Pregnancy and Celiac Disease: A Complete Guide

Being pregnant with celiac disease can be scary. Celiac disease impacts women’s health and pregnancy is one of those aspects of women’s health impacted by celiac.

In this post, we will dive into all things celiac disease and pregnancy. From how eating gluten can impact your baby to what kinds of nutrients you need to pay attention to for a healthy pregnancy.

Table of Contents

Pregnancy and Celiac Disease - How celiac impacts pregnancy​ - Tayler Silfverduk, celiac dietitian

Celiac can Impact Fertility

If you’re trying to get pregnant, it’s important to know that celiac can impact your chances of getting pregnant.

This is because celiac has been found to impact fertility in both men and women. This means that if you have undiagnosed, untreated, or are still recovering from a celiac diagnosis, your fertility may be impacted.

This is largely related to the fact that celiac disease can impair absorption of nutrients essential for fertility. However, fertility complications typically resolve after healing celiac. Read my blog post all about celiac disease and fertility for more info.

Celiac Disease Impacts Pregnancy

Celiac disease can impact a woman’s ability to get pregnant, remain pregnant for the full term, and have a safe delivery.

In a study done by Moleski and others in 2015, results showed women with celiac disease had higher rates of loss of pregnancy compared to non-celiacs.

Pregnancy complications are associated with impaired nutrient absorption and stores due to intestinal damage. Some key nutrients to check for before and while pregnant with celiac, include:

  • Iron
  • Folate
  • Bone minerals
  • Protein 

All of that said, don’t panic yet! The good news is that when a celiac is properly treated with a gluten-free diet, the rate of miscarriage drops.

If you’re worried about how your nutrition status and celiac will impact pregnancy, bring up your concerns with your healthcare team. In general, if you’ve restored your nutrition status, you’re consistently avoiding gluten, and you’ve healed your small intestine, celiac disease should not interfere with your pregnancy.

Can Eating Gluten Hurt my Baby?

Continuing to eat gluten can hurt your baby if you have celiac disease, however don’t beat yourself up over accidental exposure.

Accidental exposure is unlikely to cause the harms intentional and repeated exposure to gluten could cause.

If you do accidentally consume gluten, recognize that the symptoms will pass and that a one-time exposure will not cause enough damage that you need to be concerned.

Again, it is with repeated exposure that issues may arise. If you do get glutened, check out my blog post on what to do when you’re glutened for help.

Hyperemesis Gravidarum and Celiac Disease

Women with celiac disease are at a higher risk of developing hyperemesis gravidarum (HG). HG is a severe form of morning sickness that can be commonly experienced by pregnant women. Per the Cleveland Clinic, symptoms of HG include:

  • Severe vomiting (more than 4 times per day)
  • Dehydration due to excessive vomiting
  • Feeling dizzy and light headed
  • Weight loss

It is important to pay attention to this condition to mitigate the symptoms and effects as much as possible to prevent any severe complications from occurring, if possible. Strategies to manage HG include:

  • Wearing a pressure point wristband
  • Taking vitamin B6 or ginger to treat the nausea
  • Eat small, frequent meals of bland and dry foods (check out my post on gluten-free bland foods for meal ideas!)
  • Supplement with an electrolyte drink such as Liquid IV or Powerade/Gatorade to replenish the electrolytes that are lost from excessive vomiting and prevent dehydration

If HG progresses to the point that it is very severe and you require medical attention, you may be placed on IV fluids or parenteral nutrition to ensure that you are getting enough nutrients and fluids to keep yourself and the baby healthy. Don’t be afraid to reach out for help if you need it!

Can Pregnancy Cause Celiac Disease in Mom?

The answer is maybe. Pregnancy is a suspected cause of celiac disease in women. However, note that if you have the celiac gene that doesn’t absolutely mean pregnancy will trigger celiac. It just means you have the potential to develop celiac. Of course, bring up any concerns you have with your doctor.

On the same note, there is a myth going around the celiac will go away after pregnancy. This is not true. Once diagnosed with celiac disease, you will have it for the rest of your life. Pregnancy does not change that.

Can Birth Cause Celiac Disease in Baby?

If you have celiac disease, you can transfer the celiac gene to your child. That said, it is unlikely that birth can cause celiac disease genes to trigger in babies.

That’s because, in order to develop celiac disease, you must be eating gluten, and babies at birth have not yet consumed gluten to develop celiac yet.

Which leads to the question of can you prevent the development of celiac in your baby? The answer is largely no. As as your first degree relative, your baby is at a ~10% higher risk of developing celiac.

And unfortunately, there’s not anything we an do to prevent autoimmune diseases from being triggered. In part, because we don’t fully understand why or how they get triggered.

Nutrients essential for celiac pregnancy - Nutrients essential to pregnancy on a gluten-free diet -Pregnancy and Celiac Disease​ - Tayler Silfverduk, celiac dietitian

Nutrition Needs of Pregnant Celiacs

The nutrition needs during pregnancy with celiac disease are higher.

Nutrition needs are already higher when you are pregnant & for women with celiac, needs may be even higher due to malabsorption that can occur if still healing from diagnosis.

With celiac disease, an autoimmune reaction occurs in your small intestine and, over time with repeated exposure, can cause damage to the small intestine and lead to issues in fully absorbing nutrients.

Further complications that can arise due to the damage of the intestinal lining include diarrhea, dehydration, and anemia that can further increase needs of certain nutrients.

