Excessive crying and fussing in babies for unexplained reasons is not an uncommon occurrence in otherwise thriving babies, especially in the first 12 weeks of life. Despite many years of study, there are no clear treatment with regards to treating colic. Infantile colic affects an estimated 3% to 28% of infants worldwide (4).
Talk to your Doctor if you are worried about colic and your baby to see if any medical help is required.
Where there is diagnosed colic (as per the ROME criteria- see below), there are a few approaches that may be worth considering and discussing with your doctor.
What is colic?
Colic is described as bouts of crying or fussing for unexplained reasons that can occur in otherwise thriving babies.
Excessive crying is estimated to occur in up to one third of babies 3 months and younger (1) although often spontaneously resolves by age 3‐4 months without intervention.
There is even a set of criteria to define colic: the Rome IV criteria (2).
To medically term a baby as suffering from colic, the the following criteria needs to be met, however it may be up to the FGP's descretion as it can be difficult to meet alll the criteria:
an infant needs to be less than 5 months when the symptoms start and stop
recurrent and prolonged periods of infant crying, fussing* or irritability reported by care givers that occur withiut obvious cause and cant be prevented or resolved by care givers
no evidence of infant fialure to thrive,fever or illness
* Fussing refers to intermittent, distressed vocalisation and has been defined as "behaviour that is not quite crying but not awake or content either". Infants often fluctuate between crying and fussing, so that the two symptoms can be hard to destinguish from each other.
Symptoms reach their peak around 6 weeks and typically resolve by the age of 12 weeks.
Colic Caused By Dairy Protein and Soy Protein
If food seems to be triggerring colic, then the most likely candidates are dairy protein (3) and soy protein.
Often there can be other symptoms as well such as frequent loose bowel motions, vinegary smelling bowel motions, mucous and sometimes blood in the bowel motions, skin rashes, reflux and there also can be a slow down in weight gain due to calories lost through frequent bowel motions and/or excessive vomiting.
Talk to a your doctor and a specialist Dietitian if you think dairy and/or soy is triggering symptoms in your breast fed baby to ensure you are still meeting the nutritional needs for your self and your baby on removing dairy and soy from the diet.
Other Food Allergens & Colic
Breast fed babies can also react to other top allergens with colic, such as Egg, Peanuts, Tree nuts and even Wheat or Oats.
"In breastfed infants with colic, following a hypoallergenic diet that eliminates dairy, eggs, nuts, wheat, and soy may significantly reduce crying time" (4).
Predicting which allergens in play can be very hard, and multiple eliminations means your diet will not meet your basic needs for energy, protein, and a range of vitamins and minerals, let alone the boosted needs required to nourish you and provide nutrients such as iodine for your baby. Getting help from your GP and a professional schooled in helping food sensitive breast fed babies is higjly recommended to help work through te process, minimise eliminations, find food substitutes and hasten the process of safely expanding the diet.
Colic and FODMAPS
An Australian FODMAP and colic study was able to show a reduction of colic by one third (32%) in babies 9 or less weeks of age (5). The study included 13 mothers and babies with colic were given a low FODMAP diet for around 10 days followed by a typical Australian diet for 10 days (or the other way around) and the study included a control group of 7 mothers with babies without colic.
Interestingly, colic was reduced regrdless of the low FODMAP diet or typical Australian diet which shows that colic, given time was gong to imporve any way, but the improvement was larger when the low FODMAP diet was followed.
How a low FODMAP diet may reduce colic
It is unclear how a lod FODMAP diet may reduce colic, especially as it is thought that FODMAPs from the mothers' diet cannot pass into the breast milk. The folloiwng could be possible explanations:
GUT BIOEME: Potentially, changing the maternal diet FODMAP content may mean the breast milk bacteria is also changed and passed onto the baby.
METABOLITES: The break down of FODMAPs may produce other chemicals as a by product (called metabolites) which could be passed into the breast milk.
For example, eating garlic has been shown to result in a garlicky smell oil breast milk within 2-3 hours. This is not caused by the garlic aroma chemicals directly passing into the breast milk but the break down products (metabolites) which are able to cross over into the breast milk.
In a similar fashion, other metabolites from the breakdown of FODMAPs may be transferred to breast milk.
Probiotics & Colic
Other approaches to help reduce colic is to modify the infant's gut microflora. Several studies show a reduction in crying time among formula-fed infants with colic who receive Lactobacillus reuteri supplements, whereas other reports contradict those findings (6, 7).
There is stronger evidence regarding the potential positive effects of L reuteri supplementation among breastfed infants.
Refer to my blog on "Should I Give My Baby Probiotics?" for more information around probiotic choice, including colic.
Dietary Restrictions When Breast Feeding
Before undertaking such restrictions, the following may need to be considered
When breast feeding, it is really important to eat a diversity of foods to meet nutritional needs.
Breast feeding requires extra energy, with an extra 2000kj required each day in addition to normal requirements.
Dietary restrictions such as dairy or soy protein restrictions increases the level of complexity and places a nutritional risk due to a high level of diet restriction
Important nutritional considerations are iodine (important for brain development), calcium replacement for maternal bone preservation, iron (especially if maternal iron stores are low), omega 3 fatty acids, fat soluble vitamins and vitamin D.
Any diet changes can negatively affect the mother's nutrition at a time when extra nutrients and calories are needed.
When considering maternal diet changes for babies with colic, care needs to be taken to ensure a variety of nutritional alternatives and overall nutritional adequacy. Reach out for professional help if considering any dietary restricion when breast feeding.
Reviewed 12/2/25
REFERENCES
Halpern, R. and R. Coelho, Excessive crying in infants. J Pediatr (Rio J), 2016. 92(3 Suppl 1): p. S40-5.
ROME definition of colic calculator: https://www.mdcalc.com/calc/10316/rome-iv-diagnostic-criteria-infant-colic#
Lothe L, Lindberg T. Cow's milk whey protein elicits symptoms of infantile colic in colicky formula-fed infants: a double-blind crossover study. Pediatrics. 1989 Feb;83(2):262-6. Erratum in: Pediatrics 1989 Jul;84(1):17. PMID: 2913556.
Banks, J.B, Rouster, A, Chee J. Infantile Colic, 2023.
BIacovou M, Craig SS, Yelland GW, Barrett JS, Gibson PR, Muir JG. Randomised clinical trial: reducing the intake of dietary FODMAPs of breastfeeding mothers is associated with a greater improvement of the symptoms of infantile colic than for a typical diet. Aliment Pharmacol Ther. 2018 Nov;48(10):1061-1073. doi: 10.1111/apt.15007. Epub 2018 Oct 10. PMID: 30306603.
Sung V, D'Amico F, Cabana MD, Chau K, Koren G, Savino F, Szajewska H, Deshpande G, Dupont C, Indrio F, Mentula S, Partty A, Tancredi D. Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis. Pediatrics. 2018 Jan;141(1) [PubMed]
Rivas-Fernández M, Diez Izquierdo A, Cassanello P, Balaguer A. Do probiotics help babies with infantile colic? Arch Dis Child. 2019 Sep;104(9):919-923.
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