It is well established that the optimal time for introducing solids for babies is around 6 months, when the baby is showing signs of readiness. The timing of gluten introduction, in terms of whether it may influence development of coeliac disease, has been a subject of debate in recent years.
Gluten is a protein found in wheat, barley and rye. Coeliac disease is an auto-immune disease affecting around 1% of Western populations (incidence in Asian populations is not established) that arises from an adverse reaction to gluten. It causes gut damage which in turn can cause problems such as anaemia and poor growth as nutrients are not absorbed properly.
The research on the timing of gluten introduction has recently been reviewed by the European Society for Paediatric Gastroenterology, Herpetology and Nutrition (ESPGHAN), who has published a new position paper making the following recommendation:
gluten may be introduced into the infant’s diet anytime between *4 and 12 completed months of age.
Other points made in this paper:
- it does not seem to make a difference whether or not the infant is being breastfed at the time of gluten introduction, however breastfeeding should be promoted for it’s other well established health benefits.
- in children at high risk of developing coeliac disease (i.e. those with a genetic predisposition and those with first degree relatives with coeliac disease), earlier introduction is associated with earlier onset of symptoms, but does not change the incidence (i.e. delaying introduction does not prevent coeliac disease).
- consumption of large quantities of gluten should be avoided during the first weeks after gluten introduction. However, exact amount could not be defined based on the information available to date.
*the recommended time for introducing solids is around 6 months.
Therefore in practice, gluten can be introduced at any time from about 6 months up to 1 year. Gluten should be introduced gradually. Pictured below is a suggested schedule for introduction of gluten-containing foods:
Source: Feeding your baby: introducing family meals. HSE, Ireland.