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Breast-feeding Duration and Gluten Introduction Among Mothers With Celiac Disease

Welander, Adina*; Montgomery, Scott; Ludvigsson, Johnny; Ludvigsson, Jonas F.§

Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0000000000000326
Original Articles: Hepatology and Nutrition
Abstract

Objectives: Both breast-feeding duration and age at gluten introduction have been implicated in the pathogenesis of celiac disease (CD). We hypothesized that parental CD affects the feeding pattern of the offspring, mediated by parental health awareness increasing adherence to infant feeding guidelines.

Methods: Prospectively collected infant feeding data were obtained through the All Babies in Southeast Sweden study. Information regarding infant feeding was available in 9414 children. Twenty-two mothers had a history of biopsy-verified CD before delivery of a child in the study, and 9392 mothers had no diagnosis of CD before birth and thus constituted the unexposed or control population. Cox regression was used to compare the risk of early weaning and gluten introduction according to parental CD status, and logistic regression to assess whether mothers with CD were more likely to breast-feed their children at gluten introduction.

Results: Some 63% of children were breast-fed for at least 9 months. We found no association between maternal CD and early weaning (adjusted hazard ratio [HR] 1.0, 95% confidence interval [CI] 0.6–1.7), or between paternal CD and early weaning (HR 0.5, 95% CI 0.1–1.9). Sixty percent of children were introduced to gluten in months 5 and 6. Maternal CD was not associated with age at gluten introduction (adjusted HR 0.8, 95% CI 0.6–1.3). There was no statistically significant association between maternal CD and breast-feeding at the time of gluten introduction (odds ratio 1.4, 95% CI 0.4–4.7).

Conclusions: Feeding patterns do not seem to vary between offspring and mothers with CD and those without.

Author Information

*Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm

Division of Pediatrics, Linköping University, Linköping

Clinical Epidemiology and Biostatistics, Örebro University Hospital, Örebro

§Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.

Address correspondence and reprint requests to Adina Welander, MD, PhD, Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, 17176 Stockholm, Sweden (e-mail: adina.welander@ki.se).

Received 28 January, 2014

Accepted 28 January, 2014

The present study, as part of the All Babies in Southeast Sweden (ABIS) project, was generously supported by the Juvenile Diabetes Research Foundation, Wallenberg Foundation (K 98-99D-12813-01A), the Swedish Medical Research Council (MRF Vetenskapsrådet; K99-72X-11242-05A), the Swedish Child Diabetes Foundation (Barndiabetesfonden), the Swedish Diabetes Association, the Soderberg Foundation, the Swedish Society of Medicine, the Swedish Research Council, the Swedish Celiac Society, and the Novo Nordisk Foundation. None of the funding agencies had any role in the design or conduct of the study (collection, analysis, and interpretation of the data, nor preparation, review, or approval of the manuscript).

A.W. was supported by a grant from the Karolinska Institute Board of Postgraduate Education. J.F.L. was supported by a grant from the Örebro University Hospital while writing this article. The other authors report no conflicts of interest.

© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,