Colic and Dairy Allergy

"A baby with colic cries inconsolably for hours at a time for at least three weeks," explains Dr. Allan Stillerman of Allergy & Asthma Specialists, PA in Minneapolis, MN.

That's miserable for all concerned. Even worse is the simple truth that nobody really understands what causes colic.

But this press release from Nutricia North America, identifies a possible correlation. Colic may be related to a dairy allergy.

Babies with a milk allergy can experience a variety of symptoms, such as diarrhea, vomiting, gas, skin rash, wheezing, low or no weight gain or an overall failure to thrive.

"A milk allergy can be treated by either eliminating milk proteins from the nursing mother's diet or replacing the typical milk-based formula with an amino acid-based formula such as Neocate(R)," says Dr. Stillerman.

It should not surprise anyone at this point that Nutricia North America is the manufacturer of Neocate.

Which is probably why they throw in this line:

Babies who are allergic to milk cannot process the milk protein chains found in milk- based baby formulas and are usually allergic to soy as well.

"Usually" allergic to soy? More like "sometimes." About 25% is the figure I've seen.

An expensive specialty formula like Neocate is normally not the solution to a dairy allergy. It can certainly help in those cases in which the baby is indeed allergic to both milk and soy, although other alternatives exist as well. And there's some hope:

The good news is if your baby is not allergic to milk, she likely will outgrow the colic in about three or four months.

Is Stillerman correct when he associates colic with dairy allergies? Appears so. A check of the medical literature reveals that a connection is suspected by many pediatricians.

What is known about infant colic?, by M. L. Cirgin Ellett. Gastroenterol Nurs. 2003 Mar-Apr;26(2):60-5.

Review of the infant colic literature suggests there are at least five possible explanations-cow's milk/soy protein allergy or intolerance; immature gastrointestinal system; immature central nervous system; difficult infant temperament; and parent-infant interaction problems consisting of either the transfer of parental anxiety to the infant or the inability of the infant to give clear cues about needs to the caregiver. It is likely the cause of infant colic is multifactorial because it has proven to be so elusive.

A prospective 10-year study on children who had severe infantile colic, by F. Savino et al. Acta Paediatr Suppl. 2005 Oct;94(449):129-32.

There was an association between infantile colic and recurrent abdominal pain (p=0.001) and allergic disorders: allergic rhinitis, conjunctivitis, asthmatic bronchitis, pollenosis, atopic eczema and food allergy (p<0.05). ... Our findings confirm that severe infantile colic might be the early expression of some of the most common disorders in childhood.

Clinical inquiries. What is the best treatment for infants with colic?, by C.A. Crotteau, S. T. Wright, and A. Eglash. J Fam Pract. 2006 Jul;55(7):634-6.

Several small studies report some benefit from use of a hypoallergenic (protein hydrolysate) formula, maternal diet adjustment (focusing on a low-allergen diet), and reduced stimulation of the infant.

At one time, many years ago, the notion that lactose intolerance was a cause of colic was raised by some doctors. Although it is not considered a major cause, there is some evidence that treating breastmilk with lactase drops can help.

Improvement of symptoms in infant colic following reduction of lactose load with lactase, by D. Kanabar, M. Randhawa, and P. Clayton. J Hum Nutr Diet. 2001 Oct;14(5):359-63.

These findings suggest that infant colic may have a multiple aetiology, and that in a significant number of cases the immediate cause is transient lactose intolerance, in which cases pretreatment of feeds with lactase can result in considerable symptomatic benefits.

However, there are far fewer studies connecting colic with lactose intolerance than with a cow's milk protein allergy.