My own research has identified a certain haplotype (“design”) of DNA differences that show a protective effect (disease at an older age) whilst another haplotype increases the risk of childhood disease.

As coeliac disease can arise at any age, these prospective studies need a long time (30-40 years) to give us definite answers.

As doctors and health workers we have to abide by scientific proof as well as recommendations from knowledgeable groups (if we do not do so, we can be sued that we did not follow good medical practice). The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition have put up the following recommendation:

“Exclusive or full breast-feeding for about 6 months is a desirable goal. Complementary feeding (ie, solid foods and liquids other than breast milk or infant formula and follow-on formula) should not be introduced before 17 weeks and not later than 26 weeks. There is no convincing scientific evidence that avoidance or delayed introduction of potentially allergenic foods, such as fish and eggs, reduces allergies”……”It is prudent to avoid both early (or=7 months) introduction of gluten, and to introduce gluten gradually while the infant is still breast-fed, inasmuch as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy.”

As you can see that whilst the word “may” implicates some uncertainty, the recommendation is better to err towards being prudent rather than going head on.

As for the racial (I would rather use the word ethnic – ethnic differences exist but not racial ones) this seems to be more to do with environmental factors rather than genetic – basically asians who have rice as their main cereal have a lower incidence but those that move to the West and integrate a western diet have an increased incidence approaching the 1-1.2% of the Western world. BTW one of the highest areas is amongst the Saharawi population in the Sahara desert – around 5-6%.

[Daphne – Forget the parents, plural: what’s best for the mother’s health and mental well-being is best for the baby, and that’s indisputable. A baby who feeds and sleeps irregularity, adding to the mother’s mental and physical exhaustion, is a major contributing factor in post-natal depression.]

[Daphne – The one thing they don’t tell you is that babies sleep through the night as early as four months when they are bottle-fed. What I noticed when I had my children at St Luke’s was that the only women gullibly listening to the midwives were those who had had their first baby, and that the most experienced women all had their bottles out.]

[Daphne – I make no assumptions at all. I simply observe.]

As for the studies, understand that for a study to be published in a journal of repute, it requires vigorous peer review and possibly re-testing (I know, I have just had a paper accepted for publication in a major journal on the discovery of a novel gene associated with coeliac disease, after two major reviews by three reviewers and re-testing with alternative methods).

The major study on breast feeding and coeliac disease was initially an epidemiological study on the whole Swedish population (basically it was based on the national register of coeliac disease cases.) At the moment, I am involved in a pan-european prospective study on 1500 at-risk (a particular HLA type – a major protein involved in immunity) new born babies born to coeliac families just to study this ideal time window of introducing gluten.

As for immunity – it has now been proven that it is a major component in various chronic diseases such as diabetes, heart disease, osteoporosis, coeliac disease,rheumatoid arthritis, lupus, psoriasis and cancer (some of these disorders affecting young and healthy individuals). A health immunity does not only mean an immunity against infection, but getting the immune system to attack the enemy and not turn on to the body’s own tissues. The role of foreign (non-human) proteins in the partially mature, young infant’s intestinal tract, could trigger an autoimmune reaction that can give rise to the disorders listed above.

As I said, I do not condone excessive pressures on mothers to breastfeed, but I am all for giving real and factual information and giving adequate time to individuals to ask questions and thus make a truly well informed decisions

In reality it is not known whether breastfeeding protects against the life-long risk of developing coeliac disease although it has been found to protect (though not guarantee)against the development of the disease in childhood. Therefore breastfeeding may only be delaying the onset of the disease rather than actually preventing its life-long development.

A genetic factor is certainly involved, as you would know, as is a racial factor, the disease being much more common in some peoples than others.

[Daphne – People who are fixated on breast-feeding wouldn’t know what you’re talking about.]