Maternal Dietary Intake and Presence of Colic Symptoms among Exclusively Breastfed Infants in Selected Healthcare Facilities in Akure South Local Government Area of Ondo State, Nigeria

Background: Infantile colic, defined as inconsolable crying exceeding three hours per day, more than three days per week, for at least three weeks, remains a major concern in neonatal and infant care. Maternal dietary intake during exclusive breastfeeding has been implicated as a potential modifying factor. This study examined the association between maternal dietary intake and the occurrence of infantile colic symptoms among exclusively breastfed infants in selected primary healthcare facilities in Akure South Local Government Area, Ondo State, Nigeria.
Methods: A descriptive cross-sectional design was adopted. Using simple random sampling, 351 nursing mothers of infants aged 0–24 months attending selected healthcare facilities were recruited. Data were collected via a structured questionnaire and analysed using SPSS version 25. Descriptive statistics and chi-square test were employed.
Results: The majority of mothers demonstrated good dietary practices (52.4%), with high consumption of fruits (38.5% consumed 3–4 times/week), vegetables (43.6%), fish (42.7% at 5–7 times/week), meat/poultry (48.1% at 5–7 times/week), and processed/fast foods (58.7% at 5–7 times/week). The prevalence of infantile colic was 22.8%. Antibiotics were the predominant management strategy (80.1%). Chi-square analysis revealed no statistically significant relationship between maternal dietary intake and infantile colic (X²=1.65, df=2, p=0.43).
Conclusion: Although overall maternal dietary quality was good, the high prevalence of infantile colic (22.8%) and predominant use of over-the-counter antibiotics as a management strategy underscores the urgent need for targeted health education and nutritional counselling among breastfeeding mothers in Nigerian primary healthcare settings.

Infantile colic, maternal dietary intake, exclusive breastfeeding, colic prevalence, Nigeria, primary healthcare, nutritional counselling

1. Amzat, J., Aminu, K., Matankari, B., Ismail, A., Almu, B., & Kanmodi, K. K. (2024). Sociocultural context of exclusive breastfeeding in Africa: A narrative review. Health Science Reports, 7(5), e2115. https://doi.org/10.1002/hsr2.2115 [Google Scholar] [Crossref]

2. Anwer, T., Masood, S., Mustafa, S., Akhtiar, D., Ahmed, S., & Ali, S. (2025). Incidence of infantile colic in exclusive breastfeeding vs exclusive formula feeding vs combination feeding infants in Abbasi Shaheed Hospital, Karachi. Indus Journal of Bioscience Research, 3(4), 1213–1216. [Google Scholar] [Crossref]

3. Barnett, D., Thijs, C., Mommers, M., Endika, M., Klostermann, C., Schols, H., Smidt, H., Nauta, A., Arts, I., & Penders, J. (2025). Why do babies cry? Exploring the role of the gut microbiota in infantile colic, constipation, and cramps in the KOALA birth cohort study. Gut Microbes, 17(1), 2485326. https://doi.org/10.1080/19490976.2025.2485326 [Google Scholar] [Crossref]

4. Benninga, M. A., Faure, C., Hyman, P. E., Hyams, J. S., & Schechter, N. L. (2016). Childhood functional gastrointestinal disorders: Neonate/toddler. Gastroenterology, 150(6), 1443–1455. [Google Scholar] [Crossref]

5. Biagioli, E., Tarasco, V., Lingua, C., Moja, L., & Savino, F. (2016). Pain-relieving agents for infantile colic. Cochrane Database of Systematic Reviews, 9, CD009999. https://doi.org/10.1002/14651858.CD009999.pub2 [Google Scholar] [Crossref]

6. Camilleri, M., Park, S. Y., Scarpato, E., & Staiano, A. (2017). Exploring hypotheses and rationale for causes of infantile colic. Neurogastroenterology and Motility, 29(2), 1–11. https://doi.org/10.1111/nmo.12943 [Google Scholar] [Crossref]

7. Chandran, D., Warren, K., McKeone, D., & Hicks, S. D. (2023). The association between infant colic and the multi-omic composition of human milk. Biomolecules, 13(3), 559. https://doi.org/10.3390/biom13030559 [Google Scholar] [Crossref]

