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The goal of this clinical trial is to determine whether a fennel-water infusion taken by mothers reduces colic in breastfed infants. The study will also assess the effect of the fennel infusion on the mothers' milk and the gut microbiota of the infants. The main questions it aims to answer are:
Participants-mothers of infants-will:
The project will investigate the effect of maternal ingestion of fennel infusion and the associated microbial changes in milk and the infant gut. A beneficial effect has been reported by mothers as part of popular medicine, but this has not been studied in controlled trials.
The trial aims to elucidate the mechanisms by which fennel compounds exert a colic-reducing effect in babies via breast milk. The investigators will determine whether an orally administered fennel seed infusion affects monitored symptoms or microbial parameters, and whether the composition of the fecal microbiota differs between colicky and non-colicky infants. Mothers will be asked to drink an infusion of fennel seeds (Foeniculum vulgare var. dulce) (20 g/L, 1 L per day) for one week. Samples of milk and feces will be collected at the beginning of treatment (day 0) and at the end of treatment (day 7) for microbiome analysis.
Samples will be prepared for Illumina sequencing by 16S rRNA gene amplification of the bacterial community. Raw reads will be extracted from the Illumina MiSeq System in fastq format and processed in the QIIME2 package using DADA2 to infer amplicon sequence variants (ASVs) and their relative abundances across samples. Taxonomy will be assigned to ASVs with the q2 feature-classifier using a pre-trained NaĆÆve Bayes classifier of the Silva database. For species assignment, sequences will be further analyzed using the GenBank DNA database with the Basic Local Alignment Search Tool (BLAST) algorithm.
Alpha diversity will be determined using the number of taxa, individuals - amplicon sequence variants (ASVs), dominance (1-Simpson index), Margalef's richness index, evenness, and Chao1. Alpha diversity results will be compared before and after the intervention using the Wilcoxon signed-rank test. Beta diversity will be measured using principal coordinate analysis (PCoA) based on Bray-Curtis distance matrices for ASVs and PERMANOVA. The Wilcoxon signed-rank test will be used to compare normalized ASVs at the genus and species levels before the intervention (day 0) and after (day 7).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mother - Infant | Experimental | Breastfeeding women and their infants |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fennel infusion | Dietary Supplement | The mothers were asked to drink an infusion of fennel seeds (1 L per day) for one week . |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of participants with a ā„50% reduction in daily crying duration as measured by a parent-reported 24-hour diary. | Response is defined as a reduction of at least 50% from baseline in mean daily crying duration. The baseline value is the mean daily crying duration recorded by parents in a 24-hour diary for the two days before treatment initiation, as reported in a questionnaire. The post-treatment value is the mean daily crying duration recorded in the 24-hour diary on the final two days of the one-week treatment period. | One week |
| Changes in bacterial community of infant stool samples | The bacterial community, assessed by changes in biodiversity indices and the relative proportions of bacterial genera in infant stool samples, will be evaluated before the intervention (day 0) and at the end of the trial (day 7). | One week |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in bacterial community of breast milk | The bacterial community, assessed by changes in biodiversity indices and the relative proportions of bacterial genera in breast milk samples, will be evaluated before the intervention (day 0) and at the end of the trial (day 7). | One week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| CƩlia C. Silva | IITAA, Universidade dos AƧores | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universidade dos AƧores, IITAA | Angra do HeroĆsmo | Azores | 9700-042 | Portugal | ||
| Universidade dos AƧores, FCAA |
IPD used in the results publication.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| ICF | No | No | Yes | Informed Consent Form | Apr 4, 2021 | Oct 4, 2025 | ICF_000.pdf |
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| ID | Term |
|---|---|
| D003085 | Colic |
| ID | Term |
|---|---|
| D007232 | Infant, Newborn, Diseases |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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Single Group Assignment
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| Angra do HeroĆsmo |
| Portugal |