Data from: Infant feeding and risk of developing celiac disease: a systematic review

Objective: To review the evidence for the association of breastfeeding, breastfeeding duration or the timing of gluten introduction and the later development of celiac disease. Design: Systematic review. Methods: We searched MEDLINE, via PubMed, Embase and Web of Science for the studies published up to August 31st 2015, investigating the association of breastfeeding duration, breastfeeding at the moment of gluten introduction or the timing of gluten introduction and the later development of celiac disease. Prospective studies had to enroll infants/children at high risk of celiac disease. For retrospective studies, participants had to be children or adults with CD. The paper quality was assessed by means of GRADE score and the bias risk was assessed by the Newcastle-Ottawa Scale (for observational cohort studies) and Cochrane Collaboration’s tool (for randomized trials). Results: Out of 149 retrieved papers, 48 papers were considered in depth and 16 were included in this review (9 were prospective and 2 of them were interventional). We found that neither duration of breast-feeding nor breast-feeding at time of gluten introduction nor the delayed introduction of gluten during weaning were effective in preventing the later development of celiac disease. Conclusions: Currently, there is no evidence on the optimal breastfeeding duration or the effects of avoiding an early (< 4 months of age) or a late (> 6 or even at 12 months) gluten introduction in children at risk of celiac disease. Accordingly, no specific general recommendations about gluten introduction or optimal breastfeeding duration can be presently provided on evidence-based criteria in order to prevent celiac disease.