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Effects of formula change on intestinal hydrogen production and crying and fussing behavior
R G Barr1, J Wooldridge, J Hanley
1Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
Insights
Formula changes in infants can reduce gas production and fussing, even in healthy babies. This study investigated how different infant formulas affect crying and gas, finding that soy-based formulas significantly reduced hydrogen excretion and fussing.
Area of Science:
- Pediatrics
- Gastroenterology
- Infant Nutrition
Background:
- Incomplete carbohydrate absorption may influence infant behavior after formula changes.
- Understanding formula composition's impact on infant gas and crying is crucial for pediatric care.
Purpose of the Study:
- To investigate the role of carbohydrate malabsorption in mediating formula change effects on infant crying.
- To assess breath hydrogen excretion and behavioral changes in response to different infant formulas.
Main Methods:
- 17 normal formula-fed infants were studied from 28 days of life.
- Comparisons included lactose vs. reduced lactose soy-based formulas and usual vs. soy-based variable-carbohydrate formulas.
- Breath hydrogen excretion and infant fussing/crying duration were measured.
Main Results:
- Reduced lactose formula showed a trend towards decreased hydrogen excretion (p=.07) but no change in crying.
- Soy-based variable-carbohydrate formulas significantly reduced hydrogen excretion (p<.03) and fussing (21% decline, p<.08).
- Fussing decreased by 40% within 8 days of switching to soy-based formulas.
Conclusions:
- While carbohydrate content differences may not significantly alter behavior in normal infants, formula changes involving protein and carbohydrate can reduce colonic gas.
- These effects on gas production might influence infant crying, but their role in treating colic requires further research.
Abstract:
To determine whether incomplete carbohydrate absorption plays a role in mediating the effects of formula change on babies' crying, breath hydrogen excretion and behavior were measured in 17 normal formula-fed infants who entered a feeding trial at 28 days of life. The trial permitted two comparisons between (1) lactose and reduced lactose soy-based formulae, and (2) the infant's usual pretrial formula and the subsequent soy-based variable-carbohydrate formulae. Reduced lactose formula was associated with a small reduction in H2 excretion (from a mean of 15 to 7 ppm, p = .07) but no difference in crying or fussing. However, compared with their usual pretrial formula, the change to soy-based variable-carbohydrate formulae was associated with a substantial and sustained reduction in H2 excretion (mean 32 to 11 ppm, p less than .03) and a modest 21% decline in fussing (90.4 to 71.5 min/24 hr, p less than .08). By 8 days after the formula change, there was a 40% decline (90.4 to 53.9 min/24 hr) in fussing. These results suggest that, although behavioral changes due to differences in carbohydrate content are unlikely in normal infants, formula changes involving protein and carbohydrate can reduce colonic gas production and may have some effect on crying. Such effects may be implicated when feeding changes occur in normal infants, but their potential role in treatment of crying problems (colic) is yet to be demonstrated.