Impact of breastfeeding on serological recovery and metabolic homeostasis in postpartum women with celiac disease: a longitudinal study.

OBJETIVES: Pregnancy and the subsequent postpartum period represent a physiological challenge for women with Celiac Disease (CD), often characterized by nutritional depletion and hormonal fluctuations. While the benefits of breastfeeding for the infant are well-established, its impact on maternal CD clinical evolution remains under-researched. OBJECTIVE: To evaluate the influence of exclusive breastfeeding (EBF) on the normalization of serological markers, iron stores, and bone mineral homeostasis in women with CD. METHODS: A prospective longitudinal study was conducted with 255 CD women in Central Spain. Participants were followed from the third trimester of pregnancy (T0) to 12 months postpartum (T2). Parameters included anti-tissue transglutaminase (tTG-IgA) titers, serum ferritin, and bone mineral density (Z-score). RESULTS: At 12 months, the EBF group (n = 160) showed a significantly higher rate of serological remission (92%) compared to the formula-feeding (FF) group (74%, p < 0.001). Mean tTG-IgA levels decreased more rapidly in the EBF group (18.4 ± 4.2 to 2.1 ± 0.8 U/mL). Furthermore, EBF was independently associated with a robust recovery of ferritin stores (42.1 ± 8.2 vs. 31.5 ± 7.1 ng/mL, p = 0.012) and significant improvements in bone Z-scores (+0.8 ± 0.2 deviation). CONCLUSIONS: Breastfeeding acts as a beneficial physiological modulator in the celiac mother, accelerating the clearance kinetics of serological markers and promoting a more efficient recovery of metabolic and nutritional homeostasis during the postpartum transition.