I. Jakobsson

Cow's milk as a cause of infantile colic in breast-fed infants.

18 mothers of 19 breast-fed infants with infantile colic were put on a diet free of cows-milk protein. The colic disappeared promptly from 13; in 12, it reappeared on at least two further indirect challenges (in the form of a diet containing cows milk to the mother). Most infants became symptom-free at age 2 to 4 months; at 4 months, only 4 reacted with colic when the mother took cows milk. 5 infants were directly challenged with cows milk; 4 reacted promptly with colic. Other signs of intolerance to cows-milk protein developed in 3 infants during weaning. The treatment of infantile colic in breast-fed infants by a diet free of cows milk for the mother appears worthwhile.

Bovine β-Lactoglobulin in the Human Milk

ABSTRACT. Human milk samples (n=232) collected during the whole lactation period from 25 healthy, Swedish mothers were analyzed by radioimmunologic method for content of bovine β‐lacto‐globulin. Detectable amounts (5‐800 μ/1) were found in 93 of 232 milk samples (40%). Six mothers had no detectable β‐lactoglobulin in their breast milk on any occasion. Two mothers had measurable /Mactoglobulin in all their milk samples. No correlation was found between daily cows milk intake and concentration of β‐lactoglobulin in the milk samples. Six mothers with allergic symptoms such as asthma, hay‐fever, eczema all had detectable amounts of β‐lactoglobulin in their milk. Of 19 mothers without allergy, 13 had detectable amounts. This difference did not show statistical significance. The presence of symptoms in the infant such as diarrhoea, vomiting, colic, exanthema was significantly correlated to high levels of β‐lactoglobulin in the milk. Bovine β‐lactoglobulin was also detected in 7 of 13 serum samples. The two mothers with detectable β‐lactoglobulin in all milk samples had the highest serum values, and their infants suffered from gastro‐intestinal symptoms, weight decline and exanthema.

Dietary Bovine β Mactoglobulin is Transferred to Human Milk

ABSTRACT. Human milk from 38 mothers was analysed by radioimmunological method for content of bovine (5‐Iactoglobulin. Detectable amounts (5‐33 μg/1) of immunoactive β‐lactoglobulin were found in 18 human milk samples. Milk from 3 mothers, whose infants suffered from infantile colic contained high amounts of fi‐lactoglobulin (32, 18 and 14 μg/1 respectively). With the mothers on a cows milk free diet the contents fell to non‐detectable amounts in two mothers and to 6 μg/1 in the third. All three infants became free from colic,

Infantile colic—less common than previously estimated?

A two‐part population‐based study investigating the occurrence of infantile colic was undertaken. in which 92% of mothers with newborn healthy infants were reached. In the prospective part 152 mothers (“diary group”) registered crying and fussing in their infants during 12 weeks. In the retrospective part 224 mothers (“interview group”) were contacted by telephone at an infant age of 5‐7 months. The colic occurrence was determined according to four different definitions; the rates varied from 3.3 to 17.1%. The classical “Wessel‐type” colic was present in 9.3%. Colic defined as “crying seen as a problem by parent” was present in 12.1% of the “interview group”, but in only 3.3% of the “diary group”. Some earlier studies may have overestimated colic occurrence. Another possibility is an actual decline. The contributive part of preventive measures is discussed.

Macromolecular Absorption in Preterm and Term Infants

ABSTRACT. Human o‐lactalbumin (α‐LA) has been used as a marker for measuring macromolecular absorption. The serum concentration of human α‐LA after a human milk feed has been studied in 32 healthy very low birthweight infants (VLBW), fed human milk (gestational age 26–32 weeks) and in 56 term, breast‐fed infants, age 3–140 days. At 31 weeks of gestation the serum concentration of human α‐LA was more than 10 times higher (mean value 3000 and median value 2101 μg/1 serum/1 human milk/kg body weight, n= 11) than in the term infants aged 3–30 days (mean value 257 and median value 152, n= 29). The serum concentration of o‐LA decreased with increasing maturity in the VLBW‐infants. At a postconceptional age of 37 weeks the values were similar (mean value 200 and median value 99, n= 8) to those found for term infants during the first month. In the term infants a decreasing absorption of α‐LA was found with increasing postnatal age.

Infantile colic. Follow-up at four years of age : still more emotional

This paper presents a follow‐up at 4 y of formerly colicky infants and controls, with respect to behaviour, temperament, eating and sleeping habits, psychosomatic complaints, number of hospital stays, growth and “family climate”. There were no differences between the two groups in most parameters studied. However, ex‐colicky children displayed more negative emotions according to the temperament scale. There were also more negative moods during meals, and more reported stomach‐ache. Although relationships regarding crying and mother‐infant interaction remain extremely complex, the findings point toward a possible temperamental contribution to the pathogenesis of the infantile colic syndrome.

