Pregnancy holds no greater risk for women diagnosed with coeliac disease than those without, but it remains important to adhere to a strict gluten free diet to avoid complications. There are no specific nutritional guidelines for pregnant women with coeliac disease, however, you should also aim to follow general healthy eating principles, including plenty of calcium and iron rich foods.
All pregnant women should take a folic acid supplement (400 micrograms a day) for three months prior to conception and until the 12th week of pregnancy to help protect against neural tube defects. Eating plenty of green leafy vegetables will also increase your natural intake of folate (folic acid).
If you get food on prescription, being pregnant increases your allowance by 1 more unit per month during the 3rd trimester.
As a coeliac, your baby will have a 1 in 10 chance of developing coeliac disease, but that means there is an overwhelming 9 in 10 chance that they will not develop it. You should not introduce gluten into the baby’s diet before six months of age but research suggests there is no benefit in withholding gluten containing foods beyond this point, regardless of family history. It is actually necessary to introduce gluten in to a baby’s diet in order to diagnose coeliac disease.
Current guidelines recommend that solid foods be introduced at six months of age, however, it is not uncommon for babies fed solely on milk to require solid food before this age. Solid foods should not be introduced before 4 months of age. If you are unsure if your baby is ready to wean, seek advice from your health visitor or a dietitian.
There may be a lower risk of developing coeliac disease in childhood for those children breastfed at and beyond introduction of gluten to the diet. However, it is important to be aware that the research in this area is not conclusive. Formula milk is gluten free if you decide not to breastfeed.
Babies require energy dense foods in order to fuel growth and development. Suitable gluten free first foods include; pureed fruit and vegetables, and gluten free cereals such as baby rice. Protein containing foods including meat, fish, eggs, beans and pulses may be introduced from around 6 months, in addition to soft finger foods which will help encourage independent eating, co-ordination and chewing skills. Weaning is a gradual process but by one year old, most children will be eating chopped/mashed family foods.
Below are some of the symptoms of coeliac disease in infants. If you notice any of these symptoms you should make an appointment with your GP and discuss coeliac disease testing:
• Stools often yellow and foul smelling
• Lower than expected weight gain
• Generally unhappy/irritability
• Muscle wasting
• Abdominal swelling
• Poor appetite
It is important to continue on a gluten containing diet whilst undergoing tests for coeliac disease to ensure accurate results.
Read about coeliac disease and children here