Effect of Maternal Diet on Colic Among Breastfed Infants

Recent research suggests that maternal intake of food allergens is an important factor in the pathogenesis of infantile colic among breastfed infants.

Infantile colic affects up to 28% of infants in the first months of life. Colic symptoms usually peak at 6 weeks of age and improve gradually over the following weeks. In the study, which appears in the current issue of the journal Pediatrics, a randomized, controlled trial of a low-allergen maternal diet was conducted among exclusively breastfed infants presenting with colic.

In the test group, mothers excluded cow's milk, eggs, peanuts, tree nuts, wheat, soy, and fish from their diet; mothers in the control group continued to consume these foods.

The mothers first recorded how often their babies cried or fussed on days one and two of the study. Then each group of mothers started its diet regimens for a week. The mothers recorded their babies' crying and fussing again on days eight and nine.

Outcomes were assessed after 7 days, as the change in cry/fuss duration over 48 hours, with validated charts. The primary end point was a reduction in cry/fuss duration of 25% from baseline. Mothers also assessed the responses to diet with categorical and visual analog scales.

At the end of the study, 74% of infants in the low-allergen group experienced at least a 25% reduction in crying and fussing. Only 37% of infants in the standard-diet group had a similar reduction. "These findings suggest that maternal intake of food allergens is an important factor in the [development] of infantile colic among breastfed infants," the researchers write.

Exclusion of allergenic foods from the maternal diet was thus found to be associated with a reduction in distressed behavior among breastfed infants with colic presenting in the first 6 weeks of life.

This study suggests that study shows breastfeeding moms should consider avoiding allergenic foods.

However, the researchers wars that breastfeeding mothers should not make drastic diet changes on their own, as elimination diets have associated risks, particularly if sustained for long periods. They suggest additional studies to define the pathophysiologic features and role of maternal elimination diets in infantile colic.