Evaluating the Timing of Gluten Introduction into Infant’s Diet and Other Influential Factors in Children with Celiac Disease

Vaziri, Houra; Mohammadi, Saeed; Marefat, Maryam; Jafari, Seyyed Ali; Kianifar, Hamidreza; Kiani, Mohammadali; Khalesi, Maryam; Ghanei Zare, Farzane

doi:10.22038/jpp.2026.92062.5609

Evaluating the Timing of Gluten Introduction into Infant’s Diet and Other Influential Factors in Children with Celiac Disease

Document Type : original article

Authors

Houra Vaziri ¹

Saeed Mohammadi ²

Maryam Marefat ²

Seyyed Ali Jafari ²

Hamidreza Kianifar ²

Mohammadali Kiani ²

Maryam Khalesi ²

Farzane Ghanei Zare ³

¹ Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

² Department of Pediatric Gastroenterology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

³ Department of Geriatric Nursing, Faculty of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnourd, Iran.

10.22038/jpp.2026.92062.5609

Abstract

Background: Gluten is recognized as the main causative factor of celiac disease (CD), affecting many children worldwide.
Objective: This study aimed to assess the potential relationship between the timing of gluten introduction into infants’ diet and other influential factors in children diagnosed with CD.
Methods: This descriptive-analytical cross-sectional study was conducted from January 2016 to 2022 and included all patients, aged 1-18 years, who were referred to our hospital over this 6-year period. Patients had a confirmed diagnosis of CD. Patient hospital records were retrospectively reviewed, and the investigated variables included patients’ age, gender, mode of delivery, infant feeding mode, and timing of introducing gluten into their diet. A P-value <0.05 was considered statistically significant.
Results: A total of 155 children, comprising 101 (65.2%) girls and 54 (34.8%) boys, met the inclusion criteria. Patient age ranged from 1 to 17 years (mean: 9.68 ± 4.03 years). The average duration of breastfeeding was 23.14 ± 2.2 months. Most patients were born through vaginal delivery (57.4%) and were exclusively breastfed without any supplementary milk (67.7%). The majority of children (59.4%) had a timely introduction of gluten into their diet. There was no statistically significant correlation between the timing of gluten introduction and the other investigated variables (P > 0.05 for all).
Conclusion: Within this cohort of children with confirmed celiac disease, the timing of gluten introduction was not associated with the measured early-life factors. Prospective studies with non-celiac controls are needed to clarify potential causal relationships.

Keywords

Breast milk

Cesarean section

Celiac

Gluten

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