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Ron Hoggan said:
 
>I had the good fortune to hear Dr. Fassano speak in New York, on
>Saturday, and he indicated that delaying dietary introduction  of gluten
>only resulted in later, atypical presentations of the disease. (As these
>would be more difficult to diagnose, *my* inclination would be to feed
>my child gluten and aim at an early diagnosis.)
 
I just wanted to add that according to my reading of cel-pro posts, Dr.
Fasano's view, while shared by many celiac experts, has never been proven.
Other celiac experts disagree, and there is some evidence in other disorders
to support the avoidance theory.  Although juvenile diabetes is an entirely
different disorder, several papers have implied that avoiding cow's milk
during the first year of life reduces the risk of diabetes in genetically
susceptible children.
 
My eldest son had significant developmental delays during his period of
undiagnosed celiac.  For example, he lost his ability to speak and it took
more than a year to redevelop.  I would never recommend that a parent feed
gluten to a baby at risk for celiac until at least the second year of life.
Why take the risk of interfering with the enormous mental and physical
development which occurs during those first years?
 
As Dr. Fasano said, it is possible that if the introduction of gluten is
delayed, atypical symptoms may result which are more difficult to diagnose.
However, if the parent is already familiar with CD, they should be doing
endomysial blood tests on all siblings of a celiac every 2-3 years, just to
be sure that a "silent" form of CD has not developed.  And certainly if any
illness developed in a sibling, and any medical testing was being done, the
parents could insist that an endomysial test be repeated.  This test is more
than 90% accurate as a CD screen, so it is quite unlikely that an atypical
presentation of CD would be overlooked.
 
In addition, genetic HLA typing could be done on the sibling to determine
whether they are even at risk for celiac -- in most families, half the
children will not be at risk.  We tested the umbillical cord blood of our
third child, having arranged the process before going into the delivery room.
 
For more information on the endomysial tests and HLA typing, send an email to
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GET CELIAC DAIG-TST
GET CELIAC CEL-HLA
 
Bill Elkus
Los Angeles