A TRIAL OF LACTASE IN THE MANAGEMENT OF INFANT COLIC

Objective: To investigate transient lactose intolerance as a factor in the aetiology of infant colic. Design: We undertook a randomized, dou ble-blind, crossover trial of lactase and placebo drops added to milk formula to determine whether this method of reducing lactose intake af fected infant colic. Subjects: Infants with colic were referred from c linics in keeping with Wessel's modified criteria. Interventions: Infa nts were randomly allocated to add either lactase or placebo drops to their formula feeds for 1 week, followed by 2 days 'wash out'. The add ition was changed for the second week so that subjects served as their own control. The formulas were kept refrigerated for 24 h before inge stion. The parents kept a diary of their baby's crying time. Results: Thirteen babies completed the trial, of whom nine were boys. The mean birth weight was 3.7 kg (8.2 lb). Colic symptoms began in less than 1 month in 12 of the babies. The effect of the lactase was to reduce cry ing time by 1.14 h per day (CI 0.23-2.05). The reduction in crying tim e was significant (t= 2.75, d.f. =11, P=0.019). Conclusion: Transient lactose intolerance may have a role in the aetiology of infant colic. Lactase drops require prior incubation with milk formula to be effecti ve. The response to lactase in this study supports 'colic', i.e. spasm of the large intestine as a factor in these infants' discomfort.