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From:
William Elkus <[log in to unmask]>
Date:
Sat, 22 Apr 2000 17:29:17 -0700
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<<Disclaimer: Verify this information before applying it to your situation.>>

On Fri, Tom Valinote ATI <[log in to unmask]> wrote:

>Thank You - For your responses regarding the question of whether Gluten
>passing from mother to baby via breast milk is harmful.  We received 28
>responses and basically the message from the respondents , mostly
>mothers out there was stay away from Gluten when breast feeding just to
>be safe.  However, every doctor we spoke to assured us that Gluten does
>not pass through breast milk. Yesterday my wife spoke to a renowned
>Celiac Specialist at UCLA and he said that Gluten does not pass through
>breast milk. He also said that if the baby is breast feeding and has
>been successfully, then my wife does not even need to stay away from
>dairy as well.  ...

I wanted to reprint some old posts on this topic from our List, and some
private email:

===========================

Date:         Wed, 8 Mar 1995 11:00:40 GMT
From:         William Elkus <[log in to unmask]>
Subject:      Gluten in Breast Milk?

In the post from the Sprue-nik Press, it said:

>Dr. Alessio Fasano, University of Maryland
>------------------------------------------
>
>A question was raised: Can a baby receive gluten through breast milk?
>Dr. Fasano stated that it has never been described that gluten can go
>through breast glands

Although I have never read the journal articles myself, Dr.  Kalle
Reichelt, a Norweigan researcher, has cited several articles as evidence
that dietary proteins in general, and gluten/gliadin specifically, can be
transfered to a breast-fed baby:

The following is from a post written by Reichelt to another internet
discussion group, but if you do a CELIAC archives search on 'reichelt' you
will find very similar posts on our own discussion group:

>...food proteins can be demonstrated in mothers milk (3-6) as intact
> proteins. This could easily therefore take place also during pregnancy.
>
>3: Kilshaw PJ and Cant AJ (1984) The passage of maternal dietary
> protein into human breast milk. Int Arch Allergy and Appl
> Immunol 75: 8-15.
>
>4: Axelsson I, Jacobsson I, Lindberg T, and Benediktsson B (1986)
> Bovine lactoglobulin in human milk .Acta Paed Scand 75: 702-707.
>
>5: Stuart CA, Twiselton R, Nicholas M and Hide DW (1984) Passage
> of cow s milk protein in breast milk .Clin Allergy 14:533-535.
>
>6:Troncone R, Scarcella A, Donatiello A, Cannataro P, Tarabusco A and
> Auricchio S (1987) passage of gliadin into human breast milk .
> Acta paed Scand 76: 453-456.

Since Ihave not read the articles, I have no idea whether the amounts of
these proteins would be sufficient to trigger a Celiac (or other
autoimmune) response in a susceptible child.

....

Bill Elkus
[log in to unmask]

===========================

Date:         Thu, 9 Mar 1995 13:41:28 GMT
From:         William Elkus <[log in to unmask]>
Subject:      Fwd: Trace amount of protein in milk.

From Dr.  Reichelt in reply to my post yesterday, in which I wondered
whether the amounts of gluten in mother's milk is significant:

 3/9/95    4:38 PM
Subject: Trace amount of protein in milk.
From:  Kalle Reichelt,[log in to unmask]

Hi.

It should be stressed that the amount are small.  However, the point is
that even trace amounts can be important because if the proteins are not
properly broken down peptides will accumulate.  After all the uptake of
proteins from the gut into blood has also been demonstrated:Husby et al
(1985) passage of undegraded dietary antigen into the blood of healthy
adults .Scand j Immunol 22:  83-92.

Other references in brief :
Bloch KJ et al (1979) gastroenterology 77:1039-1044.

Thomas et al (1974)Immunology 27:631-639.

Walker WA et al (1974) gastroenterol 67: 531-550.

Because gluten contains at least 15 opioid sequences per molecule
(Fukudodme S-I and Yoshikawa M (1991) Opioid peptides derived from wheat
gluten :Their isolation and characterization .FEBS Letters 296:107-111.)
It is therefore clear that one molecule could theoretically give 15 opioids
.  This means that trace amount of peptide could quickly become very
important.
Cheers                          Tiny

K. Reichelt
Pediatric Research Institute
N-0027 Oslo, Norway
Tel: +47 22 86 90 45
Fax: +47 22 86 91 17
E-mail: [log in to unmask]

===========================

Then in 1997, I emailed Dr. Troncone, the Italian researcher whose paper
Dr Reichelt quoted.  I received the following reply:


Dear Mr Elkus,

thank you for your message.  The amount of gliadin that can be measured in
breast milk can be as high as 95 ng/ml (so the total amount pr day is
certainly less than 1 mg).  Moreover, there is no indication from the data
in the literature for gluten-free diet during pregnancy and lactation in
mothers of coeliacs.  As a matter of fact, breast feeding has been clearly
shown to be protective vs coeliac disease, and in principle it cannot be
excluded that the gluten present in breast milk is responsible for such a
tolerant antigliadin mucosal immune response.

I look forward to hearing your comments

Riccardo Troncone

============================

I have not pursued this further and would be interested in learning more
if anyone else does.  It would seem to me that there are several issues
here:

a) 95 nanograms per milligram is a very small amount of gliadin, and
Troncone says it is certainly less than 1 milligram per day.  Posts
several years ago on cel-pro speculated that less than 10 milligrams per
day is unlikely to damage an adult (this has not been proven).  An infant
obviously weighs much less and has a more delicate and immature digestive
system.  Could such a small amount be harmful to a child genetically
predisposed to celiac?

b) If it is not practical for the nursing mom to avoid gluten in her diet,
might the well documented benefits of breast milk to the immune system be
more important than the celiac risks?

c) Perhaps, as Troncone suggests, the small amount of glidian in breast
milk might "immunize" the infant and reduce, rather than increase, the
risk of later getting Celiac Disease.


Bill Elkus

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