After listening to your baby’s high-pitched screaming and crying for several hours a day, day after day, week after week, it must come as little comfort when your doctor confirms your baby has infantile colic. Perhaps even less impressive is the range of solutions offered to soothe your baby’s pain – because there are few treatment options and no definitive fix.
Exactly what causes colic in somewhere between 5% and 25% of newborn babies in the first few months of their lives is unknown. And although there is light at the end of the tunnel – colic typically resolves itself by four to five months of age – what the parents want is a solution today for their baby’s pain.
For some time there has been a suggestion that certain foods in a mother’s diet may cause colic symptoms in breastfed babies. In 1996 a US study, published in the Journal of the American Dietetic Association, announced that “maternal intake of cruciferous vegetables, cow’s milk, onion or chocolate during exclusive breastfeeding is associated with colic symptoms in young infants”. And so it was that cabbage, cauliflower and broccoli were cast aside by breastfeeding mums.
Still, that didn’t explain why formula-fed babies suffer from colic, as clearly there’s no cauliflower or chocolate in infant formula. But our understanding of foods and gut-related problems has advanced since 1996, and we now know that cabbage and certain infant formulae do indeed have something in common – Fodmaps!
Fodmaps is an acronym for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. These molecules are found in food and are normally completely harmless. However, some people can’t absorb Fodmaps properly; instead Fodmaps travel from their small intestine into the large intestine, where bacteria ferment them, producing gases and causing symptoms such as bloating, pain, wind and diarrhoea or constipation in people with irritable bowel syndrome, for example.
Members of the research team at Melbourne’s Monash University who identified the link between Fodmaps and irritable bowel syndrome were contacted by a number of mothers who said their low-Fodmap diet had reduced their baby’s colic. These reports inspired an investigation into the potential role of Fodmaps in infantile colic. Subsequently, Fodmap levels were measured in 13 infant formulae and 10 common “gas forming foods” that breastfeeding mothers are advised to avoid, and a small pilot study of breastfed infants with colic was conducted.
Fodmaps were identified in a number of infant formulae, including hypoallergenic formulae (such as Neocate) recommended for infants with colic. In addition, high levels of Fodmaps were found in foods breastfeeding mothers are advised to avoid – for example, onion, garlic, cabbage, broccoli and legumes.
More promising still were the findings from their pilot study. The mothers of five breastfed infants with colic were asked to follow their normal diet for three days while keeping a diary of their baby’s crying. On average the babies cried for 207 minutes (±32 minutes) a day during this period. The mothers then ate a low-Fodmap diet for seven days while continuing to keep a crying diary. When the mothers consumed a low-Fodmap diet, their babies cried 35% less, with just 141 minutes (±34 minutes) of crying a day – over an hour less. And this wasn’t due to the babies sleeping more; the babies actually slept slightly less while their mothers were on the low-Fodmap diet.
The positive results led to four of the five mothers opting to continue with the low-Fodmap diet after the study ended. The fifth mother, a vegetarian, returned to her normal diet only to have colic symptoms return in her baby. Given that vegetarian diets are often high in Fodmaps, this wasn’t surprising. More research is needed on the role of low-Fodmap diets in resolving colic symptoms. But in the meantime, there may be merit in breastfeeding mothers of colicky babies trying a low-Fodmap diet under expert supervision, or for formula-fed babies trying a change in infant formula, to see if symptoms improve.
For more information on low-Fodmap diets, it is recommended you visit a registered dietitian. To find one in your region, go to www.dietitians.org.nz/find-a-dietitian-2.
Email: firstname.lastname@example.org, or write to “Nutrition”, c/o Listener, PO Box 90783, Victoria St West, Auckland 1142.