Going Gluten-FreeJune 1, 2010

Celiac Disease and C-Section

When news broke a couple weeks ago about a research study out of Germany reporting that children who develop celiac disease appear to be more likely born by c-section, I paid special attention. Rarely has a news items been so timely and personal – I’m a celiac delivered via c-section, and I’m just weeks away from my own delivery. I’m expecting my second daughter sometime next month.

But I was curious, why would c-sections have anything to do with celiac disease? What’s the connection?

One theory put forth is that the mode of delivery can impact the mix of bacteria in the newborn’s gut. As I understand it, a c-section is a ‘cleaner,’ more sterile delivery – in this case not necessarily a good thing – and it may contribute to abnormal intestinal bacteria that might make the newborn more vulnerable to celiac disease.

Because I was already hoping to avoid a c-section, I considered bringing up the study results with my obstetrician. But after reading up on the study, I decided against it. Not only would my doctor be likely to advise me that c-sections are reserved for medically necessary situations – and can be life-saving—if she was aware of the study specifics, I bet she wouldn’t put too much stock in it just yet. It’s the first time a link has been made between c-sections and celiac disease. Even if the association proves to be real one day, it’s a link, not a cause.

Still, I wonder—if I’m suddenly faced with a c-section, will this study come to my mind and send me into a small panic? I hope not. I’d like to be able to trust that the reasons for intervening with a c-section are far more compelling than this very preliminary information about celiac and c-sections.

I imagine we’ll learn more about the celiac/c-section connection in the future. For now, I’m focusing on enjoying the final days of this pregnancy. I’m trying to think less about the specifics of the delivery and more about the excitement of meeting my new daughter.

Comments (17)

posted by: Lucinda CD is absolutely triggered by stressful events sometimes. I never had a problem until I had surgery nine years ago and have had nothing but problems since.

Posted by: Lucinda S | July 11, 2010 2:09 PM    Report this comment

I have 4 children. Only one has celiac disease and she was a normal, full term delivery! She was dx at 20 months.

Posted by: Nancy V | June 9, 2010 11:27 AM    Report this comment

Interesting! I was a "normal" delivery but have had 2 C-Sections. One child, has Celiac and the other does not. Both my daughter and I were diagnosed as *very* new onset Celiac the same year. She was 4 yrs old at the time. But my daughter was also a premmie, stressed from birth. Hard to believe that the method of delivery could affect an autoimmune disease, but interesting.

Posted by: Allison F | June 4, 2010 6:12 PM    Report this comment

Amy, I'm curious what you meant when you said if you have Celiacs Disease that you do not have an allergy to gluten. I understand that gluten intolerant is not the same as CD; however, with CD, certainly you have to avoid any hint of gluten. Is it that with gluten intolerant, they just get stomach aches, etc., etc., but with CD, it actually destroys the lining of the intestine? And I, too, just find it interesting that someone connected C-section with CD. I suppose you just about do a test on anything and find a connection. It's still best to have your baby vaginally. ;-) Oh, and what did you mean that a very stressful life event triggers CD? I have not heard that before... Thank you!

Posted by: MaryO | June 4, 2010 6:06 PM    Report this comment

If you have CD, then you do not have an allergy to gluten. I have to remember that. It's easier to say you have an allergy as it decreases the explanation. I had a son via vaginal delivery and genetically speaking he basically has a 50/50 chance of developing CD. My husband does not have it, luckily. It may just be a look at the numbers and statistics of it. If you have the CD gene, then you have to experience a very stressful life event to "turn it on". I really don't think there is that much of a connection, just interesting.

Posted by: Amy G | June 4, 2010 1:48 PM    Report this comment

I have celiac disease and was diagnosed on Sept 2, 2008 and now I'm 47. I have had 3 normal pregnancies and did not have c-section. All this came to a shock and couldn't believe that I have celiac disease. I believe my mom (passed away Aug 2006) had celiac because she always had stomach aches and bowel problems. My mom's sister had colon cancer (1992) and she passed away March 2006 due to lung cancer).

Posted by: Treece | June 4, 2010 6:57 AM    Report this comment

For those interested, here's a link to the celiac/c-section study:

www.pediatrics.org/cgi/doi/10.1542/peds.2009-2260

Pediatrics, online May 17, 2010. Please note, only the abstract is available without a subscription to the journal.

