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.