Infantile colic and the role of trait anxiety during pregnancy in relation to psychosocial and socioeconomic factors

Aims: A study was undertaken to assess the impact of psychological, psychosocial and socioeconomic factors on the risk of having a child with infantile colic. Methods: Psychosocial and psychological factors were assessed by self-administered questionnaires in the 17th, and by telephone interviews in the 35th—37th pregnancy weeks; infantile colic occurrence was assessed by telephone interviews at infant age 5 weeks; subjects were 1,099 mother—infant dyads. Results: High trait anxiety increased the colic risk; OR 2.04 (95% CI: 1.16, 3.59), and so did affirming a perceived risk of spoiling young infants with too much physical contact; OR 1.77 (1.07, 2.91). In the final step of a multivariate model, not cohabiting with the childs father was the factor with the strongest association with colic; OR 3.48 (1.38, 8.77). Analyses of effect modification showed that high education seemed to protect from the influence of high trait anxiety. Young women were particularly high in trait anxiety, and being exposed to both these risk factors seemed to act synergistically on the risk of having a colicky infant; OR 2.41 (1.12, 5.18). Conclusions: Psychological and psychosocial factors were found to be significantly related to an increased risk for infantile colic, and these factors interacted with age, parity, social support, and educational level in a complex manner. Even though no single most important psychosocial risk factor was identified, the findings lend support to the strategy of offering special attention in terms of information and support in the maternal healthcare system to very young women, women who do not cohabit with the father, and women with high trait anxiety.

Allergy development and macromolecular absorption in infants with different feeding regimens during the first three days of life. A three-year prospective follow-up

A group of 129 infants were randomly assigned at birth to one of three feeding regimens: human milk (HM), cows milk formula (CMF) or a casein hydrolysate formula (CHF) during the first 3 days of life. Blood samples were taken on at 4 days and at 2, 4, 8, 12 and 24 months of age. Macromolecular absorption was analysed by measuring the serum concentration of human α‐lactalbumin (S‐α‐LA) with a competitive radioimmunoassay (RIA). Total serum IgE was measured by RIA. A family history of allergy correlated to the proportion of infants with allergic symptoms both at 24 and 36 months of age (p= 0.03 and p= 0.04 respectively). In none of the three groups did correlation exist between the duration of breastfeeding and serum α‐LA, serum IgE, family history of allergy, frequency of allergic symptoms and proportion of infants with infections.

In vitro digestion of cow's milk proteins by duodenal juice from infants with various gastrointestinal disorders.

The hydrolysis of bovine α-lactalbumin, β-lactoglobulin, and casein by duodenal juice from 20 infants (18 with normal exocrine pancreatic function, 2 with pancreatic insufficiency), aged 3–19 months was studied in vitro with the aid of electroimmunoassay and sodium dodecyl sulfate–poly-acrylamide gel electrophoresis. The results from the two methods were almost identical. Duodenal juice from infants with cows milk protein intolerance (7), celiac disease (5), and unclassified gastrointestinal disorder (6) had the same capacity to hydrolyze the milk proteins. No hydrolysis occurred in the two patients with pancreatic insufficiency. The hydrolyzing capacity was not correlated with age in the actual age group. The hydrolysis of the milk proteins occurred at a considerably slower rate when the proteins were crude, as in cows milk, adapted, or unadapted formula, than when they were in a purified form. About 1 mg of purified α-lactalbumin or β-lactoglobulin, and about 30 mg of purified casein could be hydrolyzed per milliliter duodenal juice per minute. Corresponding figures for the hydrolysis of the various proteins in cows milk were 0.03, 0.12, and 16.1 mg/ml duodenal juice/min. Preincubation (60 min) with gastric aspirate after adjusting pH to 4–5 did not change the results. In conclusion, the duodenal juice from infants with normal exocrine pancreatic function has a great ability to hydrolyze casein. Corresponding hydrolytic capacity for α-lactalbumin or β-lactoglobulin is considerably lower.

Colicky infants according to maternal reports in telephone interviews and diaries: a large Scandinavian study.

ABSTRACT. In this population-based study the colic incidence was 9.4%, according to telephone interviews with the parents made when the infants were 5 weeks of age (n = 1628), and parental concern about infant crying was common. However, 7-day diaries of colicky and control infants (n = 116 + 119) revealed low distress amounts in colicky infants in general. In the subgroup of Wessel-colicky infants (n = 37), distress episodes were frequent and long lasting, and there was a high proportion of colicky crying versus fussing and normal crying. Even if there may be a reduction in the infantile colic incidence and support for the hypothesis that infantile colic is at least partially “in the eye of the beholder,” that is, the concerned parent, a subgroup of infants may be more “genuinely colicky.” Women who had stated in late-pregnancy interviews that there is a risk of spoiling an infant with too much physical contact were more likely to have infants with colic, and their infants were more distressed, even when given the same amount of physical contact. This finding warrants further elucidation.