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Food Allergies and Colic: Is Your Diet Causing Your Baby’s Colic?

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As any parent of a colicky baby quickly learns, colic is one of the more mystifying ailments of childhood. Conflicting evidence abounds in every area, including its diagnosis, its treatment and even its cause. It’s enough to make a parent want to cry right along with her infant. One of the biggest controversies to date is whether food allergies could cause colic. Even more confusing, could a food allergy be the cause of colic in an exclusively breastfed baby? The latest studies seem to show that food allergies can lead to colic in both bottle and breastfed babies. Let’s look at the data.

Food Allergies Are On The Rise

From 1997 to 2007, the prevalence of reported food allergies increased 18% among children under age 18 years1. 4% to 6% of children have a documented food allergy2.

Eight foods account for 90% of all food-allergic reactions: milk, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish5.

Food allergy in exclusively breastfed infants may range from as low as 0.04%3 to as high as 0.5%4. And these babies haven’t even eaten anything yet!

The data on food allergies and colic is fairly clear-cut with formula-fed babies. In one landmark study, 70 formula-fed infants with severe colic were switched from a cow’s milk formula to a soy formula6. After 1 week, the parents of 50 of these infants reported significant improvement in their colic that relapsed within 24 hours of returning to cow’s milk formula.

Subsequent studies have shown even better results using non-soy formulas instead of soy formulas* as some babies who are allergic to cow’s milk protein are also allergic to soy protein2. Protein hydrosylate formulas, such as Alimentum and Nutramigen, undergo processes to break down proteins so they are less likely to cause an allergic reaction7. Studies show even better colic improvement when babies are switched to these formulas.

Evidence indicates that food allergies may also cause colic in exclusively breastfed babies. Intact proteins from the mother’s diet can cross into the breast milk, provoking an allergy response in some infants8-10. A randomized, controlled study showed that the infants of moms who eliminated dairy, soy, wheat, eggs, peanuts, tree nuts and fish from their diets cried about 90 minutes less per day than the infants of moms who did not change their diets11.

Unfortunately, not all of these studies have been as convincing for various reasons. Just like with any diet, it is very difficult to follow these study diets 100% of the time; yet any cheating can cause an allergic reaction in the baby and interfere with the study results. Further, it is difficult to eliminate all of these foods from your diet, even if you are trying, as processed foods often contain surprising ingredients you wouldn’t think to check for. In addition, moms in the control arm of the trial may inadvertently avoid foods they should be eating due to food preference issues. They may not realize that they aren’t eating any soy products, for example, because soy may not be a part of their usual diet. So the control group may not be exposed to all of the foods they should be. Unless the mothers live in a research lab, there is no way to be sure they are eating exactly what they should and reporting their eating accurately13.

Food Sensitivities Survey – Mothering.com Results

QuestionMost Common Response% Selected
1. Do any of your children have any food sensitivities or allergies? Yes
89.5%
2. What is the age of the child you are answering these questions about? 2-5 years
21.9%
3. Which food is your child sensitive to? Dairy
67.8%
4. What is your child’s reaction to the above food(s)? Irritibility/Mood/Behavioral Changes
55.3%
5. How soon after consuming a food does your child exhibit a reaction/sensitivity? Greater than two hours after ingestion
34.1%
6. How did you discover your child’s food sensitivities? Choose all that apply. Reactions
66.4%
7. Has your child been tested for or officially diagnosed with a food sensitivity/allergy? Yes
55.7%
8. How do you currently manage your child’s food sensitivities? Choose all that apply. Strict Food Avoidance for the Child
78.2%
9. Do YOU experience any food sensitivities? Yes
52.5%
10. Did/do food sensitivities impact your breastfeeding relationship with your child? Yes
53.6%
11. What would you consider your best FIRST recourse to treat stomach pain? Strict Elimination Diet
76.1%

While these studies seem to indicate that food allergies may cause colic, this fact is not universally accepted in the scientific community. Most parents of colicky babies, however, believe it to be so.

