Ask the Doc: 5 week old baby with celiac?

Q. A baby 5 weeks old while only on breastmilk developed diarrhea and blood in the stool. A celiac center claimed they had just returned from a conference in Maryland that said it is impossible to have celiac at that age because the body can’t produce antigens at that age. However a different center said the opposite. When I asked the first if a baby could be gluten intolerant through the breastmilk and cause a similar celiac symptoms they said yes but not the classic immune disease disorder. Can you clarify the facts? Other common allergen foods such as nuts, shellfish, milk, eggs and soy have already been eliminated from the diet.

A. Your question is not easy to answer as we lack data on gliadin (gluten protein) levels in breast milk of mothers who have proven celiac disease. One study (Chirdo FG et al Scand J Gastroenterol 1998;33:1186), demonstrated high levels of gliadin and antibodies to it in breast milk of non-celiac mothers. Three days of a gluten-free diet did not lower the levels of gliadin in the milk of 6 mothers. One mother with proven celiac disease on a gluten free diet had no measurable levels of gliadin in her milk. Many other studies have demonstrated that breast feeding actually protects babies from celiac disease, so in this case, another, more common cause of bloody diarrhea in the baby in question needs to be found. I suggest that you take the baby to a pediatric gastroenterologist to disclose the cause and arrive at specific treatment. What we do know is that the baby has only a 10% chance of getting the disease if either parent has it, and that the introduction of gluten in the diet before four months will lead to an increase in tissue transglutaminase, but that usually does not translate into major disease until development becomes more obvious, and will present as behavioral abnormalities such as learning disorders, neurological problems such as seizures, and decreased weight for height. Again, bloody diarrhea at five weeks is not celiac disease.
Health and happiness,
Dr. Aron

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