Posted by: Christine Boyd | June 3, 2010 5:21 PM    Report this comment

Virginia, the article merely states that there may be a connection between C-section and Celiac, not that all C-section babies have Celiac. One out of 133 (how they came up with that number, I don't know) - but 1 out of 133 people have Celiac and are misdiagnosed with syndromes and diseases. So the chances that a C-section person has Celiac is pretty high. ;-} Having Celiac yourself, and all five of your children, I'm sure you are plenty aware of the stats related to Celiac. Are there other reasons to not have C-section? You bet. God designed every bit of the process and entering through the birth canal is vital for a lot of reasons. And the C-section rate is so high because giving birth has become a BUSINESS. A very lucrative one, at that. Pity.

Posted by: MaryO | June 3, 2010 2:40 PM    Report this comment

08 Sep 2003

(USA) - Some infants who are delivered by cesarean section may have an increased risk of developing food allergies, according to a new report published in the August issue of the Journal of Allergy and Clinical Immunology.

Investigators have identified a relationship between cesarean section delivery and subsequent food allergy in children of mothers with allergies.

Cesarean delivery might delay the growth of normal intestinal flora--bacteria that normally line the intestine--in the newborn infant, Dr. Merete Eggesbo, of the Norwegian Institute of Public Health in Oslo, and colleagues note. One theory is that delays or abnormalities in the growth of these bacteria may increase the risk of allergic disease.

To further investigate, the researchers obtained data on mode of delivery, maternal or infant use of antibiotics, and potential confounding factors in a population of 2803 children.

The main outcome measures were the parent's opinions of their child's reaction to egg, fish, or nuts. The child's reaction to egg at 2.5 years of age was also objectively confirmed by laboratory tests.

For children with allergic mothers, the researchers found that cesarean section was associated with a sevenfold increased rate of parental reports of reactions to egg, fish, or nuts in children. The risk of confirmed egg allergy was increased by fourfold in these children.

For children without allergic mothers, the association between cesarean section and the risk of food allergy was weak and not significant.

There was no association between maternal or infant antibiotic use and an increased risk of food allergy.

These results 'lend circumstantial support to the importance of microbiologic stimuli in early life,' Eggesbo and colleagues conclude. They suggest that this might be another factor to consider when mode of delivery is discussed with pregnant women.

SOURCE: Journal of Allergy and Clinical Immunology, August 2003.

Posted by: BARI L | June 3, 2010 1:22 PM    Report this comment

I have Celiac as do my 5 children and none of us were c sections. I don't think it matters.

Posted by: Virginia F | June 3, 2010 1:19 PM    Report this comment

08 Sep 2003

(USA) - Some infants who are delivered by cesarean section may have an increased risk of developing food allergies, according to a new report published in the August issue of the Journal of Allergy and Clinical Immunology.

Investigators have identified a relationship between cesarean section delivery and subsequent food allergy in children of mothers with allergies.

Cesarean delivery might delay the growth of normal intestinal flora--bacteria that normally line the intestine--in the newborn infant, Dr. Merete Eggesbo, of the Norwegian Institute of Public Health in Oslo, and colleagues note. One theory is that delays or abnormalities in the growth of these bacteria may increase the risk of allergic disease.

To further investigate, the researchers obtained data on mode of delivery, maternal or infant use of antibiotics, and potential confounding factors in a population of 2803 children.

The main outcome measures were the parent's opinions of their child's reaction to egg, fish, or nuts. The child's reaction to egg at 2.5 years of age was also objectively confirmed by laboratory tests.

For children with allergic mothers, the researchers found that cesarean section was associated with a sevenfold increased rate of parental reports of reactions to egg, fish, or nuts in children. The risk of confirmed egg allergy was increased by fourfold in these children.

For children without allergic mothers, the association between cesarean section and the risk of food allergy was weak and not significant.

There was no association between maternal or infant antibiotic use and an increased risk of food allergy.

These results 'lend circumstantial support to the importance of microbiologic stimuli in early life,' Eggesbo and colleagues conclude. They suggest that this might be another factor to consider when mode of delivery is discussed with pregnant women.

SOURCE: Journal of Allergy and Clinical Immunology, August 2003.

