Celiac disease primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]


Effective measures for the primary prevention of celiac disease include breastfeeding, delayed introduction of gluten-including diet, and preventing gastrointestinal (GI) infections.[1]

Primary Prevention

Effective measures for the primary prevention of celiac disease include

Breast feeding

Infants who were breastfed for periods less than one month were found to be at four times increased risk of having celiac disease and those who were breastfed for periods less than three months had five times increased risk.[2]

Increasing breastfeeding duration

The mean duration of breastfeeding for infants having celiac disease was shorter compared to those who don’t have the disease.[3]

Exclusive breastfeeding for at least six months

Six months of exclusive breastfeeding were associated with delayed onset of symptoms of celiac disease and improved outcome of the disease.[4]

Continued breastfeeding at the time of introduction of gluten

Continued breastfeeding decreases the amount of gluten delivered to the intestine and protects against GI infections (which are believed to increase the risk of disease).[3]

Delayed and decreased amount of gluten at the time of first introduction

Following these measures is believed to decrease the incidence of new cases in Sweden.[2][5][6][7]

Protection against GI infections

GI infections are believed to increase the permeability of the GI mucosa which allows for penetration of antigens. Also, some hypotheses suggest the disease might be viral in origin (namely rotavirus)


  1. Selimoğlu MA, Karabiber H (2010). "Celiac disease: prevention and treatment". J. Clin. Gastroenterol. 44 (1): 4–8. doi:10.1097/MCG.0b013e3181b7ead2. PMID 20027009.
  2. 2.0 2.1 Greco L, Mayer M, Grimaldi M, Follo D, De Ritis G, Auricchio S (1985). "The effect of early feeding on the onset of symptoms in celiac disease". J. Pediatr. Gastroenterol. Nutr. 4 (1): 52–5. PMID 3981369.
  3. 3.0 3.1 Persson LA, Ivarsson A, Hernell O (2002). "Breast-feeding protects against celiac disease in childhood--epidemiological evidence". Adv. Exp. Med. Biol. 503: 115–23. PMID 12026010.
  4. Akobeng AK, Ramanan AV, Buchan I, Heller RF (2006). "Effect of breast feeding on risk of coeliac disease: a systematic review and meta-analysis of observational studies". Arch. Dis. Child. 91 (1): 39–43. doi:10.1136/adc.2005.082016. PMC 2083075. PMID 16287899.
  5. Mäki M, Kallonen K, Lähdeaho ML, Visakorpi JK (1988). "Changing pattern of childhood coeliac disease in Finland". Acta Paediatr Scand. 77 (3): 408–12. PMID 3389134.
  6. Juto P, Meeuwisse G, Mincheva-Nilsson L (1994). "Why has coeliac disease increased in Swedish children?". Lancet. 343 (8909): 1372. PMID 7910367.
  7. Mitt K, Uibo O (1998). "Low cereal intake in Estonian infants: the possible explanation for the low frequency of coeliac disease in Estonia". Eur J Clin Nutr. 52 (2): 85–8. PMID 9505150.