University of Michigan
Department of Pediatrics
Evidence-Based Pediatrics Web Site

Question

• Does restricting foods in the maternal diet decrease colic in breastfed infants compared to breastfed infants of mothers with an unrestricted diet?

Clinical Bottom Lines

1. Elimination of several major food allergens (dairy, wheat, soy, eggs, peanuts, tree nuts, and fish) from the diet of breastfeeding mothers for one week is associated with reduction in their infant’s cry/fuss duration.
2. Low allergen diet was associated with a reduction of approximately 3 hours when compared to the control diet.
3. Mothers on the low-allergen diet did not subjectively assess a difference in cry/fuss duration compared to mothers on the control diet.

Summary of Key Evidence

1. 35 of 47 infants responded to the low-allergen diet compared to 16 of 43 infants on the control diet with respect to reduction of cry/fuss duration of greater than or equal to 25%.
2. There was an absolute risk reduction of 37%.
3. The cry/fuss duration per 48 hours was reduced in the low-allergen diet by an average reduction of 21% (416 min from 690 of low-allergen group compared to 529 min from 631 of control group).
4. The mean scores for the visual analog scales in reduction of cry/fuss duration reported by mothers were 4.3 for low-allergen group compared to 5 for the control group, which was not statistically significant.

Additional Comments

• When analyzing the mothers who stuck strictly to the diet, there was not a statistical significance between the two groups in cry/fuss duration. •
• Although the evidence shows that there is a reduction in cry/fuss duration when mothers changed to a low allergen diet, mothers did not subjectively assess a difference, which may be the most important point. •
• Changing to a low allergen diet can be expensive and requires dedication.

Citation

1. Hill DJ et al. Effect of a Low-Allergen Maternal Diet on Colic Among Breastfed Infants: A Randomized, Controlled Trial. Pediatrics 2005;116e709-e715

CAT Author: Jennifer McAllister, M.D.

CAT Appraisers: Amanda Dempsey, M.D.

Date appraised: <April 29, 2009