Manipulating the diet of breastfeeding mothers to relieve the symptoms of infantile colic: A randomised controlled double blinded crossover study.

INTERVENTION: The low FODMAP diet refers to Fermentable, Oligosaccharides, Disaccharides, and Monosaccharides and Polyols. These are short‐chain carbohydrates that may be slowly digested or indigestible, and can lead to IBS symptoms in some adults. These FODMAPs are found in 'gas‐yielding' foods and are commonly avoided by breastfeeding mothers during the time of lactation, for a more settle baby. Foods that contain, fructose in excess of glucose (eg. Apples, honey), fructans and/or galacto‐olicosaccharides (eg. garlic, onion, legumes, wheat as a major ingredient), lactose (cow's milk, yoghurt, ice‐cream) and polyols, sorbitol (eg. avocado, artificial sweeteners) and mannitol (eg. mushrooms, watermelon), Alternative low FODMAP options are provided. eg bananas, strawberries, orange for fruit, green beans, carrots, capsicum for vegetables, and lactose‐free dairy products and hard cheese. Participants will receive adequate food to meet their energy requirements (kJ), based on their estimated energy requirements (including extra 2MJ/day for lactation). The diet (10 days) is prepared and provided to all participants (from Melbourne and surrounds) by the key researcher (also a dietitian, with 9 years experience) with the assistance of qualified chefs. Breastfeeding mothers. Mothers are expected to complete daily infant baby diaries, capturing crying‐fussing times, awake and sleeping times and feeding times, and a daily food diary for themselves, and provide one breast milk samples during baseline, and two during the dietary intervention (days 7 and 10 of the diet intervention)., Uneaten food containers are returned from the dry foods, uneaten portions of food products from fresh and/or frozen foods are discarded. A portable freezer is provided to participants to place samples in. All materials and food, are delivered to the home of participants and collected at the end of the study. The alternate diet is the Typical Australian Diet which is provided and prepared by the same researcher/chefs for 10 days and diaries/sample collections are also required for collection at the same time‐points as the low FODMAP diet. There is no washout period between the 2 diets. CONDITION: Infantile colic PRIMARY OUTCOME: Crying‐fussing times (combined) assessed using validated Barr diaries (Baby Day diaries). These are completed by the breastfeeding mothers (the participants) SECONDARY OUTCOME: A change in breast‐milk composition of short‐chain carbohydrates (Fructose, polyols, fructans, galacto‐oligosacchrides and lactose) will be assessed using HPLC and UPLC methods. Calprotectin levels will be assessed in infant faecal samples. Change in faecal pH will be assessed in infant faecal samples. INCLUSION CRITERIA: Exclusively breastfeeding mothers. with Infants <9 weeks of age. All participants with ther infants, need to meet the "Wessel criteria' for colic