Premium
Randomised clinical trial: reducing the intake of dietary FODMAP s of breastfeeding mothers is associated with a greater improvement of the symptoms of infantile colic than for a typical diet
Author(s) -
Iacovou Marina,
Craig Simon S.,
Yelland Greg W.,
Barrett Jacqueline S.,
Gibson Peter R.,
Muir Jane G.
Publication year - 2018
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15007
Subject(s) - medicine , crying , breastfeeding , infantile colic , crossover study , breast milk , prospective cohort study , infant formula , pediatrics , placebo , breast feeding , gastroenterology , biochemistry , alternative medicine , pathology , chemistry , psychiatry
Summary Background Therapeutic diets for infantile colic lack evidence. In breastfed infants, avoiding “windy” foods by the breastfeeding mother is common. Aim To examine the effects of a maternal low‐ FODMAP (Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, And Polyols) diet compared to a typical‐Australian diet on infant crying‐fussing durations of infants with colic in a randomised, double‐blind, crossover feeding study. Methods Between 2014 and 2016 exclusively breastfed infants aged ≤9 weeks meeting Wessel criteria for colic were recruited. Mothers were provided a 10‐day low‐ FODMAP or typical‐Australian diet, then alternated without washout. Infants without colic (controls) were observed prospectively and mothers remained on habitual diet. Infant crying‐fussing durations were captured using a Barr Diary. Measures of maternal psychological status and samples of breast milk and infant faeces were collected. Results Mean crying‐fussing durations were 91 min/d in seven controls compared with 269 min/d in 13 colicky infants ( P < 0.0001), which fell by median 32% during the low‐ FODMAP diet compared with 20% during the typical‐Australian diet ( P = 0.03), confirmed by a two‐way mixed‐model analyses‐of‐variance (ƞ p 2 = 0.719; P = 0.049) with no order effect. In breast milk, lactose concentrations remained stable and other known dietary FODMAP s were not detected. Changes in infant faecal calprotectin were similar between diets and groups, and faecal pH did not change. Median maternal anxiety and stress fell with the typical‐Australian diet ( P < 0.01), but remained stable on the low‐ FODMAP diet. Conclusions Maternal low‐ FODMAP diet was associated with enhanced reduction in crying‐fussing durations of infants with colic. This was not related to changes in maternal psychological status, gross changes in breast milk or infant faeces. Mechanisms require elucidation. Trial Registration Australian New Zealand Clinical Trials Registry ( ANZCTR ): 12616000512426 ‐ anzctr.org.au