Maternal Prenatal Diet and Colic and Eczema Among Infants

Importance Infantile colic is a disorder of gut-brain interaction whose cause is poorly understood. Objective To estimate associations of maternal diet quality and intakes of specific allergenic foods with infant eczema and colic. Design, Setting, and Participants Project Viva prospective cohort of 2128 mother-child pairs unselected for atopic risk with recruitment in early pregnancy in Eastern Massachusetts from April 1999 to November 2002, with follow-up to October 2003, and data analysis November 2025 to July 2026. Exposures Prenatal diet via food frequency questionnaires in early pregnancy (median [IQR], 9.9 [8.8-11.3] weeks) and midpregnancy (median [IQR], 27.9 [26.7-28.8] weeks). The Mediterranean Diet Score (MDS) and Dietary Inflammatory Index (DII) were calculated and intake of commonly allergenic foods was determined. Main Outcomes and Measures Maternal report of colic symptoms and eczema diagnosis at median (IQR) of 6.3 (6.0-6.8) months. Results Among 1324 pairs with exposure and outcome data, mean (SD) maternal age was 32.6 (4.6) years, 667 (50.4%) were nulliparous, and 532 (40.2%) reported a history of atopy; 152 (11.5%) infants had eczema alone, 273 (20.6%) had colic alone, and 61 (4.6%) had both. In multinomial logistic regression models adjusted for maternal age, race, ethnicity, education, parity, smoking, and atopy, greater mean (SD) MDS (4.6 [2.0] points) was associated with lower odds of colic and eczema (odds ratio [OR], 0.85; 95% CI, 0.74-0.98 per 1 point), and mean (SD) DII (−2.7 [1.3]) was associated with higher odds (OR, 1.34; 95% CI, 1.12-1.61 per 1 point). Neither diet score was associated with eczema or colic alone. Seafood intake was associated with lower odds of colic and eczema combined (OR, 0.75; 95% CI, 0.58-0.97 per weekly serving). Nut intake was associated with higher risk for colic among those without eczema (eg, OR, 1.05; 95% CI, 1.00-1.09 per weekly serving of any nuts or peanuts), but not with colic and eczema combined (OR, 0.97; 95% CI, 0.88-1.07). Dairy or egg intakes were not associated with any outcomes. Associations of dietary scores and fish intake with colic were stronger among infants of atopic mothers. Conclusions and Relevance In this cohort study of 1324 mother-child pairs, poorer maternal diet quality and lower seafood intake were associated with infantile colic with eczema or maternal atopic history.