Have you wondered if your child may be suffering with celiac disease, or do you need some thoughtful information about it? We are happy to share this super helpful article full of the simple facts by Dina DiMaggio, MD, and Anthony Porto, MD, Authors of The Pediatrician’s Guide to Feeding Babies and Toddlers.
Since May is Celiac Awareness Month, we want to discuss celiac disease and the gluten free diet. According to a new article, there are more google searches on the gluten free diet than there is for celiac disease! This increase mirrors the fact that though the incidence of celiac disease has increased, more and more families are following or are interested in following a gluten free diet even when their child does not have celiac disease. Here are 6 facts you need to know:
1. Celiac disease is an immune mediated reaction caused by exposure to gluten.
It is estimated to occur in 1% of the general population and is higher in families with a history of celiac as well as in children with Down syndrome and type I diabetes. It is a life-long condition requiring removal of gluten from the diet. Symptoms may include gastrointestinal symptoms such as vomiting, abdominal pain or bloating, poor weight gain, constipation and/or diarrhea, or non-gastrointestinal symptoms including short stature (lower height than expected), rashes and iron-deficiency that is not responsive to supplementation.
2. Although celiac disease is genetic, it is very common for a child to be diagnosed without a family history of celiac disease.
We know that a person needs to have at least one of the celiac genes to be at risk for developing celiac. The genes, HLA-DQ2 and HLA-DQ8, are present in about 35-40% of the population. However, it is estimated that for every person diagnosed with celiac disease, there are 25 people who have not been diagnosed. Celiac disease can present at any time and some family members may not even be diagnosed with it since some people with celiac may not show any symptoms.
3. Accurate screening tests are available for celiac disease.
Depending on your child’s age, your pediatrician may recommend blood tests to screen your child for celiac disease. If the screening tests are elevated, your pediatrician will refer you to a pediatric gastroenterologist to perform an endoscopy and confirm the diagnosis . During an endoscopy, a piece of tissue or biopsy is taken to look for a specific type of inflammation that occurs with celiac disease.
4. Speak to a pediatric gastroenterologist or pediatrician first before removing gluten from your child’s diet.
The accuracy of celiac screening tests is affected if your child is on a gluten free diet. It is important for your doctor to make an accurate diagnosis of celiac disease since children with celiac require strict elimination of gluten containing grains, such as rye, wheat and barley.
5. Infant nutrition practices have not been shown to prevent celiac disease.
We do not know what causes those at risk (who carry the specific celiac genes) to develop celiac disease. Recent studies have shown that breast-feeding is not protective against celiac disease. Likewise, delay of gluten into a baby’s diet does not prevent celiac disease. We recommend introduction of gluten containing grains, therefore, at around 6 months of age, after an introduction of a few other first foods.
6. Following a gluten free diet should be done under the guidance of an experienced dietitian.
Though the gluten free diet is needed for children with celiac disease, it may lead to nutritional deficiencies if not followed properly since gluten free products may lack certain vitamins, such as B vitamins. Some children with celiac disease, therefore, may require a multivitamin. Patients with celiac disease following a gluten free diet may be consuming large amounts of rice, which has been shown to potentially contain high levels of inorganic arsenic. Eating a variety of gluten free grains is also important then to ensure adequate vitamin and mineral intake. Eating a gluten free diet is not as easy or straight forward as may first appear, and a child’s pediatrician should help decide whether eating a gluten free diet is medically necessary.