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Ask the Doc: Will my second baby have celiac?

Q. 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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