8. Chinawa, J. M., Odetunde, O. I., Ndu, I. K., Chinawa, A. T., & Aniwada, E. C. (2013). Abdominal colic among children: Perception and management practices of mothers. Journal of Tropical Paediatrics, 60(2), 147–151. [Google Scholar] [Crossref]

9. Clifford, T. J., Campbell, M. K., Speechley, K. N., & Gorodzinsky, F. (2002). Infant colic: Empirical evidence of the absence of an association with the source of early infant nutrition. Archives of Paediatrics & Adolescent Medicine, 156(11), 1123–1128. [Google Scholar] [Crossref]

10. Ćorić, N., Pandža, N., Bevanda, I., & Karlović, A. (2022). Maternal dietary habits and food restrictions during breastfeeding. Proceedings/Zbornik Radova, 3. [Google Scholar] [Crossref]

11. Ellwood, J., Draper-Rodi, J., & Carnes, D. (2020). Comparison of common interventions for the treatment of infantile colic: A systematic review of reviews and guidelines. BMJ Open, 10(2), e035405. https://doi.org/10.1136/bmjopen-2019-035405 [Google Scholar] [Crossref]

12. Evans, R. W., Allardyce, R. A., Fergusson, D. M., & Taylor, B. (2018). Maternal diet and infantile colic in breast-fed infants. The Lancet, 317(8234), 1340–1342. [Google Scholar] [Crossref]

13. Fukushima, Y., Kawata, Y., Hara, H., Terada, A., & Mitsuoka, T. (1997). Effect of a probiotic formula on intestinal immunoglobulin A production in healthy children. International Journal of Food Microbiology, 37(2–3), 223–227. [Google Scholar] [Crossref]

14. Garnacho-Garnacho, V. E., Rodríguez-López, E. S., Oliva-Pascual-Vaca, Á., Goenaga-Echave, L., & Otero-Campos, Á. (2024). Maternal psychological well-being as a protector in infantile colic. Nutrients, 16(14), 2342. https://doi.org/10.3390/nu16142342 [Google Scholar] [Crossref]

15. Ghatak, N., Saleem, S. M., & Bhattacharya, S. (2021). Infantile colic in exclusively breastfed babies: A clinical dilemma. Journal of Surgical Specialities and Rural Practice, 2(2), 32–33. [Google Scholar] [Crossref]

16. Hanna, M. (2020). The effect of a maternal dairy-free Lebanese Mediterranean diet on colic and allergy symptoms in exclusively breastfed infants (Unpublished thesis). Lebanese American University. [Google Scholar] [Crossref]

17. Halpern, R., Victora, C. G., Faraco, I. M., Barros, F. C., & Giugliani, E. R. J. (2015). Risk factors for suspicion of developmental delay at 12 months among a birth cohort. Jornal de Pediatria, 76(6), 421–428. [Google Scholar] [Crossref]

18. Helen, Y. (2024). Magnitude and associated factors of infantile colic among infants attending paediatric outpatient clinics at public health care facilities in Wolkite Town, Gurage Zone, Central Ethiopia Region (Unpublished thesis). Ambo University. [Google Scholar] [Crossref]

19. Hide, D. W., & Guyer, B. M. (2019). Prevalence of infant colic. Archives of Disease in Childhood, 57(7), 559–560. [Google Scholar] [Crossref]

20. Iacovou, M., Ralston, R. A., Muir, J., Walker, K. Z., & Truby, H. (2012). Dietary management of infantile colic: A systematic review. Maternal and Child Health Journal, 16(6), 1319–1331. https://doi.org/10.1007/s10995-011-0842-5 [Google Scholar] [Crossref]

21. Johnson, J. D., Cocker, K., & Chang, E. (2015). Infantile colic: Recognition and treatment. American Family Physician, 92(7), 577–582. [Google Scholar] [Crossref]

