母亲低FODMAP饮食可缓解婴儿肠绞痛
J Hum Nutr Diet（2018）
doi: 10.1111/jhn.12488. Epub 2017 Jun 20.
Reducing the maternal dietary intake of indigestible and slowly absorbed short-chain carbohydrates is associated with improved infantile colic: a proof-of-concept study.
论文摘要
Infantile colic occurs in typically-developing infants with no underlying cause and is the reason for 10–20% of all early visits to pediatricians (1). The prevalence of excessive crying, a symptom associated with infantile colic, is reported to range from approximately 14% to 30% in infants up to 3 months of age (2). Although its aetiology remains uncertain, infantile colic has been defined by the ‘Wessel Criteria’ since 1954, as paroxysms of crying epi- sodes, lasting for more than 3 h per day, for 3 or more days per week, and for three or more weeks (1,3). In infants with colic, inconsolable unexplained crying epi- sodes tend to commence in the early weeks of life, peak- ing around 6–8 weeks of age and spontaneously resolve by 3–4 months of age (1). Infants with colic may also pre- sent with symptoms of excessive flatulence, and be very unsettled, fussing or irritable. Infantile colic can lead to parental exhaustion resulting in early cessation of breast- feeding (4), post-natal depression (5) and in extreme cases, ‘Shaken Baby Syndrome’ (6). Although current treatment methods involve a range of behavioural, pharmacological and dietary strategies, dietary intervention appears to be one of the most common approaches applied. Most stud- ies have targeted formula-fed infants and, therefore, the infant’s diet (7). Studies investigating maternal dietary change in breastfed infants are limited and in general hypothesise to trigger immunological responses or influ- ence breast milk composition, but to-date there is no evi- dence of the mechanism of action by which maternal diet might influence colic in infants (7). For instance, evidence that shows efficacy of maternal avoidance of allergenic foods or its mechanism of action, are not clear (7–9), and of the more commonly applied strategy of avoiding intestinal gas-producing foods such as onion, garlic, cab- bages and legumes lacks evidence (10).
Intestinal gas-producing foods are high in indigestible or slowly absorbed short-chain carbohydrates, collectively termed fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs). A diet low in FODMAPs is efficacious for functional gastrointestinal symptoms (11) and is now commonly used as a therapy for people with irritable bowel syndrome (IBS) (12).
实验综述
① FODMAP是指难吸收的短链碳水化合物，如可发酵的寡聚糖、二糖、单糖和多元醇饮食。
② 本文研究母乳喂养的母亲食用低FODMAP含量的饮食，是否会减轻婴儿的肠绞痛症状。
③ 对纯母乳喂养的母亲及其健康婴儿进行FODMAP饮食干预的单盲试验；收集母乳进行FODMAP含量分析 、收集粪便测定pH值。
④ 低FODMAP母乳喂养的婴儿哭泣时间、哭泣发作次数以及烦躁持续时间均有所减少。
⑤ 因此，哺乳期妇女低FODMAP饮食可能与婴儿性绞痛症状减少有关。