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FORMULA CHANGE REDUCES CRYING BEHAVIOR: EVIDENCE FOR ROLE OF INTRAINTESTINAL GAS

To study the role of intraintestinal gas production in mediating the effects of formula changes on crying behavior, 17 normal 4-wk-old infants entered a feeding trial consisting of 5 four-day feeding periods (FP). Following baseline (FPO) on cow's milk - based lactose formula, infants received equivalent lactose (L) or reduced lactose (RL) soy-based formulae in a double-blind double crossover design (FP1-4). Parents blind to the specific study hypothesis recorded 6 behaviors (including cry/fuss) by pretested diaries. To monitor gas production, breath H2 samples were taken over 4 hr on day 4 of each FP. Duration and frequency of cry/fuss and average 4-hr H2 values were calculated for L vs. RL conditions and for each feeding period.There were no differences in cry/fuss measures between L and RL formulae. However, breath H2 declined significantly across periods (mean (ppm): FPO 32; FP1 15; FP2 7; FP3 7; FP4 15; ANOVA F4, 55= 5.69; p<.001) followed by a similar significant depression in cry/fuss duration (mean (min/24 hr): FPO 137, FP1 154, FP2 123; FP3 108; FP4 124: ANOVA F4,62 = 3.04; p=.02: FPO,1 > FP2,3,4 Tukey p<.05). There was no difference in cry/fuss frequency across periods.Conclusion: Change from cow's milk to soy-based formula suppresses gas excretion and reduces duration of cry/fuss behavior. Formula changes may lessen cry/fuss behavior by the mechanism of transient suppression of intraintestinal gas production.