22. Karaahmet, A. Y., Dolgun, G., & Özen, M. (2024). Effects of probiotics on gastrointestinal symptoms, anthropometric measurements, and breastfeeding duration in infants with colic: A randomised controlled trial. Sao Paulo Medical Journal, 142(4), e2023069. https://doi.org/10.1590/1516-3180.2023.0069 [Google Scholar] [Crossref]

23. Karcz, K., Lehman, I., & Królak-Olejnik, B. (2020). Foods to avoid while breastfeeding? Experiences and opinions of Polish mothers and healthcare providers. Nutrients, 12(6), 1644. https://doi.org/10.3390/nu12061644 [Google Scholar] [Crossref]

24. Karcz, K., Lehman, I., & Królak-Olejnik, B. (2021). The link between knowledge of the maternal diet and breastfeeding practices in mothers and health workers in Poland. International Breastfeeding Journal, 16(1), 58. https://doi.org/10.1186/s13006-021-00403-4 [Google Scholar] [Crossref]

25. Kariyawasam, K. P., Somaratne, G., Dillimuni, S. D., & Walallawita, U. (2025). Comparative analysis of breastfeeding and infant formulas: Short‐ and long‐term impacts on infant nutrition and health. Food Science & Nutrition, 13(9), e70788. https://doi.org/10.1002/fsn3.70788 [Google Scholar] [Crossref]

26. Kidd, M., Beattie, J., & Lam, T. (2019). Maternal dietary exclusions for the prevention of infant colic: A systematic review. Paediatric and Perinatal Epidemiology, 33(2), 78–88. [Google Scholar] [Crossref]

27. Krugman, R. D. (1993). Child abuse and neglect: Critical first steps in response to a national emergency. American Journal of Diseases of Children, 147(7), 730–731. [Google Scholar] [Crossref]

28. Lam, T., Chan, P., & Goh, L. (2019). Approach to infantile colic in primary care. Singapore Medical Journal, 60(1), 12–16. https://doi.org/10.11622/smedj.2019004 [Google Scholar] [Crossref]

29. Mirzanoori, M., Rezaei, M., Amini, S., & Molavi, A. (2021). Did the diet during pregnancy of mothers of infants with colic differ from that of control infants? Nutrition Today, 56(6), 311–316. [Google Scholar] [Crossref]

30. Moreno-Villares, J. M., Andrade-Platas, D., Soria-López, M., Colomé-Rivero, G., Catalan Lamban, A., Martínez-Figueroa, M. G., Espadaler-Mazo, J., & Valverde-Molina, J. (2024). Comparative efficacy of probiotic mixture Bifidobacterium longum KABP042 plus Pediococcus pentosaceus KABP041 vs Limosilactobacillus reuteri DSM17938 in the management of infant colic: A randomised clinical trial. European Journal of Paediatrics, 183(12), 5371–5381. [Google Scholar] [Crossref]

31. Ogechi, U. P. (2014). A study of the nutritional status and dietary intake of lactating women in Umuahia, Nigeria. American Journal of Health Research, 2(1), 20. https://doi.org/10.11648/j.ajhr.20140201.14 [Google Scholar] [Crossref]

32. Oshikoya, K. A., Sebanjo, I. O., & Njokanma, O. F. (2009). Self-medication for infants in Lagos, Nigeria. International Journal of Risk & Safety in Medicine, 21(1–2), 31–38. [Google Scholar] [Crossref]

33. Ostadi, R., Pourvali, A., Tajerian, A., Alinezhad, S., Lotfi, A., & Javaheri, J. (2024). Evaluating the influence of parental atopy on the effectiveness of a maternal dairy-free diet in alleviating infantile colic: A before-and-after study. BMC Pediatrics, 24(1), 710. https://doi.org/10.1186/s12887-024-05180-5 [Google Scholar] [Crossref]

34. Ouald Chaib, A., Levy, E. I., Ouald Chaib, M., & Vandenplas, Y. (2020). The influence of the gastrointestinal microbiome on infant colic. Expert Review of Gastroenterology & Hepatology, 14(10), 919–932. https://doi.org/10.1080/17474124.2020.1803412 [Google Scholar] [Crossref]

