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PREVENTCD, Prevent Celiac Disease, is an international project investigating the hypothesis of possible induction of tolerance to gluten in genetically predisposed children through introducing small quantities of gluten during the period of breastfeeding.
Professor Szajewska and colleagues from Poland summarized current knowledge on the possible relationship between early feeding practices and the risk of celiac disease.
The team searched the Cochrane Library, MEDLINE, and EMBASE databases in 2011, and the search was updated in 2012.  | | Both early and late introduction of gluten may increase the risk of celiac disease | | Alimentary Pharmacology & Therapeutics |
The team noted that some studies show a protective effect of breastfeeding, while others show no effect. The team found that no studies have shown a long-term preventive effect. Results from a meta-analysis of 5 observational case-control studies suggest that breastfeeding at gluten introduction is associated with a lower risk of celiac disease compared with formula feeding. It is unclear whether breastfeeding provides a permanent protection or only delays the onset of celiac disease. The team reported that both early and late introduction of gluten may increase the risk of celiac disease. There was 1 incident case-referent study documented that the introduction of gluten in large amounts compared with small or medium amounts increased the risk of celiac disease.
Professor Szajewska's team concludes, "In the absence of clear evidence, in order to decrease the risk of later celiac disease, it is reasonable to avoid both early and late introduction of gluten, and to introduce gluten while the infant is still being breastfed." "Future studies may clarify the remaining uncertainties."
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