Lerner Aaron^{1, 2,}, Matthias Thomas²

The puzzle of breast feeding effects on celiac disease development is complicated and despite numerous studies, remains unresolved. An observational prospective study on the topic is reported from India. It showed that breast milk is protective against celiac disease, delays the introduction of gluten in infant diet as well as, delays symptomatic celiac disease. The geoepidemiology teaches us that celiac disease incidence, in the west is increasing, while breast feeding is decreasing, going along with the protective effect of mother’s milk. But, human milk and gluten are only two in the growing list of environmental factors that affect celiac disease induction or behavior. The recent increased knowledge on gluten side effects in non-celiac populations and the fact that human milk contains gluten peptides, further complicate the breast milk-gluten-celiac disease cross-talks. Most recent studies revealed that breast feeding, whether exclusive or in combination with formula intake, did not reduce the risk of CD development. More so, recent publications concluded that timing of introduction of gluten to infant diet did not influenced the risk of development of CD. The Indian observations contradict those conclusions. It is hypothesized that local environments, nutritional habits, intestinal ecosystems or genetic background might have influenced the study results. Much more epidemiological and prospective investigational studies might clarify the jigsaw puzzle of breast feeding and celiac disease behavior.

celiac disease, breast feeding, protective, infant, onset, gluten, timing