms can be unexplained anemia, marked fussiness, fatigue, growth failure, recurrent mouth sores … to name a few.
Q: Is gluten sensitivity and celiac disease in young children ever mistaken for anything else?
A: It can be mistaken for many things including allergy to dairy products and other foods, lactose intolerance and irritable bowel syndrome.
Q: How do you test to confirm gluten tolerance issues in infants?
A: Celiac disease (not gluten intolerance) is confirmed on the basis of blood tests to look for the specific antibodies and an intestinal biopsy to examine the lining of the intestines under the microscope… The diagnosis of non-celiac gluten sensitivity can only be made after celiac disease has been excluded on the basis of negative testing for antibodies or a biopsy of the small intestine that is normal. In these cases removal of “gluten” from the diet is undertaken to see if the symptoms resolve. If the symptoms do resolve then the presumptive diagnosis is “non-celiac gluten sensitivity.”
Q: Is gluten sensitivity and celiac disease genetic? Should parents with gluten sensitivity or celiac disease have their infants tested right away?
A: Celiac disease does have a genetic component. If a parent has celiac disease and wants their child tested it should only be done when the child is on a gluten-containing diet. The recommendation is to consider screening children with the blood tests only after 3 years of age providing they are asymptomatic and are ingesting a regular diet. If a child of a parent who has celiac disease has any symptoms before this age then they should be tested right away.
… I do not know of cases where infants have been tested for non-celiac gluten sensitivity. It is possible the condition exists in the very young child but I suspect it is rare in this age group.
Q: How do you treat gluten tolerance problems in infants? Is there a difference between treating for celiac disease and non-celiac gluten sensitivity?
A: Celiac disease requires a strict gluten free diet for life. Those with non-celiac gluten sensitivity will also respond to removal of gluten from their diet. What is not known is whether those with non-celiac gluten sensitivity have to be strictly gluten-free or whether they can tolerate small amounts of gluten in their diet without having any adverse symptoms.
For more about celiac disease, visit the Celiac Disease Center online.
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