The Jigsaw Puzzle of Breast Feeding and Celiac Disease

The puzzle of breast feeding effects on celiac disease development is complicated and despite numerous studies, remains unresolved. Several prospective or retrospective observational studies on the topic were reported, with contradictory results. The geoepidemiology teaches us that celiac disease incidence, in the west, is increasing, while breast feeding is decreasing, going along with the protective effect of mother’s milk. But, human milk and gluten are only two in the growing list of environmental factors that affect celiac disease induction or behavior. The recent increased knowledge on gluten side effects in non-celiac populations and the fact that human milk contains gluten peptides, further complicate the breast milk-gluten-celiac disease cross-talks. Latest studies revealed that breast feeding, whether exclusive or in combination with formula intake, did not reduce the risk of CD development. More so, recent publications concluded that timing of introduction of gluten to infant diet did not influenced the risk of development of CD. It is hypothesized that local environments, nutritional habits, intestinal ecosystems or genetic background might have influenced the published results. Much more epidemiological and prospective investigational studies might clarify the jigsaw puzzle of breast feeding and celiac disease behavior.