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Evaluation of the effect of a fiber-enriched formula on infant colic
W R Treem1, J S Hyams, E Blankschen
1Division of Pediatric Gastroenterology and Nutrition, Hartford Hospital, Connecticut 06115.
Insights
Adding fiber to infant formula did not significantly reduce colic symptoms for most infants. However, parents of a majority of infants preferred the fiber-supplemented formula for their colicky baby.
Area of Science:
- Pediatrics
- Gastroenterology
- Nutrition
Background:
- Infant colic is characterized by excessive crying and fussing, potentially linked to abdominal pain.
- Adult irritable bowel syndrome patients may benefit from dietary fiber, suggesting a similar approach for infant colic.
Purpose of the Study:
- To investigate if adding fiber to infant formula alleviates colic symptoms in infants.
- To assess the impact of fiber supplementation on infant crying, fussing, and gastrointestinal function.
Main Methods:
- A randomized crossover trial involving 27 infants with colic, comparing standard formula to fiber-supplemented formula over 9-day periods.
- Parental diaries tracked crying, fussing, and stooling; lactulose breath hydrogen tests assessed gut function.
- A subsequent open-label phase allowed parents to choose the preferred formula, with growth and biochemical markers monitored.
Main Results:
- No significant reduction in average daily crying and fussing was observed with fiber-supplemented formula.
- Parents of 18 out of 27 infants preferred the fiber-supplemented formula.
- Fiber supplementation increased stool frequency and breath hydrogen excretion, indicating altered gut transit and fermentation.
Conclusions:
- Supplementing infant formula with soy polysaccharide did not significantly improve colic symptoms in the majority of infants.
- While some infants may experience reduced crying, the majority continued to exhibit excessive fussing and crying.
- Further research may be needed to identify optimal fiber types or dosages for infant colic.
Abstract:
Because infants with colic appear to have abdominal pain similar to that of adults with irritable bowel syndrome, who may benefit from the addition of fiber to their diet, we tested whether fiber added to infant formula would alleviate colic. Twenty-seven normal, term infants (aged 2 to 8 weeks; 14 girls) with colic, defined as crying plus fussing for more than 3 hours a day for at least 3 days of a 6-day baseline period, were enrolled. Infants were randomly assigned in 9-day periods to a sequence of placebo (Isomil formula) followed by fiber-supplemented formula (Isomil plus soy polysaccharide) (n = 12) or the reverse (n = 15). Daily diaries of crying, fussing, sleeping, formula, intake, and stooling were kept. Twenty-two infants completed three lactulose breath hydrogen tests at the end of the baseline period and after each study period. The crossover trial was followed by 30 to 35 days of use of the study formula chosen by the parents as most beneficial but unknown to the investigators. Growth was monitored throughout. Serum cholesterol, calcium, phosphate, albumin, iron, and zinc concentrations were measured at the conclusion. There were no significant differences in average daily time spent by the infants in fussing and crying during ingestion of the fiber-supplemented formula. However, parents of 18 of 27 infants chose fiber-supplemented formula as most beneficial in ameliorating symptoms of colic. While the infants were consuming fiber-supplemented formula, stool frequency increased, and breath hydrogen excretion increased significantly, in response to lactulose. Growth and serum biochemical measurements were normal in all infants. Supplementation of infant formula with the level of soy polysaccharide used in this study may have reduced crying and fussing in some infants but did not affect colicky behavior in the majority of infants, who continued to cry and fuss excessively.