Some clinical practice guidelines recommend maternal dietary modification for colic, but not all do. The American Academy of Family Physicians’ 2015 national guidelines for colic recommend elimination of common allergens from the maternal diet, whereas the UK and Irish national guidelines for infantile colic do not recommend modifying the maternal diet.[1][2]
A recent Cochrane review examined the evidence for dietary modifications for infantile colic. Due to the effects being small, and the evidence being rated as very low quality (because of small sizes of studies, and the high risks of bias), no specific interventions were recommended.[3] However, some of the trials in this review are worth examining.
Infants using a hypoallergenic (hydrolyzed) formula, compared to standard formula, had a greater reduction in crying time (on average 101 minutes per day) after 1 week. However, the number of infants who responded to the intervention was not significantly different between groups (8 of 23 infants in the hypoallergenic group versus 5 of 23 in the standard group).[4] In addition, a partially-hypoallergenic formula (lower lactose, partially hydrolyzed), compared to standard formula with simethicone, had fewer episodes of colic after 2 weeks.[5] Formula-fed infants with colic and atopic conditions (such as eczema or psoriasis) may have a higher likelihood of improving their colic with hypoallergenic formula, though much of the evidence is not based on randomized controlled trials, but instead clinical reasoning.[6][7]
Soy-based formulas have insufficient quality evidence for colic to warrant recommendation.[7][8][9]
Maternal diet may affect infantile colic: a group of mothers who excluded the allergens cow’s milk, eggs, peanuts, tree nuts, wheat, soy, and fish improved their breastfed babies’ colic compared to a group that did not. 74% of the low-allergen-group babies reduced their crying and fussing duration by more than 25%, compared to 37% of babies in the control group.[10]