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Wednesday, January 17, 2007

Colic from Dairy Allergies?

I wrote in my book, Milk Is Not for Every Body: Living with Lactose Intolerance, that colic was not caused by lactose intolerance.

Still true.

However, a press release ["ARA Content provides free, high quality feature articles to reporters, editors and print publishers. These features are copyright free and in a variety of categories coordinated to fit the editorial calendars of a typical newspaper."] disguised as a news story on quotes a doctor as saying that dairy allergies may be a cause.

"The medical community defines 'colic' as anytime a baby cries inconsolably for hours at a time for a minimum of three weeks," explains Dr. Steven Yannicelli, director of science and education for Nutricia North America. "A colicky baby will usually draw up her legs and appear restless and agitated. She is inconsolable, even though she isn't tired, hungry, hot, cold or upset for some other obvious reason."

Colic affects both boys and girls and usually begins when a baby is between three and six weeks old. Treatment of colic is specific to the cause, which may include overfeeding or emotional distress.

According to Dr. Yannicelli, colic can also be the result of a variety of allergic or gastrointestinal conditions. One possible cause is a milk protein allergy. Babies with this allergy cannot process the complex protein chains in milk-based baby formula and may be allergic to soy, too. According to the American Academy of Pediatrics, babies with a milk protein allergy should not be given soy-based formula either.

Babies with a milk protein allergy may also experience one or more other symptoms, such as diarrhea, vomiting, gas, skin rash, wheezing, low or no weight gain, or an overall failure to thrive.

Interesting, if true. Unfortunately, we're still at the stage of "some doctors believe..." rather than having hard data on this, as this page from states:
Colic is believed by some doctors to be another symptom of milk allergy. Colic is a condition in which an infant has frequent, long bouts of unexplained crying. But the connection between colic and milk allergy is uncertain. In fact, most babies with colic are not allergic to milk. But in a small percentage of cases, symptoms improve or even disappear when cow's milk is removed from a colicky baby's diet. If your doctor decides that your colicky child may benefit from switching formulas, you can be confident that your baby will still be getting proper nutrition from non-milk formulas. However, you should not remove cow's milk from your baby's diet - or your own diet if you're breastfeeding - unless your doctor has confirmed that the child does actually have a milk allergy.

And it's hard to know in which babies the cause is true a milk protein allergy and not something else.

Agostino Nocerino, MD, PhD, Chief of Pediatric Oncology, Department of Pediatrics, University of Udine, Italy, and Stefano Guandalini, MD, Director, University of Chicago Celiac Disease Program, Section Chief of Gastroenterology, Hepatology and Nutrition; Professor, Department of Pediatrics, University of Chicago Comer Children's Hospital, write on
Studies including a selected population of infants report percentages of responses to the elimination diet to be as high as 89%. One blind study showed that 18% of infants with colic improved with soy formula, while 0% improved in another blind study. Moreover, in most of the responsive infants, the duration of the effect is not sustained, in spite of an ongoing elimination diet. In any case, true food protein intolerance can only be demonstrated in a small subgroup of infants with colic.

So the best that can be said is that if you can't find another cause for your baby's colic, consider the removal of milk from the diet. It may work, but it's not a cure-all.

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1 comment:

Anonymous said...

tricky issue, definitely. however, i don't quite agree with a sentence up there with the first article: "Babies with this allergy cannot process the complex protein chains in milk-based baby formula..."

Milk allergy is not a digestion issue, like lactose intolerance. My son, who had milk allergies, would show symptoms by mere contact, not even consumption. Allergies are hyper-immune responses to, not inability to "process", milk proteins.