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Ask the Doc: Will my second baby have celiac?

Posted on August 10th, 2007 by Alison Read 3 Comments - Add Your Own »

questionmarkgreen1.jpgQ. Please help. I am 7 months pregnant, and my 3 year old child was diagnosed with celiac shortly after my husband and I found out about the pregnancy. I asked his GI doctor what to do about preventing the onset of celiac with our second child and she knew very little to tell me. I would like to know the percent chance that baby #2 will have celiac. Child #1 is the only person in the family with it as far back as we know. Should I breastfeed this baby? Do I need to be on a gluten free diet when breastfeeding? When should I introduce gluten in baby #2′s diet?

A. The best answer appears in the British Journal “Gut” 25 April 2007, from Bourgey, M et al. You must test yourself, you husband, your first baby for HLA-DQ2 and HLA-DQ8 genes. The lab must test for the alleles, or components of these genes. If you or your husband both have HLA-DQ2 with 2 copies of DQB1*0201, then there is a grerater than 80% chance that the new baby will have celiac disease. If the alleles of you and your husband are DQB1*0201 and DQA1*0501 and in a trans position, then there is a 68% chance for the baby. If these alleles are in a cis position, then a 23% chance is possible. If both of you have DQB1*04, then there is a 1% chance. If there is one copy of DQ8 and one copy of either DQB1*02 or DQA1*05 then a 1 in 50 chance. So you will need to contact Prometheus labs in San Diego to get these tests.

Breast feeding is safe and even helpful. You should be on a gluten-free diet while breast feeding. Do not introduce gluten until solid food is taken, which is usually after 6 months. Good Luck.

Health and happiness,
Dr. Aron

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Comments

  1. I would also suggest a strict schedule for vaccinations. Look on the DAN (Defeat Autism Now) website. Vaccinations MAY predispose the body for autoimmune disorders, which celiac is. (they suggest a later timeframe and only ONE vaccination at a time – none that are 3 in one,etc.)

    I know many that do not start solids with cereal either, but with food. (many baby foods have cereal in them, easy to make your own food by pureeing or mashing)

  2. I feel for you! We were in the same position a year ago. Our now four-year old was biopsy diagnosed with celiac after testing 187 on her TTG’s at age 21 months. I was pregnant with our second and worried that he or she might also have celiac even though neither my husband or I had it. Since we didn’t want to go through the same trials with our second child (extremely fussy aka “colic” baby), the doctors advised us to gene-test at birth. My husband and I had both tested negatively for antibodies but we did not gene-test ourselves. Although you can’t get accurate antibody testing until much exposure and an older age, a newborn can/will show the same genes (and hence predisposition toward the disease) that they would at an older age. So we gene-tested our son in the hospital (had the pediatrician research how to have this done before he was born so that when he was being poked with needles for other tests they could do this at the same time (born August ’06). We had to wait about two weeks for results. Docs wanted me to go gluten-free while breastfeeding until we learned results. Our docs have said that research has proven that wheat protein indeed transfers through breastmilk. They are unsure if other forms of gluten transfer. Two weeks later we learned that our son tested positive for both genes (DQ2 and DQ8). Docs advised us to go GF for at least the first year and possibly never introduce gluten. I’ll admit that I cried. Although everyone consoled me by saying “at least both kids can eat the same thing,” I was so disheartened to learn that he will forever be GF also. We felt very fortunate however to learn through testing rather than through years of pain and discomfort. Our son just turned one and I just stopped breastfeeding. I went GF the whole time. Two different days I cheated and had some gluten. Perhaps it was coincidental or psychosymatic, but our son seemed really fussy those days so I dared not cheat again. I just started having gluten again. It was a tough year but after I got into the swing of things, it really was not that hard. If you end up going GF, I’d be happy to give you tips and support and be your “temporary GF” buddy.

  3. it is very hard to hadle a kid with celiac disease i see i feel sorry for u parents that your babies or kids have it .

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