According to a poll on Mothering.com, 55.3% of mothers believe their child’s food allergy causes irritability or mood changes12.

So Where Should You Start?

The first step in the treatment of any baby with colic is a thorough examination by a physician to rule out a medical cause of increased crying. Once that has been done, you may consider some dietary changes. If you are formula-feeding your baby, switch to an extensively hydrolyzed formula for 2-4 weeks. If an allergy is the cause of the colic, most cases will improve within 72-96 hours14,15. If symptoms improve, continue with this new formula. If you are exclusively breastfeeding, you may choose to follow the AAP’s “Maternal Lactation Diet” which is intended for mothers of infants with confirmed food allergies for 2-4 weeks. In these situations, the AAP recommends exclusively breastfeeding mothers restrict cow’s milk protein and all cow’s milk protein-containing products (such as dairy), eggs, fish, peanuts and tree nuts2. Refer to Table One for a list of non-dairy foods containing calcium. Many other protocols recommend eliminating soy as well. Table Two contains a list of ingredients to avoid while maintaining a soy-free diet. Table Three contains ingredients to avoid while maintaining a dairy-free diet. It is a good idea to keep a strict food journal while following an elimination diet.

When your baby’s symptoms have decreased and have remained stable for at least a few weeks, you may add back one eliminated food at a time. If there is no reaction after one week, add back one additional eliminated food. If you notice an increase in symptoms after adding an item back to your diet, immediately eliminate it until you are done breastfeeding. It is important to take calcium and vitamin D supplements while on a restricted breastfeeding diet to avoid vitamin deficiencies. Be sure to review your diet with your physician before you make any changes.

New studies, such as those at the University of California, Davis Medical Center, are testing the use of the Pancreas enzyme16 along with the elimination diets discussed above. Just as the extensively hydrolyzed formulas decrease allergic reactions by pre-digesting the proteins in formula, the Pancreas enzyme may decrease allergic reactions by pre-digesting the breast milk proteins. Preliminary studies show great promise and it is possible that a major breakthrough in the treatment of colic is just around the corner.

While the evidence isn’t definitive, it seems likely that food allergies can cause colic in a large number of infants. Luckily, there are many simple changes parents can make to ease their child’s symptoms. Even better, you don’t have to stop breastfeeding! As always, check back here for the latest updates in the treatment and studies concerning colic. And may you have a peaceful night’s rest.

5 organic anti colic recipes for the breastfeeding mother

Table One17: Non-Dairy Sources of Calcium

  • Kale
  • Broccoli
  • Spinach
  • Fortified Cereal
  • White Beans
  • Dried Figs
  • Black-Eyed Peas
  • Seaweed
  • Fortified Orange Juice

Table Two17: For A Truly Soy Free Diet, Avoid Foods That Contain Any Of The Following Ingredients:

  • Miso
  • Shoyu Sauce
  • Soy (Flour, Grits, Nuts, Milk, Sprouts)
  • Soybean (Granules, Curd)
  • Textured Vegetable Protein (TVP)
  • Tofu
  • Y Protein (Concentrate, Isolate)
  • Y Sauce
  •  

Table Three17: For A Truly Milk Free Diet, Avoid Foods That Contain Any Of The Following Ingredients:

  • Artificial Butter Flavor
  • Butter
  • Butter Fat
  • Buttermilk
  • Casein
  • Caseinates
  • Cheese
  • Cottage Cheese
  • Curds
  • Custard
  • Half & Half
  • Lactalbumin
  • Lactoglobulin
  • Lactose
  • Milk
  • Milk Protein
  • Milk Solids
  • Condensed Milk
  • Evaporated Milk
  • Dry Milk
  • Milk Derivative
  • Nougat
  • Pudding
  • Rennet Casein
  • Sour Cream
  • Sour Cream Solids
  • Sour Milk Solids
  • Whey
  • Yogurt
  •  

* Studies show that most soy allergic individuals may safely eat products containing soy lecithin and soy oil.