Coeliac disease in babies: everything you need to know

Coeliac disease is an autoimmune disorder in which the body attacks gluten with antibodies, causing damage to the intestine and symptoms such as stomach pain and growth problems. 

Coeliac disease affects around one in every 100 people, and it can develop any time after introduction of wheat or other gluten-containing food into a baby’s diet. This usually occurs at around 6-9 months of age, and scientists are investigating whether the timing or manner in which gluten is introduced into the diet may help to prevent coeliac disease. 

Some children with coeliac disease may develop it very quickly after their first gluten exposure, while may not experience symptoms until years later.  

Will my baby have coeliac disease?  

Coeliac disease is hereditary. If the mother, father, or a sibling of the baby have coeliac disease, there is a one in 10 chance that the child will also develop the condition. In such cases, it is very important to test the child at the first possible signs of coeliac disease.  

In terms of coeliac disease in breastfed babies, it seems to be very rare for a baby to develop the condition before he or she is eating solid foods. That said, some research suggests that mothers can pass some gluten into breastmilk if they are consuming gluten-containing foods. In fact, many doctors think that the small quantities of gluten reaching a baby through breastfeeding are more likely to be helpful as a first, limited exposure to gluten. 

Coeliac disease is also more likely in a child who has Down syndrome, type 1 diabetes, or another autoimmune condition. 

Infants with coeliac disease react to gluten in a variety of ways in terms of severity and timing. Some children experience symptoms within minutes or hours of consuming gluten, and these symptoms may go away fairly quickly. Others may develop symptoms more slowly, and these may last several days, or even weeks. Many children will have mild symptoms that are easy to miss, such as gas, abdominal pain, constipation, or diarrhea. Others might have more harmful or long-lasting symptoms, including poor growth or weight loss. 

Other symptoms to look out for in babies who may have coeliac disease are vomiting, bloating, irritability or a lack of interest in playing, and very foul-smelling baby poop.   

If your child has any of the symptoms mentioned above, you should discuss this with your pediatrician. They may suggest running certain tests to identify what the problem might be. It is important not to change the child’s diet at this stage, as the tests for coeliac disease will not give a correct result if there is no gluten in the child’s diet. 

Typically, coeliac disease has a two-stage diagnosis. First a blood test is used to detect the antibodies produced by the immune system to attack gluten. If this test is positive, a biopsy sample of intestine is taken for testing with an endoscope (a tube with a light and camera) inserted inside the body.  

Don’t panic if your baby is diagnosed with coeliac disease. Infants typically respond well to treatment with a gluten-free diet. Most children feel significantly better after just two weeks on the diet, and grow to be a normal height and weight. Coeliac disease is believed to be one of the most under-diagnosed conditions, with possibly more people having it and not realizing than those who do. A diagnosis of coeliac disease opens the route to good health through strict observance of a gluten-free diet, whereas not knowing may lead to other health complications later in life. 

Coeliac disease is not curable in babies, children or adults. However, there are cases of infants who have a temporary problem with gluten, typically caused by a gut infection. This is known as transient gluten intolerance.  

Coeliac disease, gluten sensitivity, and wheat allergy are often confused in babies and patients of all ages. They all involve some form of intolerance for proteins found in cereals, and the symptoms can be very similar.   

Gluten intolerance or non-coeliac gluten sensitivity (NCGS) are terms used to describe the condition of people who cannot tolerate gluten and experience symptoms similar to those who have coeliac disease – but without the same kind of intestinal damage.  Gluten sensitivity affects an estimated 18 million people in the United States – more than six times the number of people who have coeliac disease. NCGS symptoms may come and go, but coeliac disease is always permanent.  

Wheat allergy is an allergic reaction to foods containing wheat. The allergic reaction can be caused by eating wheat and, in some cases, by inhaling wheat flour. Wheat allergy is a common allergy among young children, but many will outgrow it.  

The only treatment for coeliac disease is a strict 100% gluten-free diet, and it must be followed for life. It is important to transition your baby to a gluten-free diet as quickly as possible to resolve symptoms and heal the small intestine.  

Seeking advice and support from an association or local support group will help you get the information you need on the gluten-free diet and help you make sure your child is well nourished It will also be important to ensure that the full circle of caretakers around your child know about the condition, including family members, friends, and teachers.      

As far as is currently known, there is no way to prevent a child from developing coeliac disease. However, medical research is beginning to investigate some of the variables that may have an impact on whether a baby who is genetically predisposed does eventually develop the condition. 

Several studies have suggested that breastfeeding may play a protective role. In some cases, it is believed that prolonged breastfeeding during the introduction of gluten into the baby’s solid food can lead to a reduced risk of coeliac disease. Several studies suggest that the best time to introduce gluten into the baby’s diet is between four and six months of age, and preferably while still breastfeeding. However, research in this field is ongoing and there is little information known about the exact amounts of gluten that should be given to a baby during the ‘window of opportunity’ period of months five and six. For the time being, experts agree that gluten should be introduced prior to seven months of age..