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A Case-Control Study of the Effect of Infant Feeding on Celiac Disease

Peters U.a · Schneeweiss S.b,c · Trautwein E.A.a · Erbersdobler H.F.a
aInstitute of Human Nutrition and Food Science, University of Kiel, Germany; bDepartment of Epidemiology, Harvard School of Public Health, Boston, Mass., USA; and cDepartment of Medical Informatics, Biometry and Epidemiology, University of Munich, Germany Ann Nutr Metab 2001;45:135–142 (DOI:10.1159/000046720)


Aims: The aim of this study was to investigate the association between the duration of breast-feeding and the age at the first gluten introduction into the infant diet and the incidence and age at onset of celiac disease. Methods: In a case-control study, 143 children with celiac disease and 137 randomly recruited gender- and age-matched control children were administered a standardized questionnaire. Multivariate-adjusted odds ratios (OR) as estimates of the relative risk and corresponding 95% confidence intervals (95% CI) were calculated. Results: The risk of developing celiac disease decreased significantly by 63% for children breast-fed for more than 2 months (OR 0.37, 95% CI 0.21–0.64) as compared with children breast-fed for 2 months or less. The age at first gluten introduction had no significant influence on the incidence of celiac disease (OR 0.72, 95% CI 0.29–1.79 comparing first gluten introduction into infant diet >3 months vs. ≤3 months). Conclusions: A significant protective effect on the incidence of celiac disease was suggested by the duration of breast-feeding (partial breast-feeding as well as exclusive breast-feeding). The data did not support an influence of the age at first dietary gluten exposure on the incidence of celiac disease. However, the age at first gluten exposure appeared to affect the age at onset of symptoms.


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