Guest poster Melanie Potock, pediatric feeding specialist, shares her best tips for comfortable and pleasant feeding of babies and young children using the S.I.T. Model: Stability and Independence at the Table.
Posts from the ‘Nutrition’ Category
When is the best time to introduce your baby to solid foods? I sort through the research to find out.
A recent study found that feeding children small amounts of peanut products in the first 5 years of life can prevent the development of peanut allergy. Here's what you need to know.
Readers Brenda and Leah wonder if they need to feed their baby a commercial infant cereal. Here's the answer, in 7 parts, all supported by science.
Two new studies indicate that timing of introduction of gluten and breastfeeding have little impact on the development of celiac disease in high-risk babies.
A recent study reports that moms find the task of getting family meals on the table incredibly stressful. Let's look at what's really important about family meals and how to simplify the task.
Can babies digest starch? If you search for the answer to this question online, you will run into dire warnings of the dangers of giving starch to babies. But these sites might set off your woo detector – as they should. I figured it was time to put some evidence-based information about babies and starch digestion on the Internet.
A study published yesterday in the journal Pediatrics suggests that later introduction of gluten and breastfeeding beyond 12 months both increase the risk of a child developing celiac disease. These new findings add to the already muddy waters of our current understanding of the role of infant feeding in celiac disease.
Celiac disease is an immune response to gluten, a protein found in wheat, barley, and rye. Celiac is characterized by inflammation and damage to the small intestine, leading to symptoms such as diarrhea and digestive pain. In the U.S., celiac disease is present in about 1 in 141 people, although many of these cases go undiagnosed. Infants that develop celiac disease often have poor growth or weight loss, because intestinal damage compromises nutrient absorption. They also may have chronic diarrhea and a swollen, painful belly.
Celiac can usually be treated with a gluten-free diet, but there isn’t a cure for the disease. Multiple genetic markers have been identified for celiac disease, but many genetically susceptible individuals tolerate gluten and never develop symptoms, leading to speculation about other risk factors, including early childhood nutrition.
This latest study was a large, prospective survey of infant feeding practices and development of celiac disease in Norwegian children. Parents were asked when they first introduced gluten and how long they breastfed their babies. Children that developed celiac disease were tracked through Norway’s national medical system. The study included 324 children with diagnosed celiac disease and 81,843 without celiac. The researchers then looked for patterns in the data that might help to explain why some children developed celiac disease and others did not.
There were two major findings to emerge from this study:
- Children that had not yet tried gluten by 6 months of age were more likely to develop celiac disease.
- Breastfeeding at the time of introduction to gluten did NOT appear to be protective. In fact, breastfeeding for longer than 12 months was associated with an increased risk, although it was borderline significant (P=0.046).
Both of these findings are contradictory to current infant feeding advice in the U.S. The AAP’s Section on Breastfeeding recommends exclusive breastfeeding for about 6 months before introducing solid foods, followed by “continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.” The same AAP policy goes on to say, “There is a reduction of 52% in the risk of developing celiac disease in infants who were breastfed at the time of gluten exposure.” But this Norwegian study effectively found that following the current advice of the AAP seems to increase a baby’s risk of celiac, not decrease it.
Obviously, we need more information here. And as usual, one study isn’t enough to give us the full picture of what we know and don’t know about this topic.
To understand the evolving hypotheses around celiac disease and infant feeding, we need to go back to Sweden in the mid-1980’s, when the rates of celiac disease in young kids suddenly quadrupled from an incidence of 1 in 1000 births to 4 in 1000 births over just a few years. It was an epidemic, and it appeared to be isolated to Sweden; neighboring countries weren’t affected. What’s more, celiac was showing up in really young kids. The median age of diagnosis during the epidemic was just about a year old. In 1995, celiac disease in Sweden plummeted back to pre-epidemic levels, and the median age of diagnosis increased to 4 years of age. Read more