Low FODMAP Diet and Infant Colic
As a nutritional biochemist by training, I absolutely love when my love of nutrition collides with my love of breastfeeding. For this reason, I was so excited when I found this study that looked at maternal consumption of a low FODMAP (fermentable oligo-, di- and mono-saccharides and polyols) diet on associated infant colic symptoms.
What is a low FODMAP diet?
A low FODMAP diet aims to reduce or eliminate gas-producing foods from the diet. This reduction in gas production may help individuals who suffer from diarrhea, digestive disorders, abdominal pain, or bloating. "Gas-producing foods" are foods that contain high proportions of indigestible or poorly digested short chain carbohydrates and sugar alcohols. When foods are poorly digested, they become food for the bacteria living in your gut. When bacteria digest these carbohydrates (e.g. undergo fermentation) gas is a byproduct. Some foods that would fall into the FODMAP category include beans, lentils, wheat, and dairy.
What does this have to do with infant colic?
Colic is defined as crying for more than 3 hours per day, for 3 or more days of the week, over a span of at least 3 weeks and may show signs of gassiness. Much of the evidence that we currently have around infant colic is focused on formula fed infants. In these studies, dietary changes are made to attempt to help with colic. In an exclusively breastfed baby, infant diet (human milk) would be influenced by maternal diet. We don't have good science looking at maternal diet changes and the associated effect on infant colic symptoms.
How did the study work?
Mothers of infants confirmed to have colic were enrolled in the study. Prior to dietary change, a milk sample and an infant fecal sample were collected. Mothers were then put on a low FODMAP diet for 7 days, and during day 5, 6, and 7, infants were reassessed for colic symptoms. On day 7 new milk and fecal samples were taken.
What did the authors find?
The trial provided a 5g/day FODMAP diet and participants in the study consumed on average 30 grams of FODMAP foods per day.
No change was found in in fecal pH or lactose content of analyzed maternal milk samples was reported.
The study did report a significant reduction in measured crying duration, crying episodes, fussing duration, combined crying-fussing times, feeding duration, and feeding episodes and a significant increase in awake-and-content duration.
What did the moms have to say?
Baby is much more content
Baby can be put down without crying
Baby's cries are no longer pain-sounding screams
Can now read baby's tired signs
Applying this to practice
Anecdotally, we have seen many mothers practice elimination diets and see relief in their infant's gastrointestinal discomfort. Dairy has long been made the culprit of all infant gastro discomfort. This study shows that is may be more complex than "eliminate dairy".
For mothers of infants with confirmed colic, a low FODMAP diet may translate to decreased infant colic symptoms.