35. Rajesh, V., Hegde, A., Shetty, V., Garg, M., Kamath, A., Ballal, M., Mutreja, A., & Kumar, V. (2023). Implications of exclusive breastfeeding and complementary feeding practices on gastrointestinal health and antibiotic exposure: A questionnaire-based assessment: Clinical Epidemiology and Global Health, 21, 101281. [Google Scholar] [Crossref]

36. Robert, E., Chabrol, H., & Chabrol, C. (2004). Crying, colic and mother-infant interaction. Devenir, 16(3), 223–232. [Google Scholar] [Crossref]

37. Savino, F., Tarasco, V., Sorrenti, M., Lingua, C., Moja, L., Gordon, M., & Biagioli, E. (2014). Dietary modifications for infantile colic. Cochrane Database of Systematic Reviews, 3, CD011029. https://doi.org/10.1002/14651858.CD011029 [Google Scholar] [Crossref]

38. Vandenplas, Y., Abkari, A., Bellaiche, M., Benninga, M., Chouraqui, J. P., Çokura, F., & others. (2015). Prevalence and health outcomes of functional gastrointestinal symptoms in infants from birth to 12 months of age. Journal of Pediatric Gastroenterology and Nutrition, 61(5), 531–537. [Google Scholar] [Crossref]

39. Vandenplas, Y., Broekaert, I., Domellöf, M., Indrio, F., Lapillonne, A., Pienar, C., Ribes-Koninckx, C., Shamir, R., Szajewska, H., & Thapar, N. (2024). An ESPGHAN position paper on the diagnosis, management, and prevention of cow's milk allergy. Journal of Pediatric Gastroenterology and Nutrition, 78(2), 386–413. [Google Scholar] [Crossref]

40. Vázquez, B., Barrow, M., Neil, J., Seidler, K., & others. (2025). Is there a role for nutritional advice during breastfeeding for infant colic relief? A mixed-method study. Heliyon, 11(1). https://doi.org/10.1016/j.heliyon.2025.100001 [Google Scholar] [Crossref]

41. Venkataraman, R., Basvanyappa, M. K., Samanta, B., Yadla, M., Ravi, N. A., Neelamraju, J., & Madempudi, R. S. (2025). Efficacy of Limosilactobacillus reuteri UBLRu-87 in infantile colic and its symptoms: A double-masked, placebo-controlled study. Cureus, 17(4). [Google Scholar] [Crossref]

42. Wessel, M. A., Cobb, J. C., Jackson, E. B., Harris, G. S., & Detwiler, A. C. (1954). Paroxysmal fussing in infancy, sometimes called colic. Paediatrics, 14(5), 421–435. [Google Scholar] [Crossref]

43. Weerth, C., Fuentes, S., Puylaert, P., & Vos, W. M. (2013). Intestinal microbiota of infants with colic: Development and specific signatures. Pediatrics, 131(2), e550–e558. https://doi.org/10.1542/peds.2012-1449 [Google Scholar] [Crossref]

44. Wolke, D., Bilgin, A., & Samara, M. (2017). Systematic review and meta-analysis: Fussing and crying durations and prevalence of colic in infants. Journal of Paediatrics, 185, 55–61.e4. https://doi.org/10.1016/j.jpeds.2017.02.020 [Google Scholar] [Crossref]

45. Zhu, J., Dingess, K. A., & Hettinga, K. A. (2019). Selective resistance of human milk proteins and their fragments to digestive enzymes. Nutrients, 11(4), 847. [Google Scholar] [Crossref]

• Measuring Waste of Patient Time in Health Care at Non-Digitized Hospital: An Observational Study in Bangabandhu Sheikh Mujib Medical University, Bangladesh
• Reaffirming Clinical Confidence in Atorvastatin Therapy: A Digital Outreach Case Study from Tamil Nadu, India
• Clinical Manifestations and Therapeutic Response in a Patient with Hypothyroidism: A Case Report
• Eranda (Ricinus Communis) In Gridhrasi (Sciatica): Classical Rationale, Pharmacology and Clinical Evidence- A Narrative Literature Review
• Magnetotherapy in Pain Management: Mechanisms, Clinical Applications, and Future Perspectives – A Review