Eight-year-old Kevin Castro's family have accused Father Phil Henning, priest at the Sacred Heart Catholic Church of Floresville, Texas, of 'discrimination' after he refused to carry out the ritual.
Instead Father Henning offered to give the the boy the sacrament of the anointing of the sick.
Irma Castro, Kevin's grandmother, said: 'That is the anointing they give you before death. That was very offensive.'
She claims the priest said her grandson, who suffers from cerebral palsy and has a mental age of six months, did not qualify for the Catholic initiation 'because he was not able to understand the meaning of receiving the body of Christ.'
First Communion - the colloquial name for a child's first reception of the Sacrament of the Holy Eucharist - is an important religious milestone for children raised in Catholic families.
Catholic doctrine says that a child receiving Holy Communion must have 'sufficient knowledge' of Christ, but it doesn't specify what level of knowledge is considered sufficient.
Deacon Pat Rodgers, from the Archdiocese of San Antonio, said the decision whether to give the sacrament lies with the priest.
'It's never our desire, hope or wish to withhold a sacrament from someone who wants or needs it,' Father Rodgers told KSAT12.
Mrs Castro said after spending months preparing her grandson for his communion the refusal had shaken her faith.
'I hurt for my grandson and my family,' she said.
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