Hill D J, Hudson I L, Sheffield L J, Shelton M J, Menahem S, Hosking C S
Department of Allergy, Royal Children's Hospital, Parkville, Melbourne, Australia.
J Allergy Clin Immunol. 1995 Dec;96(6 Pt 1):886-92. doi: 10.1016/s0091-6749(95)70224-5.
The effect of diet change in 38 bottle-fed and 77 breast-fed "colicky" infants, referred from community-based pediatric facilities was studied over a 1-week period in a double-blind (within each feeding mode), randomized, placebo-controlled trial.
Bottle-fed infants were assigned to either casein hydrolysate or cow's milk formula. All mothers of breast-fed infants were started on an artificial color-free, preservative-free, additive-free diet and also randomized to an active low allergen diet (milk-, egg-, wheat-, nut-free) or a control diet.
The response to diet was assessed on day 1 and day 8 with the use of a previously validated infant distress chart on which parents recorded distress levels. If successful outcome was defined as a reduction in distress of 25% or more, after adjusting for age and feeding mode, infants on active diet had a significantly higher rate of improvement than those on the control diet (odds ratio, 2.32; 95% confidence interval, 1.07-5.0; p = 0.03). Analysis of the day 8 to day 1 distress ratio, again adjusted for age and feeding mode, showed that infants on the active diet had distress reduced by 39% (95% confidence interval, 26-50) compared with 16% (95% confidence interval, 0-30) for those on the control diet (p = 0.012).
The results suggest a period of dietary modification with a low allergen diet and appropriate nutritional support should be considered in healthy infants with colic.
在一项为期1周的双盲(在每种喂养方式内)、随机、安慰剂对照试验中,对从社区儿科机构转诊来的38名人工喂养和77名母乳喂养的“腹绞痛”婴儿进行了饮食改变的效果研究。
人工喂养的婴儿被分配到酪蛋白水解物配方奶粉组或牛奶配方奶粉组。所有母乳喂养婴儿的母亲均开始食用无人工色素、无防腐剂、无添加剂的饮食,并随机分为活性低过敏原饮食组(无牛奶、鸡蛋、小麦、坚果)或对照饮食组。
在第1天和第8天,使用先前验证过的婴儿痛苦图表评估饮食反应,家长在该图表上记录痛苦程度。如果将成功结果定义为痛苦程度降低25%或更多,在调整年龄和喂养方式后,食用活性饮食的婴儿改善率显著高于对照饮食组(优势比,2.32;95%置信区间,1.07 - 5.0;p = 0.03)。对第8天至第1天的痛苦比率进行分析,同样调整年龄和喂养方式后,结果显示食用活性饮食的婴儿痛苦程度降低了39%(95%置信区间,26 - 50),而对照饮食组婴儿为16%(95%置信区间,0 - 30)(p = 0.012)。
结果表明,对于健康的腹绞痛婴儿,应考虑进行一段时间的低过敏原饮食调整并给予适当的营养支持。