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LITURGY Q & A: Communion for Celiac Sufferers

What to Do in Severe Cases

Answered by Legionary of Christ Father Edward McNamara, professor of liturgy and dean of theology at the Regina Apostolorum university.

Q: We have a student in our school who has severe allergies — so much so that we have created a makeshift “clean room” for him. I have been told that he has not received the Eucharist since his first Communion due to potentially life-threatening allergic reactions to the gluten in the host. The only way he can receive Communion is by having a separate chalice with the Precious Blood so there is no chance of cross-contamination. What is the proper protocol here: Should a second chalice be placed on the altar for consecration? Should the priest pour the Precious Blood from his own chalice to a second one right before it is given to the student? Is there some other procedure? — J.P., Montvale, New Jersey

A: I have addressed some of the doctrinal and practical issues involving sufferers of celiac disease on September 14, 2004. Little has changed since that time except for the development of several forms of very low gluten hosts which are recognized as valid matter for the celebration of the Eucharist and at the same time safe for the majority of those living with the ailment. The newsletter of the Committee on Divine Worship of the U.S. bishops’ conference issued an updated pastoral response in April 2016: http://www.usccb.org/prayer-and-worship/the-mass/order-of-mass/liturgy-of-the-eucharist/celiac-disease-and-alcohol-intolerance.cfm.

The document addresses, among other issues, where to find very low gluten hosts in the United States. With respect to the risk of cross-contamination it says:

“For those members of the faithful with gluten intolerance, even trace amounts of gluten can be damaging. It is important, therefore, to be mindful of ‘cross-contamination’ when using either low-gluten hosts or when offering Holy Communion to someone only under the species of wine. It might be best, for example, for the communicant to prepare a pyx with the low-gluten host before Mass, in order to avoid the situation of a sacristan who has handled the other hosts also to handle the low-gluten ones. At Communion time, then, they could approach the sanctuary together with any Extraordinary Ministers of Holy Communion and receive the pyx from the celebrant with the words ‘The Body of Christ’ (or, if possible, they could be given the pyx within the normal Communion line, provided ‘contamination’ from handling of the pyx is avoided). Similarly, it might be necessary for someone who has permission to receive Holy Communion under the species of wine alone to prepare before Mass a chalice, which will not be part of the commingling rite and from which either they alone will receive or from which they will be the first to receive. Such precautions are not only medically necessary, but they demonstrate compassion to avoid singling out those who want to receive Communion, but are unable to receive one or the other species.”

With respect to low-gluten hosts and mustum it states:

“The most recent Church teaching on the use of mustum and low-gluten hosts at Mass remains the letter from then-Cardinal Joseph Ratzinger … on July 24, 2003 (Prot. n. 89/78-17498), which was addressed to the Presidents of Conferences of Bishops. In that letter, pastors and the faithful are reminded that for bread to be valid matter for the Eucharist, it must be made solely of wheat, contain enough gluten to affect the confection of bread, be free of foreign materials, and unaffected by any preparation or baking methods which would alter its nature. The amount of gluten necessary for validity in such bread is not determined by minimum percentage or weight, though hosts which have no gluten are considered invalid matter for Mass. (In the Roman Rite, the bread prepared for the Eucharist must also be unleavened.)

“Mustum is defined as grape juice in which fermentation has begun, but has been suspended with the result that its alcohol content (usually less than 1.0%) does not reach the levels found in most table wines. It should not contain additives and may be stored through freezing or other means. The process used for the suspension of fermentation must not alter the nature of the juice in any way. The amount of alcohol needed for validity in mustum is not determined by a minimum percentage or weight. Pasteurized grape juice in which all alcohol has been evaporated through high-temperature preparations is invalid matter for Mass. In the United States, it is forbidden to sell wine without the addition of sulfates as preservatives. The Church has determined that the very small amount of sulfates is acceptable and does not make the matter invalid.

“The lay faithful who are not able to receive Holy Communion at all under the species of bread, even of low-gluten hosts, may receive Holy Communion under the species of wine only, regardless of whether the Precious Blood is offered to the rest of the faithful present at a given celebration of Mass.

“Permission for priests, deacons, or the lay faithful without distinction to use mustum or low-gluten hosts is within the competence of the diocesan Bishop. The authority to permit the lay faithful to use mustum and low-gluten hosts in the reception of Holy Communion may be delegated to pastors under canon 137 §1 of the Code of Canon Law. Medical certification of a condition justifying the use of mustum or low-gluten hosts for Holy Communion is not required. Such permission, once granted, stands for as long as the condition persists which occasioned the request for the original permission.

“As a best practice, it is recommended that individuals with gluten and/or alcohol intolerance arrange through their parish the purchase any low-gluten hosts or mustum. This facilitates the oversight and good stewardship of the pastor who is responsible as mentioned above. It also ‘normalizes’ the practice for the communicant, as well as keeping the purchase of liturgical supplies together in the parish budget.

“It is also worth recalling that, through the doctrine of concomitance, the Church teaches that under either species of bread or wine, the whole Christ is received (cf. General Instruction of the Roman Missal, no. 282; Catechism of the Catholic Church, no. 1390). Thus, the faithful may be confident in the Real Presence of Christ in the Eucharist they receive, even under only one or the other species.”

Therefore, in the precise case at hand, it would appear that the best solution for our reader’s student is to receive from the chalice. In this case, a small chalice, such as those used in Mass kits for traveling priests, may conveniently be used. This chalice should usually be prepared beforehand and left on the credence table until the presentation of gifts during which it is placed on the corporal.

Since it is not the principal chalice, it does not receive any part of the priest’s consecrated host.

At the moment of communion a priest or a designated minister brings the chalice to the communicant and presents it as the Blood of Christ in the normal way.

While an effort should be made to avoid any embarrassment to the communicant, it is also true that today there is greater awareness of the presence of this ailment on the part of the faithful. And the fact that some members of the community receive Communion in a different manner is, thankfully, accepted and understood as something fairly normal.

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Readers may send questions to zenit.liturgy@gmail.com. Please put the word “Liturgy” in the subject field. The text should include your initials, your city, and your state, province or country. Father McNamara can only answer a small selection of the great number of questions that arrive.

About Fr. Edward McNamara

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