Celiac disease, also known as Gluten Enteropathy is characterized by sensitivity towards gluten, which is a protein predominantly found in wheat, rye and barley. This sensitivity occurs in people who are genetically predisposed.
What is Celiac Disease in Babies?
The onset of this disease is usually from infancy to young adulthood, but about 20% of cases occur in adults over 60 years of age. Celiac disease usually develops within the first three years of birth. Babies who acquire this condition fail to thrive, lose appetite and become pot bellied. Their stools are large, pale and repulsive due to presence of free fatty acids. A family history of celiac disease makes babies more prone to it.
Celiac Disease is an Auto-immune Disorder. Celiac disease is an auto-immune disorder that is a condition where the immune system mistakenly attacks and destroys healthy body tissues. It occurs due to either malabsorption or an abnormal immune reaction to gluten. When babies vulnerable to celiac disease eat foods containing gluten, their immune system reacts unusually. This causes irritation and damage or destruction of villi, the tiny, finger like projections lining the inner membrane of the small intestine which help in absorption of food from the intestine.
Role of Villi in Absorbing Nutrients. Villi help the absorption of nutrients from the small intestine into the bloodstream. Unhealthy villi lead to deficient absorption of nutrients due to which babies do not receive proper nutrition. When damaged and irritated, the villi are unable to absorb water and nutrients such as vitamins, folic acid, iron and calcium. This makes the babies susceptible to a variety of other conditions related to mal absorption, including lactose intolerance.
What are the symptoms of celiac disease?
The symptoms of celiac disease usually appear 3-5 months after first consuming foods that contain gluten, although in some cases the symptoms may appear in the first month itself. Babies do not consume gluten directly before the age of 6 months as they are breastfed.
Diarrhea. It is one of the most common symptoms that affects babies of all age-groups with celiac disease. Young babies may have chronic diarrhea and abdominal distension while older babies may suffer from chronic diarrhea, constipation or vomiting.
Growth Disturbances. Mal-absorption creates nutrient deficiencies and can lead to many manifestations like anemia i.e low levels of iron in the blood, (due to iron, vitamin B12 and folic acid deficiency). Impaired bone growth and development (due to deficient absorption of calcium and vitamin D), muscular dystrophy (due to mal absorption of calcium and magnesium and potassium loss), neurological impairment (due to deficiency of multiple vitamins), hormonal disorders and vitamin A deficiency symptoms.
Other Symptoms. Affected babies are usually underweight and don’t gain weight easily. Poor feeding, muscle wasting, irritability, mouth ulcers, dermatitis, extreme tiredness etc are some of the commonly seen symptoms in babies with celiac disease.
How to treat and manage celiac disease?
Presently, the only treatment for babies with celiac disease is a life long gluten free diet. Complete withdrawal of gluten from the diet shows marked improvement in the symptoms. However, the diet may need to be supplemented with extra vitamins, minerals and proteins to make up for the deficiencies that arise due to refraining from gluten.
Introduce Complementary Foods. Celiac disease can be prevented in babies by introducing complimentary foods not containing gluten at the right age when their gut gains enough maturity to digest and absorb gluten. WHO recommends exclusive breastfeeding in babies until the age of 6 months and introduction of complementary foods only after the age of 6 months. If your baby is genetically pre-disposed to celiac disease, complementary foods excluding gluten should be introduced only under medical guidance.
Avoid Foods Containing Gluten. Babies with gluten intolerance need to avoid foods containing gluten like wheat, rye and barley that act as triggers for this disease. Baked food items like cakes, breads and biscuits also contain wheat. If your baby has celiac disease, carefully read the labels of these food items before giving them to her. Many other daily use products like vitamin supplements and lip balms may also contain gluten. It is best to consult your pediatrician about choosing food items for your baby.
Substitute Wheat. Wheat is a staple diet in the Indian sub-continent but if your baby is not able to consume wheat, she is likely to suffer from deficiencies of many macro and micro-nutrients. To avoid this, substitute wheat, rye, oats and barley with rice, soybean, maize and corn. Plan out your baby’s meals with the help of a dietician or your pediatrician.