Severe infantile colic and food intolerance: a long-term prospective study

Area of Science:

• Pediatrics
• Gastroenterology
• Allergy

Background:

• Infantile colic affects many formula-fed infants, causing significant distress.
• Cow's milk protein intolerance (CMPI) is a potential, yet often overlooked, cause of infant colic.
• Identifying CMPI is crucial for effective infant colic management.

Purpose of the Study:

• To investigate the association between severe infantile colic and CMPI in formula-fed infants.
• To evaluate the efficacy of eliminating cow's milk protein (CMP) in managing colic symptoms.
• To assess the long-term development of alimentary intolerance in infants with CMP-related colic.

Main Methods:

• A study group of 70 formula-fed infants with severe colic (crying >4h/day) was selected.
• Cow's milk protein (CMP) was eliminated from the diet, followed by two successive challenges.
• Infants were monitored for symptom remission, recurrence, and development of overt alimentary intolerance over an 18-month follow-up.

Main Results:

• Symptom remission occurred in 71.4% of infants upon CMP elimination.
• Symptoms returned in all cases upon CMP reintroduction, confirming CMPI.
• A significantly higher proportion (44%) of infants with CMP-related colic developed overt alimentary intolerance compared to those without (5%) (p<0.02).

Conclusions:

• A significant percentage of infants with severe colic exhibit CMPI.
• Dietary modification, specifically CMP elimination, should be the initial therapeutic strategy for suspected CMPI-related colic.
• Early identification and dietary management of CMPI can potentially prevent long-term alimentary intolerance.