Hypoallergenic Baby Formulas

Child Nutrition Basics

Mother feeding baby with bottle on sofa
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Parents often change their baby's formula, going from one brand to another or one type of formula to another. For example, if their baby is gassy, fussy, or spitting up, they may change her formula from Similac Advance to Enfamil Infant and then to Gerber Good Start.

When To Change Your Baby's Formula

However, most of these formula changes, like when a baby just has simple colic, are usually unnecessary.

On the other hand, with some medical conditions, such as galactosemia, a formula change can be life-saving.

A formula change can also be a good idea if a baby has other true medical problems, such as:

  • cow's milk protein allergy
  • soy protein allergy
  • lactose intolerance (thought to be very rare though in newborns and young infants)
  • acid reflux

In these cases, you are usually switching formula to avoid something that your baby is having an allergy or intolerance to. If you only switch from one brand of formula to another, but continue giving the same type of formula, such as going from Similac Advance to Enfamil Infant, then since they are both cow's milk-based formula, you will likely not notice any improvement in any symptoms your baby is having. That is why it is usually a good idea to talk to your pediatrician before switching your baby's formula.

In addition to making sure a formula switch is really necessary, your pediatrician can help you pick which formula to switch to, whether it is to a soy, lactose free, or reduced lactose formula, such as Enfamil Gentlease, or to one with added rice (Similac for Spit-Up or Enfamil AR).

Hydrolysate Formulas

Babies sometimes won't tolerate any of the standard baby formulas, whether you try Similac Advance, Enfamil Gentlease, or Gerber Good Start Soy, etc. What do you do then?

These babies likely have both a cow's milk protein allergy and a soy protein allergy and will need a hydrolyzed protein formula, such as:

  • Enfamil Nutramigen
  • Gerber Extensive HA
  • Similac Expert Care Alimentum

In addition to being lactose free, these formulas are hypoallergenic and are made of proteins that are extensively broken down. They work well for symptoms that could be due to a formula intolerance, such as excessive crying, diarrhea, and problems sleeping.

On the downside, these formulas are much more expensive than standard baby formula. Nutramigen, Gerber Extensive HA, and Alimentum, for example, can cost about $26 to $30 for a 16-oz. can, while you can expect to pay just $14 to $15 for Enfamil, Gerber Good Start, or Similac Advance.

Elemental Formulas

What happens when your baby continues to have formula problems when she has already tried an elemental formula like Nutramigen or Alimentum? It used to mean finding Neocate Infant, an hypoallergenic formula made up of 100% free amino acids.

There are other choices now.

PurAmino (formally called Nutramigen AA Lipil) is another amino acid based formula that can help infants who have a severe cow's milk protein allergy and/or multiple food protein allergies (soy, gluten, and milk, for example).

Similac has their own amino acid based formula too - EleCare.

Parents who need these formulas can be in for a surprise though, as Elecare, Neocate and PurAmino are even more expensive than hypoallergenic formulas -- about $39 a can. They can be hard to find too, and often mean asking a pharmacist to order them for you or ordering them online:

On the plus side, insurance companies will sometimes pay for EleCare, Neocate, and PurAmino if it is a medical necessity that your baby have it. In fact, insurance companies in some states, including Illinois and Minnesota, are required by law to provide coverage for amino acid-based formulas when babies have certain medical disorders.

An evaluation by a pediatric gastroenterologist can be helpful if you think that your baby needs an amino acid-based formula, such as PurAmino. They might even have samples of some of these specialized formulas.

Sources:

American Academy of Pediatrics Clinical Report. Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. PEDIATRICS Vol. 121 No. 1 January 2008, pp. 183-191.

American Academy of Pediatrics Policy Statement. Hypoallergenic Infant Formulas. Pediatrics 2000 106: 346-349.

American Academy of Pediatrics Policy Statement. Soy Protein-based Formulas: Recommendations for Use in Infant Feeding. Pediatrics 1998 101: 148-153.

Borschel etal. Growth of healthy term infants fed an extensively hydrolyzed casein-based or free amino acid-based infant formula: a randomized, double-blind, controlled trial. Clin Pediatr. 2013;52(10):910-917.

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