Systematic review with meta-analysis: early infant feeding and coeliac disease - update 2015

Autors de IIS La Fe

• 

  Carmen Ribes Koninckx

  Autor

Autors aliens a IIS La Fe

• Szajewska H
• Shamir R
• Chmielewska A
• Piescik-Lech M
• Auricchio R
• Ivarsson A
• Kolacek S
• Koletzko S
• Korponay-Szabo I
• Mearin ML
• Troncone R
• PREVENTCD Study Group

Grups d'Investigació

• Enfermedad celíaca e Inmunopatología digestiva

  

  Leader

  Carmen Ribes Koninckx

Abstract

BackgroundNew evidence emerged on early feeding practices and the risk of coeliac disease. AimTo systematically update evidence on these practices to find out whether there is a need to revise current recommendations. MethodsMEDLINE, EMBASE and the Cochrane Library were searched from July 2012 (end of last search) to February 2015 for studies of any design that assessed the effect of gluten consumption and breastfeeding on the development of coeliac disease and/or coeliac disease-related autoimmunity. ResultsWe identified 21 publications, including two, new, large, randomised controlled trials performed in high-risk infants. Exclusive or any breastfeeding, as well as breastfeeding at the time of gluten introduction, did not reduce the risk of developing coeliac disease during childhood. For infants at high risk of developing coeliac disease, gluten introduction at 4months of age in very small amounts, or at 6 or 12months of age, resulted in similar rates of coeliac disease diagnosis in early childhood. Later gluten introduction was associated with later development of coeliac specific autoimmunity and coeliac disease during childhood, but not total risk reduction. Observational studies indicate that consumption of a higher amount of gluten at weaning may increase the risk for coeliac disease development. ConclusionsInfant feeding practices (breastfeeding, time of gluten introduction) have no effect on the risk of developing coeliac disease during childhood (at least at specific timeframes evaluated in the included studies), necessitating an update of current European recommendations.