Women that are pregnant need higher amounts of key nutrients including protein, iron, folate, and bone minerals as well as overall calories.

Iron Needs

People with celiac disease are at risk for iron deficiency. With iron being essential to a healthy pregnancy with celiac, and with the higher risk of it being present in celiacs, iron is a big nutrient of concern.

Thus, it is important that women with celiac disease get a complete iron panel to monitor iron levels as part of their  follow-up celiac testing.

Additionally, pregnancy celiacs should consume enough iron in their diet, and supplement if needed to prevent iron deficiency both before conceiving, if possible, and throughout the duration of the pregnancy. 

During pregnancy, a woman needs 27 mg of iron per day. In a woman with celiac that can be dealing with malabsorption, it is important to be intentional with consuming gluten-free iron-rich foods such as red meats, poultry, and fish.

If you choose to supplement with iron, get a supplement that does not contain both calcium and iron as they compete for absorption. 

You can also use cooking methods that increase the iron content of your food such as the Lucky Iron Fish, which is a small fish made of iron and releases 5-10 mg of iron into your food as it cooks. You could also use a cast iron skillet, which will also release iron into your food while it is cooking.

Folate Needs

Folate deficiency can directly impact pregnant celiacs. You see, folate is absorbed in the small intestine, and absorption can be impaired with celiac damage. Thus, celiacs are at risk for deficiency.

Folate is an essential nutrient during pregnancy as it is needed to prevent spina bifida and other neural tube defects in the growing fetus. The RDA for folate for women of child bearing age was established at 400 mcg in 1992. Needs are increased in all pregnant women, from the normal 400 mcg to 600 mcg.

In fact, folate is so important for a healthy pregnancy that in 1998, an intervention was put into place in the United States that required all cereal grain products to be fortified with 140mcg of folic acid per 100g of flour to prevent neural tube defects.

Being on a gluten free diet, many of these enriched grain products that provide this fortification are eliminated so it is important to pay attention to the gluten free grain products that you buy to see if folate/folic acid is added into them or if you will need to get them in your diet elsewhere from other food sources or supplementation.

You can get folate from foods like beans, spinach, broccoli, and gluten-free fortified grain products. Since this is an essential nutrient to the proper growth and development of the fetus’ nervous system, it is usually recommended that women begin a prenatal vitamin when trying to conceive or as soon as they discover that they are pregnant.

Bone Minerals

Celiac disease can impact your bone health. This risk could be higher if you’re pregnant with celiac disease.

Low bone mineral density resulting in osteopenia and osteoporosis is common in women with celiac disease. Women are recommended to keep a close eye on their calcium, vitamin D, and magnesium levels and ensure that they are getting enough of them via the diet or from supplementation

When pregnant, bone minerals are even more essential to prevent bone complications in celiacs.

The recommendations for daily consumption for pregnant women of these nutrients are:

  • 1000 mg of calcium per day. Get enough from gluten-free calcium-rich foods like: dairy products, cruciferous vegetables, and fortified calcium products like non-dairy milks and orange juice. If taking a calcium supplements, be sure to space out when you take calcium and iron, as they can compete for absorption.
  • 600 IU of vitamin D per day to meet needs but a doctor may recommend more if you are already vitamin D deficient with celiac. Get vitamin D by exposing your wrists and ankles to the sun for 5-15 minutes during peak sun hours a few times a week.
  • 350 mg of magnesium per day if pregnant. You can get magnesium from supplements (I like this one as it’s gentle on the stomach) and  through food. Foods high in magnesium include dark leafy greens, beans, nuts, seeds, and whole grains.

Protein Needs

Protein needs increase during pregnancy by about 50% per baby. Be sure to consume protein rich foods such as meats, poultry, eggs, dairy, beans, and legumes to consume adequate amounts for you and the baby.

Tips for Celiac and Pregnancy - How to Support Pregnancy and Celiac Disease​ - Tayler Silfverduk, celiac dietitian

Tips to Support Pregnancy with Celiac

There are a few things that can support pregnancy if you have celiac. Below are a list of general things you can do to support your pregnancy with celiac disease.

  • Eat enough – Pregnancy increases your needs. Make sure you’re eating enough to support a healthy pregnancy. If you need help with this, a celiac dietitian can help.
  • Consider intuitive eatingstudies show that eating intuitive while pregnant can result in better diet quality and proper weight gain to support a healthy pregnancy.
  • Maintain movement habits – continuing routine movement habits can help prevent pregnancy complications and even post-partum depression. Just be careful to choose exercise that is appropriate for your stage of pregnancy.
  • Eat a balanced gluten-free diet rich in protein, calcium, folate, iron, and fiber to support healthy growth and development of your baby.
  • Take a gluten-free prenatal vitamin to ensure you’re getting in all the nutrients needed for a healthy pregnancy. I like this prenatal vitamin. Side note: If your prenatal vitamins are making you nauseous or you are struggling with morning sickness, some find it helpful to take prenatal vitamins at night before bed.

2-Day Meal-Plan for Pregnant Celiacs

Day One

Day Two

This meal-plan is for educational purposes only.

Celiac Impacts Pregnancy

Celiac impacts pregnancy and don’t let that scare you. While mismanaged and undiagnosed celiac can impact pregnancy, if you are gluten-free and healed you should be fine.

And if you need nutrition support during your celiac pregnancy, I am happy to support you!