Posted by: BARI L | June 3, 2010 12:33 PM    Report this comment

Christine, thanks for the article. I would suggest you view the documentary by Ricki Lake called "The Business of Being Born" - like, now - before your precious daughter enters the world. You can actually find it on Netflix, or you can find it on line and order it. I was one of those who spent years being misdiagnosed (I never heard of Celiac, or I would have diagnosed myself!). I did end up in the hospital ER where they removed a grapefruit-size cancerous tumor from my colon; but gratefully, I am alive and well today - cancer free. No chemo, no radiation, just plain good eating habits, which finally included NO GLUTEN. "When in doubt, go without" is my motto. And it was a naturopath who put me on the right path. While I appreciate trauma docs, I have no use for physicians in general. Oh, another good web site: drcelltox.com - excellent insights about being healed at the cellular level. At any rate, I had both of my children C-section and literally bawled through Ricki Lake's documentary, realizing that it just didn't have to be that way...again, I appreciate trauma docs when there's an emergent situation; but mostly they are in a business, and they know how to dispense drugs to mask the real problem, and cut you open, and dispense more drugs. Both of my children eat GF, even though they've not been tested for Celiacs. They just feel better - and it's better for you. And, sorry this is so "all over the place," but it's also been scientifically proven that vaginal births are beneficial for a lot of reasons - re: what the baby gets as he passes through the birth canal, etc. My best advice: get a midwife. All 5 of my grandchildren were born naturally with a midwife - at home. It's a beautiful thing...

Posted by: MaryO | June 3, 2010 11:45 AM    Report this comment

I would suspect it has a lot to do with heredity. I was not born via c-section, though my two children were. I had trouble gaining weight with both pregnancies, adding only 12 pounds each time. I ended up on bed rest at 36 weeks with each of them. They tried to induce with my first but after three days, they did a c-section. For the second, induction was too risky.

My son was three years old when I discovered, with the help of an herbalist, that I was gluten intolerant. We then determined that my mother is as well. We believe that my grandmother was, too. Both of my children have trouble with gluten. My son is much more sensitive than his older sister. My pregnancy with him was also more difficult. Looking back, I can see a definite link between the challenges I faced (anemia, passing out, inability to gain weight, severe abdominal pains that mimicked appendicitis, etc.) and our gluten intolerance. I only wish my doctors had been educated enough to diagnose it. I honestly believe that a gluten free diet would have prevented both c-sections.

Posted by: REBECCA FLANNERY F | June 3, 2010 11:19 AM    Report this comment

I too have a question. I had 4 c-sections and my 15 yr. old daughter,was just diagnosed with Celiac Disease, 1yr. ago (she was my last c-section baby). Where is the study I can read more about this....My mom died of colon cancer and I was told,if you go undected with Celiac Disease you could get colon cancer later. I had to have c-sections,because I was told I had "pelives previa",and could not deliever any babies bigger then 7pds, naturally. All my kids weighed over 8pds. I worry, now about this too. Even though we all got tested and only 2 of the kids had high numbers and my 15 yr. old was the only one suffering from Celiac Disease. Can you send me the link to that study!

Posted by: Catalina L | June 3, 2010 11:18 AM    Report this comment

I don't have celiac's, but I do have a dairy allergy. I was a regular delivery, but both my sons were C-sections and I am very curious to know what the study found re the ratio of C-section deliveries to celiac's! As neither son has digestive issues other than occasional heartburn (my sons are grown up now and in their 20's), I am also interested in when symptoms become chronic and noticible? I know my aunt was in her late 40's early 50's when she began to have very noticible problems prompting many trips to the doctor and a couple of years to finally diagnose (and another aunt is in her 60's and just recently diagnosed with gluten sensitivity)? How old are most people when they KNOW? Also, I wonder who else is trying to replicate the findings in this study? This is a subject I will be keeping on top of! Thank you for sharing!

Posted by: robillm | June 3, 2010 10:23 AM    Report this comment

Do you have a link to the study? I was not born by c-section but all three of my children were born by c. I have been diagnosed with celiac and suspect my children. I have wondered whether women with celiac have more difficult births.

Posted by: Jake M | June 3, 2010 9:22 AM    Report this comment

I have not been diagnosed yet, nor has my eldest son... but we were both delivered via c-section. We also have several other allergies. My younger son, who was a VBAC, has only a few mild allergies (he's still got the gene). The two of us have definite issues with gluten. I have always thought that being in such a (well, mostly) sterile enviroment has something to do with our issues, but another problem is the c-section rate is so high, isn't there a possiblility of a coinincidence as well? When the c-section rate is 33%, that's got to be part of a much bigger problem, especially when c-sections can add to the possibility of a whole list of other problems.

Posted by: Amber R | June 3, 2010 8:30 AM    Report this comment

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