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Mon, 26 May 1997 21:05:58 +0000
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<<Disclaimer: Verify this information before applying it to your situation.>>

The following answers a question about Celiac Sprue & breastfeeding:

> Given that one of the best reasons to breastfeed is that mother's milk
> carries antibodies that get passed on to the baby to help protect
> against disease, is it possible that a celiac mom could "trigger" celiac
> disease in her genetically predisposed babe? In other words, if the
> little one had the gene for celiac's disease, would handing that baby
> the antibodies for celiac disease through the milk cause the baby to
> begin "fighting off" wheat gliadin so that when the babies of celiacs
> wean, they would then pick up fighting off the "grain offenders"
> themselves?

Karoly Horvath, one of the two directors of the celiac center at
University of Maryland in Baltimore, has generously offered the following
reply in a private post to me, and asked that I post it to the List:
------------
BREAST-FEEDING AND CELIAC DISEASE

 Breast milk contains antibodies against all the antigens the mother's
immune system has met prior to or during the pregnancy and has produced
antibodies to them.

 This system is the wisdom of nature and this is the way that mother's
milk protects babies from all the antigens (infectious agents, toxins etc
) occurring in the environment where the mother lives.  These antigens
without this protection may enter the body through the digestive or
respiratory systems.  The best example is that breast milk protects babies
from bacteria causing diarrheas in the underdeveloped countries.

 The antibodies are produced by the cells (plasma cells) localized in the
gut and the lung.  These cells are migrating to the lactating
breast-tissue for hormonal trigger (enteromammal plasma cell circle) and
they continue producing these antibodies in the breast.  These antibodies
appear in the breast milk.  In brief, the breast milk may contain all the
antibodies the mother has in her digestive and respiratory systems.

 The function of these antibodies is to block the entrance of antigens
infectious agents, toxins, allergens etc) across the digestive or
respiratory tract of babies.

 In case of CD, it means that if the mother has circulating antibodies to
gliadin, these antibodies appear in the milk.  If the breast fed baby
ingests gliadin (or the mother ingests accidentally and traces of gliadin
appear in the milk) the antibodies in the milk blocks the gliadin and it
will not able to cross the intestinal wall and meet with the baby's
immunosystem.  Theoretically, the breast-fed infant do not have any
immunoreaction to gliadin.

 If the mother accidentally ingests gliadin during breast feeding it is
likely that the concentration of antigliadin antibodies become higher in
the breast milk.

 To answer the question:  the antibodies in breast milk are protective and
do not "trigger" celiac disease in genetically predisposed babies.  There
are several data showing that breast feeding has a protective effect in
case of celiac disease.  Furthermore, it is well documented that breast
feeding in the first year of life decreases the risk of allergies by 50%
in babies whose parents have allergies.

 As far as the reaction after weaning concerned:  it is also known that
babies may have some reaction (loose stool or spit up or discomfort)
transiently after introducing a new food, however, this is a temporary
symptom and not allergy or immunoreaction to the food.  It is likely that
their digestive system should accomodate to the new foods.

Karoly Horvath
Baltimore

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