Celiac Disease Symptoms in Infants and Toddlers

Does Your Baby Have Celiac Disease? Symptoms To Investigate in Infants, Toddlers

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Does your baby or toddler have celiac disease?. Getty Images/Tom Merton

Babies and toddlers susceptible to celiac disease can begin showing symptoms of the condition as soon as they've been introduced to gluten-containing foods in their diets — it's not unusual for infants to be diagnosed with celiac before their second or even their first birthdays in some cases.

But how can you know if your baby should be tested?

Unfortunately, it may be hard to tell. Celiac disease symptoms in infants are subtle, and behavior that indicates distress in your baby's tummy region may just be mistaken for general fussiness.

But there are some specific indicators that you should look for, and that may warrant a trip to your pediatrician to ask about testing for celiac disease, especially if either parent has a family history of the condition. Here's what you need to know.

Failure to Thrive Most Common Celiac Symptom in Babies

When most people think of celiac disease symptoms, they think of diarrhea ... and that's common (although far from universal) in children and adults before they're diagnosed. But while some infants and toddlers have diarrhea, they're more likely to have what's called "failure to thrive."

Failure to thrive describes infants and children who don't gain weight or develop as quickly as their peers. Babies with failure to thrive may have weight that is lower than the 3rd percentile of standard growth charts or 20% below the ideal weight for their height, and they may have a smaller head circumference.

They also may exhibit normal growth that then slows or even stops, and they may start to lose weight instead of gaining it.

In addition to slowing or stalled growth, infants with failure to thrive may miss milestones for such physical abilities as rolling over, sitting, standing and walking, and they may exhibit delayed mental and social skills.

A diagnosis of failure to thrive does not mean your baby also has celiac disease — in fact, there are numerous other conditions that can cause delayed growth and poor weight gain. But failure to thrive is often the main sign of celiac in infants and young toddlers, so it's worth considering the possibility and discussing it with your pediatrician if it's not clear what's causing your child's problems.

Swollen, Sore Tummy in Celiac Infants

In some cases, failure to thrive is the only sign of celiac disease in an infant or very young child. But there are other possible indications, even though not all babies will have these symptoms.

For example, infants and toddlers with celiac disease may also have a swollen stomach — well beyond what would be considered the normal, plump tummy of a happy, thriving baby. They also may have abdominal pain that causes fussiness and crying, although you may find it difficult to determine the exact location or source of that pain.

A baby or toddler who's suffering from celiac disease may also have chronic diarrhea or constipation, although medical studies show these symptoms may be more common in older children and adults than they are in very young children.

It Could Be Celiac — What Should I Do Now?

If you suspect your baby or toddler may have celiac disease, the first step should be to talk to your child's pediatrician, who can review growth charts to see if there's truly a problem and when that problem may have begun. Be ready to describe the symptoms and to share when you first introduced gluten to your baby's diet. Don't remove gluten from your child's diet just yet, as that can invalidate testing results.

If your pediatrician agrees that celiac is a possibility, she most likely will refer your child for blood tests that screen for celiac disease. These celiac disease blood tests can't actually diagnose the condition; they only can tell whether it's likely your baby has it or not. Based on the results of those blood tests, your pediatrician may recommend your child get a procedure called an endoscopy, which can provide a definitive "gold standard"

In an endoscopy, the doctor takes samples of the intestinal lining to look for a type of intestinal damage called villous atrophy that's found in celiac disease. Although the blood tests can provide a very good indication of whether celiac is present, an endoscopy is the only way to know for certain. You should discuss with your pediatrician whether an endoscopy is necessary in your child's case.

If your pediatrician does diagnose your infant or toddler with celiac disease, your child will need to follow a gluten-free diet for life. Fortunately, once your baby starts the diet, it's likely that growth and development will rebound, and any fussiness should diminish markedly.

Sources:

Kuloğlu Z. et al. Celiac disease: presentation of 109 children. Yonsei Medical Journal. 2009 Oct 31;50(5):617-23. doi: 10.3349/ymj.2009.50.5.617. Epub 2009 Oct 20.

Medline Plus Medical Encyclopedia. Failure to Thrive. Accessed September 25, 2014.

Rubio-Tapia A. et al. ACG clinical guidelines: diagnosis and management of celiac disease. American Journal of Gastroenterology. 2013 May;108(5):656-76; quiz 677. doi: 10.1038/ajg.2013.79. Epub 2013 Apr 23.

Westerbeek E. et al. Coeliac disease diagnosed at Starship Children's Hospital: 1999-2002. New Zealand Medical Journal. 2005 Aug 12;118(1220):U1613.

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