Delaying an infant’s introduction to gluten does not appear to prevent celiac disease among at-risk infants, a new study shows. Results from the international study led by investigators associated with the Center for Celiac Research and Treatment at MassGeneral Hospital for Children challenge current thinking on possible measures to take. The report, which appears in the October 2 New England Journal of Medicine, indicates that loss of tolerance to gluten, a protein composite commonly found in wheat, rye and barley, is a dynamic process that breastfeeding or delaying the introduction of gluten-containing foods offers substantial protection against.

Carlo Catassi, MD, co-director of the Center for Celiac Research and Treatment and principal investigator of the study, said in a statement, “One of our most important findings was that the timing of gluten introduction – whether early or late in the first year of life – made no difference to the subsequent development of celiac disease.” He continued, “While earlier studies led to the hypothesis that there was a time window, between 4 and 7 months of age, during which gluten could safely be introduced to at-risk children, our results indicate we can tell mother not to worry so much about when they introduce gluten into their children’s diet.”

Alessio Fasano, MD, PhD, director of the Center for Celiac Research and Treatment and a co-author of the NEJM report, notes, “Of the several factors we studied, it’s very clear that genetic background is by far the most important in determining which infants will develop this autoimmune condition. We were particularly surprised that breastfeeding at any age provided no protective effect.”

According to the Celiac Disease Foundation, celiac disease is an autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten promotes damage in the small intestine. It is estimated to affect 1 in 100 people worldwide.