Should I introduce vegetable before fruit? When can I give my child milk? Should I avoid peanuts/egg/wheat/etc to avoid allergies? I/someone in our family has Celiac disease, should I avoid giving my baby gluten? These are some of the most common questions I am asked by parents in my practice. The answer for many of these questions probably varies from doctor to doctor; I was taught to delay potentially allergenic foods until an infant was older and possessed a more mature immune system. That meant avoiding things like eggs, nuts, and wheat until after age one or two. However, recent research suggests that we may have gotten this one wrong. This research is new and ongoing, but there is a growing body of evidence, which suggest introducing solid foods earlier while still breastfeeding may increase tolerance and actually reduce incidence of allergies.
This information is particularly interesting in light of the epidemic of Celiac disease in the United States. In the last 50 years the rates of Celiac disease in this country have quadrupled! The increased rates of Celiac are often blamed on our gluten-rich diets, wheat that is bred for it’s high gluten content, and highly processed food full of gluten fillers. However, this change on our diet does not exclusively explain the rise in the disease. Researchers followed 3,781 Finnish children for five years to examine the association between duration of breastfeeding and timing of introduction of complementary foods and the development of allergic disease and specific sensitization to foods and inhalants. They found that introducing small amounts of these “allergenic” foods earlier, between 5-6 months, while still breastfeeding was associated with lower rates of allergies. This method of food introduction was also associated with lower rates of asthma and allergic rhinitis. Total breast-feeding duration of 9.5 months or more was also associated with lower risk for other kinds of asthma (asthma not triggered by allergies, but most likely by an infection).
Breastfeeding introduces more beneficial bacteria into the digestive system. In particular, bifidobacteria is higher in breastfed babies compared to those who are formula fed. Previous research has shown that children with Celiac disease have lower levels of bifidobacteria and higher levels of e. coli present in their digestive systems. Another study showed that infants who had an immediate family member with Celiac disease and possessed genetic markers themselves for Celiac disease, were shown to experience protective benefits from breast feeding.
In short, infants may benefit from small amounts of gluten in their diet starting at around 5-6 months of age, if they are breastfed. It’s important to remember that babies are not ready to eat solid foods until they can sit upright on their own and their tongue-thrusting reflex has subsided (the tongue thrusting reflex occurs when a substance is placed on the tongue, and causes it automatically protrudes outward rather than back).
